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Combat trauma

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https://www.readbyqxmd.com/read/28720187/experiences-with-regional-anesthesia-for-analgesia-during-prolonged-aeromedical-evacuation
#1
Jeffrey M Carness, Melissa A Wilson, Mark J Lenart, Danny E Smith, Susan F Dukes
INTRODUCTION: There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. METHODS: This study was conducted as an observational retrospective cohort whereby acutely injured amputee patients were identified via the U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28713319/neuropsychological-predictors-of-trauma-centrality-in-oif-oef-veterans
#2
Roland P Hart, Rohini Bagrodia, Nadia Rahman, Richard A Bryant, Roseann Titcombe-Parekh, Charles R Marmar, Adam D Brown
This study examined whether reduced performance on two neuropsychological tasks, cognitive flexibility and working memory, were associated with higher levels of trauma centrality. A growing body of research has shown that trauma centrality, the extent to which a person believes a potentially traumatic event has become central to their self-identity and life story, is associated with post-traumatic stress disorder (PTSD). Furthermore, PTSD is often associated with alterations in neuropsychological functioning...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28707521/increased-risk-of-attempted-suicide-in-australian-veterans-is-associated-with-total-and-permanent-incapacitation-unemployment-and-posttraumatic-stress-disorder-severity
#3
Katelyn Kerr, Madeline Romaniuk, Sarah McLeay, Andrew Khoo, Michael T Dent, Mark Boshen
BACKGROUND: Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort...
July 1, 2017: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/28696563/secondary-traumatization-and-differentiation-among-the-wives-of-former-pows-a-reciprocal-association
#4
Yael Lahav, Yafit Levin, Moshe Bensimon, Yaniv Kanat-Maymon, Zahava Solomon
Repercussions of war captivity may transmit to spouses of former prisoners of war (POW) via posttraumatic stress symptoms (PTSS). Overidentification with their partners underlies the PTSS experienced by former wives of POWs, thus implying impaired self-differentiation. Although wives' indirect exposure to their husbands' captivity and subsequent PTSS has been associated with the wives' PTSS and differentiation, the combined effects remain unclear. Furthermore, previous cross-sectional studies could not illuminate directionality...
July 11, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28696288/inhibition-of-the-integrated-stress-response-reverses-cognitive-deficits-after-traumatic-brain-injury
#5
Austin Chou, Karen Krukowski, Timothy Jopson, Ping Jun Zhu, Mauro Costa-Mattioli, Peter Walter, Susanna Rosi
Traumatic brain injury (TBI) is a leading cause of long-term neurological disability, yet the mechanisms underlying the chronic cognitive deficits associated with TBI remain unknown. Consequently, there are no effective treatments for patients suffering from the long-lasting symptoms of TBI. Here, we show that TBI persistently activates the integrated stress response (ISR), a universal intracellular signaling pathway that responds to a variety of cellular conditions and regulates protein translation via phosphorylation of the translation initiation factor eIF2α...
July 10, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28693439/combatting-pain-after-orthopedic-trauma-surgery-perioperative-oral-extended-release-tapentadol-vs-extended-release-oxycodone-naloxone
#6
Gertrud Haeseler, Dirk Schaefers, Natalie Prison, Jörg Ahrens, Xiaofei Liu, Annika Karch
BACKGROUND: High post-operative pain scores after "minor" orthopedic/trauma surgery are in part attributed to inadequate prescription of opioid analgesics. Novel concepts aiming to achieve sufficient analgesia while minimizing opioid-related side effects by avoiding fluctuating plasma levels are based on perioperative oral administration of extended-release opioids beginning with the first dose pre-operatively. This is the first study to evaluate analgesic efficacy and side effect rates of extended-release tapentadol compared to oxycodone/naloxone following orthopedic/trauma surgery...
July 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28689067/individual-variation-in-plasma-oxytocin-and-vasopressin-levels-in-relation-to-the-development-of-combat-related-ptsd-in-a-large-military-cohort
#7
Alieke Reijnen, Elbert Geuze, Eric Vermetten
In an attempt to decrease the risk of developing mental health problems after military deployment, it is important to find biological markers to identify those at risk. Oxytocin (OT) and arginine vasopressin (AVP) are potential biomarkers for the development of posttraumatic stress disorder (PTSD) because they are involved in the regulation of stress and anxiety. Therefore, the aim was to examine whether plasma OT (pOT) and AVP (pAVP) levels before and after deployment are biomarkers for the development of posttraumatic stress symptoms over time in addition to other known risk factors...
June 28, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28668522/the-traumatic-bone-trauma-induced-heterotopic-ossification
#8
REVIEW
Devaveena Dey, Benjamin M Wheatley, David Cholok, Shailesh Agarwal, Paul B Yu, Benjamin Levi, Thomas A Davis
Heterotopic ossification (HO) is a common occurrence after multiple forms of extensive trauma. These include arthroplasties, traumatic brain and spinal cord injuries, extensive burns in the civilian setting, and combat-related extremity injuries in the battlefield. Irrespective of the form of trauma, heterotopic bone is typically endochondral in structure and is laid down via a cartilaginous matrix. Once formed, the heterotopic bone typically needs to be excised surgically, which may result in wound healing complications, in addition to a risk of recurrence...
June 15, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28663541/the-effect-of-trauma-and-ptsd-on-telomere-length-an-exploratory-study-in-people-exposed-to-combat-trauma
#9
Tae Yong Kim, Se Joo Kim, Jong Rak Choi, Seung-Tae Lee, Jieun Kim, In Sik Hwang, Hae Gyung Chung, Jin Hee Choi, Hae Won Kim, Se Hyun Kim, Jee In Kang
Telomere length has been suggested to be a cellular marker for age-related diseases as well as psychosocial stress. The present study investigated whether telomere length is associated with post-traumatic stress disorder (PTSD) among veterans exposed to combat trauma in the Vietnam War. The potentially associated factors on cellular aging were considered. Korean male veterans with (n = 122) and without (n = 120) PTSD were included and leukocyte telomere length was measured with a quantitative PCR-based technique...
June 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28646388/skin-conductance-reactivity-to-standardized-virtual-reality-combat-scenes-in-veterans-with-ptsd
#10
Mascha van 't Wout, Christopher M Spofford, William S Unger, Elizabeth B Sevin, M Tracie Shea
Interest in virtual reality (VR) as a clinical tool to augment posttraumatic stress (PTSD) treatment has grown substantially in recent years due to advances in VR technology. Moreover, its potential assisted use in the PTSD diagnostic process has been recognized. In this study we examined physiological responding, skin conductance, to a standardized presentation of non-personalized combat-related VR events (e.g. encountering enemy fire; explosions) as compared to non-combat classroom VR events in 19 Veterans with and 24 Veterans without combat-related PTSD who had been deployed to Iraq and Afghanistan...
June 23, 2017: Applied Psychophysiology and Biofeedback
https://www.readbyqxmd.com/read/28644123/pin-malposition-in-external-fixator-stabilization-of-combat-related-pelvic-fractures
#11
Mark P Coseo, Dustin J Schuett, Kevin M Kuhn, Joseph Bellamy
The purpose of this study was to compare the accuracy of pin placement in patients with unstable pelvic fractures undergoing either iliac crest or supra-acetabular external fixation. A retrospective review was performed of computed tomography (CT) scans and injury characteristics for all patients presenting to a North Atlantic Treaty Organization Medical Treatment Facility with data entered into the Department of Defense Trauma Registry from January 2008 to October 2013 who underwent pelvic external fixation for unstable pelvic ring injuries...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28640037/epidemiology-of-major-depressive-disorder-disability-in-the-us-military-fy-2007-2012
#12
Elizabeth R Packnett, Hoda Elmasry, Christine F Toolin, David N Cowan, Michael R Boivin
This study assesses the incidence of major depressive disorder (MDD) disability discharge and retirement in the Army, Navy, Marine Corps and Air Force and describes MDD comorbidity. Service members with a disability discharge for either MDD (n = 2,882) or any nonpsychiatric disability (n = 56,145), between fiscal years 2007 and 2012, were included in the study population. Those with MDD disability at first evaluation but not at last evaluation were excluded. The incidence of MDD disability discharge increased significantly in the Army and Air Force between fiscal years 2007 and 2012...
June 20, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28636690/opioid-use-in-trauma-combating-the-opidemic-through-thoughtful-prescribing-practices
#13
Crystal Webb, Amalia Cochran
No abstract text is available yet for this article.
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28630453/longitudinal-analyses-of-the-dna-methylome-in-deployed-military-servicemen-identify-susceptibility-loci-for-post-traumatic-stress-disorder
#14
B P F Rutten, E Vermetten, C H Vinkers, G Ursini, N P Daskalakis, E Pishva, L de Nijs, L C Houtepen, L Eijssen, A E Jaffe, G Kenis, W Viechtbauer, D van den Hove, K G Schraut, K-P Lesch, J E Kleinman, T M Hyde, D R Weinberger, L Schalkwyk, K Lunnon, J Mill, H Cohen, R Yehuda, D G Baker, A X Maihofer, C M Nievergelt, E Geuze, M P M Boks
In order to determine the impact of the epigenetic response to traumatic stress on post-traumatic stress disorder (PTSD), this study examined longitudinal changes of genome-wide blood DNA methylation profiles in relation to the development of PTSD symptoms in two prospective military cohorts (one discovery and one replication data set). In the first cohort consisting of male Dutch military servicemen (n=93), the emergence of PTSD symptoms over a deployment period to a combat zone was significantly associated with alterations in DNA methylation levels at 17 genomic positions and 12 genomic regions...
June 20, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28627921/risk-factors-for-concurrent-suicidal-ideation-and-violent-impulses-in-military-veterans
#15
Eric B Elbogen, H Ryan Wagner, Nathan A Kimbrel, Mira Brancu, Jennifer Naylor, Robert Graziano, Eric Crawford
Suicide and violence are significant problems in a subset of Iraq/Afghanistan-era veterans. This study investigates how posttraumatic stress disorder (PTSD) and resilience in veterans are associated with suicidal ideation and violent impulses while controlling for known covariates of both adverse outcomes. Structured clinical interviews were conducted of N = 2,543 Iraq/Afghanistan-era U.S. veterans. Compared with veterans denying suicidal ideation or violent impulses (n = 1,927), veterans endorsing both (n = 171) were more likely to meet diagnostic criteria for PTSD, report childhood abuse, combat exposure, physical pain symptoms, and drug misuse, and less likely to endorse self-direction/life purpose...
June 19, 2017: Psychological Assessment
https://www.readbyqxmd.com/read/28617927/biomechanical-evaluations-of-ocular-injury-risk-for-blast-loading
#16
Bahram Notghi, Rajneesh Bhardwaj, Shantanu Bailoor, Kimberly A Thompson, Ashley A Weaver, Joel D Stitzel, Thao D Nguyen
Ocular trauma is one of the most common types of combat injuries resulting from the exposure of military personnel with improvised explosive devices. The injury mechanism associated with the primary blast wave is poorly understood. We employed a three-dimensional computational model, which included the main internal ocular structures of the eye, spatially varying thickness of the cornea-scleral shell, and nonlinear tissue properties, to calculate the intraocular pressure and stress state of the eye wall and internal ocular structure caused by the blast...
August 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28609578/the-loss-of-a-fellow-service-member-complicated-grief-in-post-9-11-service-members-and-veterans-with-combat-related-posttraumatic-stress-disorder
#17
Naomi M Simon, Emily B O'Day, Samantha N Hellberg, Susanne S Hoeppner, Meredith E Charney, Donald J Robinaugh, Eric Bui, Elizabeth M Goetter, Amanda W Baker, Andrew H Rogers, Mireya Nadal-Vicens, Margaret R Venners, Hyungjin M Kim, Sheila A M Rauch
Bereavement is a potent and highly prevalent stressor among service members and veterans. However, the psychological consequences of bereavement, including complicated grief (CG), have been minimally examined. Loss was assessed in 204 post-9/11, when service members and veterans with combat-related posttraumatic stress disorder (PTSD) took part in a multicenter treatment study. Those who reported the loss of an important person completed the inventory of complicated grief (ICG; n = 160). Over three quarters (79...
June 13, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28609148/an-intensive-outpatient-treatment-program-for-combat-related-ptsd-trauma-management-therapy
#18
Deborah C Beidel, Jeremy W Stout, Sandra M Neer, B Christopher Frueh, Carl Lejuez
An estimated 18.5% of veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn are suffering from posttraumatic stress or posttraumatic stress disorder (PTSD). The number of veterans and service duty personnel requesting VA health care services is increasing, and the VA's ability to handle requests is dwindling. Thus, both the content of interventions and the format by which these services are delivered need to be reconceptualized. The authors present a multicomponent intervention program known as Trauma Management Therapy (TMT), a comprehensive, empirically supported treatment that can be delivered in an intensive, 3-week outpatient format...
2017: Bulletin of the Menninger Clinic
https://www.readbyqxmd.com/read/28601214/fluid-resuscitation-in-tactical-combat-casualty-care-yesterday-and-today
#19
REVIEW
Frank K Butler
The prevailing wisdom for the prehospital fluid resuscitation of trauma victims in hemorrhagic shock in 1992 was to administer 2 L of crystalloid solution as rapidly as possible. A review of the fluid resuscitation literature found that this recommendation was not well supported by the evidence at the time. Prehospital fluid resuscitation strategies were reevaluated in the 1993-1996 Tactical Combat Casualty Care (TCCC) research program. This article reviews the advances in prehospital fluid resuscitation as recommended by the original TCCC Guidelines and modified over the following 2 decades...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601213/treatment-of-thoracic-trauma-lessons-from-the-battlefield-adapted-to-all-austere-environments
#20
REVIEW
Lanny F Littlejohn
Severe thoracic trauma in the backcountry can be a formidable injury pattern to successfully treat. Traumatic open, pneumo-, and hemothoraces represent some of the most significant patterns for which advanced equipment and procedures may help leverage morbidity and mortality, particularly when evacuation is delayed and environmental conditions are extreme. This paper reviews the development of successful techniques for treating combat casualties with thoracic trauma, including the use of vented chest seals and the technique of needle thoracentesis...
June 2017: Wilderness & Environmental Medicine
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