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Combat trauma

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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/28101127/mental-health-and-trauma-in-asylum-seekers-landing-in-sicily-in-2015-a-descriptive-study-of-neglected-invisible-wounds
#2
Anna Crepet, Francesco Rita, Anthony Reid, Wilma Van den Boogaard, Pina Deiana, Gaia Quaranta, Aurelia Barbieri, Francesco Bongiorno, Stefano Di Carlo
BACKGROUND: In 2015, Italy was the second most common point of entry for asylum seekers into Europe after Greece. The vast majority embarked from war-torn Libya; 80,000 people claimed asylum that year. Their medical conditions were assessed on arrival but their mental health needs were not addressed in any way, despite the likelihood of serious trauma before and during migration. Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily...
2017: Conflict and Health
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/28088054/medicinal-versus-recreational-cannabis-use-patterns-of-cannabis-use-alcohol-use-and-cued-arousal-among-veterans-who-screen-positive-for-ptsd
#4
Mallory Loflin, Mitch Earleywine, Marcel Bonn-Miller
INTRODUCTION: The present study is the first to test whether veterans who use cannabis specifically for the purposes of self-medication for their reported PTSD symptoms differ from veterans who use cannabis medicinally for other reasons, or recreationally, in terms of patterns of cannabis use, use of alcohol, and reactivity to written combat trauma reminders. METHODS: Assessment measures were administered online to a sample of veterans with a history of cannabis use (n=1971)...
January 6, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28080076/adverse-childhood-experiences-and-risk-for-suicidal-behavior-in-male-iraq-and-afghanistan-veterans-seeking-ptsd-treatment
#5
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/28077328/dissociation-between-working-memory-performance-and-proactive-interference-control-in-post-traumatic-stress-disorder
#6
Diane Swick, Julien Cayton, Victoria Ashley, And U Turken
Deficits in working memory (WM) and cognitive control processes have been reported in post-traumatic stress disorder (PTSD), in addition to clinical symptoms such as hypervigilance, re-experiencing, and avoidance of trauma reminders. Given the uncontrollable nature of intrusive memories, an important question is whether PTSD is associated with altered control of interference in WM. Some studies also suggest that episodic memory shows a material-specific dissociation in PTSD, with greater impairments in verbal memory and relative sparing of nonverbal memory...
January 7, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28068141/ethnoracial-differences-in-ptsd-symptoms-and-trauma-related-cognitions-in-treatment-seeking-active-duty-military-personnel-for-ptsd
#7
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/28068139/do-acceptance-and-mindfulness-moderate-the-relationship-between-maladaptive-beliefs-and-posttraumatic-distress
#8
Jillian C Shipherd, Kristalyn Salters-Pedneault
OBJECTIVE: Maladaptive pre- and posttraumatic beliefs are reliable predictors of distress in the wake of trauma. Acceptance and mindfulness skills may be associated with less distress in the presence of these beliefs, but few studies have explored these relationships. This study examined whether individual differences in acceptance and mindfulness moderate the relationship between maladaptive thoughts and distress in postdeployment soldiers. METHOD: We explored the relationships between posttraumatic maladaptive beliefs, acceptance, mindfulness, and posttraumatic distress (posttraumatic stress disorder [PTSD] and general psychological symptoms) in a sample of recently postdeployed active duty U...
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
#9
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/28051987/traumatic-hearing-loss-in-the-context-of-blast-related-tympanic-membrane-perforation
#10
Max D Pusz, Jon Robitschek
OBJECTIVE: Identify associated clinical factors and characterize the various forms of hearing loss in the context of blast-related traumatic tympanic membrane (TM) perforation sustained in the combat setting. METHODS: A prospective study of 41 patients who sustained a TM perforation secondary to blast injury between 2010 and 2012 while serving in combat. Clinical examinations and audiograms were obtained for all patients by a single-institution Otolaryngology service with comparative data generated from review of pre and post-trauma hearing screens...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051982/single-neurosurgeon-operative-experience-at-craig-joint-theater-hospital-during-the-afghanistan-surge-november-2010-to-april-2011-part-ii-humanitarian-cases
#11
John Joseph Steele
BACKGROUND: The Afghanistan Surge saw NATO troops working with their Afghan partners to remove Taliban governance and replace it with a more democratic model. As part of this endeavor, medical support for both trauma and humanitarian cases was needed. OBJECTIVE: Identify and discuss disease trends to better prepare for future combat medical treatments. METHODS: Retrospective review of operative experience from a neurosurgeon from November 2010 to April 2011...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051981/single-neurosurgeon-operative-experience-at-craig-joint-theater-hospital-during-the-afghanistan-surge-november-2010-to-april-2011-part-i-neurotrauma-cases
#12
John Joseph Steele
BACKGROUND: The Afghanistan Surge saw NATO troops working with their Afghan partners to remove Taliban governance and replace it with a more democratic model. As part of this effort, medical support for both trauma and humanitarian cases was needed. OBJECTIVE: Identify and discuss disease trends to better prepare for future combat medical care. METHODS: Retrospective review of operative experience from a single neurosurgeon from November 2010 to April 2011...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28049065/nucleic-acid-scavenging-microfiber-mesh-inhibits-trauma-induced-inflammation-and-thrombosis
#13
Jaewoo Lee, Jennifer G Jackman, Jean Kwun, Miriam Manook, Angelo Moreno, Eric A Elster, Allan D Kirk, Kam W Leong, Bruce A Sullenger
Trauma patients produce a host of danger signals and high levels of damage-associated molecular patterns (DAMPs) after cellular injury and tissue damage. These DAMPs are directly and indirectly involved in the pathogenesis of various inflammatory and thrombotic complications in patients with severe injuries. No effective therapeutic agents for the removal of DAMPs from blood or tissue fluid have been developed. Herein, we demonstrated that nucleic acid binding polymers, e.g., polyethylenimine (PEI) and polyamidoamine dendrimers, immobilized onto electrospun microfiber mesh can effectively capture various DAMPs, such as extracellular DNAs and high mobility group box 1 (HMGB1)...
December 23, 2016: Biomaterials
https://www.readbyqxmd.com/read/27993357/amputation-not-a-failure-for-severe-lower-extremity-combat-injury
#14
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/27993204/massive-transfusion-in-pediatric-trauma-analysis-of-the-national-trauma-databank
#15
Michelle C Shroyer, Russell L Griffin, Vincent E Mortellaro, Robert T Russell
BACKGROUND: Massive transfusion (MT) in pediatric trauma has been described in combat populations and other single institutions studies. We aim to define the incidence of MT in a large US civilian pediatric trauma population, identify predictive parameters of MT, and the mortality associated with MT. METHODS: Data from the National Trauma Databank (2010-2012), a trauma registry maintained by the American College of Surgeons, were analyzed. We included pediatric trauma patients ≤14 y that underwent MT, as defined by 40 mL/kg of blood products within the first 24 h after admission...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27978789/heat-shock-proteins-therapeutic-perspectives-in-inflammatory-disorders
#16
Rekha Khandia, Ashok K Munjal, Hafiz M N Iqbal, Kuldeep Dhama
Heat shock proteins (HSPs) are highly conserved proteins present in all kingdoms of organisms. These are expressed under stress conditions in order to protect the cells from injuries. The stress induced protein denaturation is rectified by refolding and remodelling. These are intracellular proteins but can be present in extracellular fluid like serum of the patients suffering from trauma, autoimmune and inflammatory disorders. Virtually in most inflammatory diseases, immune response towards HSPs is developed...
December 13, 2016: Recent Patents on Inflammation & Allergy Drug Discovery
https://www.readbyqxmd.com/read/27977074/the-efficacy-of-prazosin-for-the-treatment-of-posttraumatic-stress-disorder-nightmares-in-u-s-military-veterans
#17
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/27959967/transfusion-80%C3%A2-c-frozen-blood-products-are-safe-and-effective-in-military-casualty-care
#18
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/27940454/acute-traumatic-coagulopathy-pathophysiology-and-resuscitation
#19
J W Simmons, M F Powell
Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction. Hypothermia and acidaemia amplify the endogenous coagulopathy and often accompany trauma. These multifactorial processes lead to decreased clot strength, autoheparinization, and hyperfibrinolysis. Furthermore, the effects of aggressive crystalloid administration, haemodilution from inappropriate blood product transfusion, and prolonged surgical times may worsen clinical outcomes...
December 2016: British Journal of Anaesthesia
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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