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https://www.readbyqxmd.com/read/28930952/military-use-of-tranexamic-acid-in-combat-trauma-does-it-matter
#1
Jeffrey T Howard, Zsolt T Stockinger, Andrew P Cap, Jeffrey A Bailey, Kirby R Gross
BACKGROUND: Tranexamic acid (TXA) has been previously reported to have a mortality benefit in civilian and combat-related trauma, and was thus added to the Joint Theater Trauma System Damage Control Resuscitation Clinical Practice Guideline. As part of ongoing system-wide performance improvement, the use of TXA has been closely monitored. The goal was to evaluate the efficacy and safety of TXA use in military casualties and provide additional guidance for continued use. METHODS: A total of 3,773 casualties were included in this retrospective, observational study of data gathered from a trauma registry...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28885943/systematic-review-of-live-tissue-versus-simulation-education-for-prehospital-trauma-providers
#2
Craig Goolsby, Andrew Branting, Jason Ausman, David Williams, Chelsea Ausman, Jason David, Rhonda Allard
BACKGROUND: Advanced simulation capabilities have provided medical educators novel approaches for learners. Simulation has successfully replaced many aspects of medical education that previously used animal live-tissue training (LTT) for physician education. However, prehospital trauma providers, such as combat medics, currently used LTT to prepare for patient care. This use of LTT has sparked a debate about the optimal educational modality for this unique learner population. At this time, there is no clear evidence-based recommendation available to recommend either LTT or simulation as a superior modality...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28865911/trauma-management-therapy-with-virtual-reality-augmented-exposure-therapy-for-combat-related-ptsd-a-randomized-controlled-trial
#3
Deborah C Beidel, B Christopher Frueh, Sandra M Neer, Clint A Bowers, Benjamin Trachik, Thomas W Uhde, Anouk Grubaugh
Virtual reality exposure therapy (VRET) realistically incorporates traumatic cues into exposure therapy and holds promise in the treatment of combat-related posttraumatic stress disorder (PTSD). In a randomized controlled trial of 92 Iraq and Afghanistan veterans and active duty military personnel with combat-related PTSD, we compared the efficacy of Trauma Management Therapy (TMT; VRET plus a group treatment for anger, depression, and social isolation) to VRET plus a psychoeducation control condition. Efficacy was evaluated at mid- and post-treatment, and at 3- and 6-month follow-up...
August 23, 2017: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/28846577/rotational-thromboelastometry-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#4
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with rotational thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28693439/combatting-pain-after-orthopedic-trauma-surgery-perioperative-oral-extended-release-tapentadol-vs-extended-release-oxycodone-naloxone
#5
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/28598905/military-use-of-txa-in-combat-trauma-does-it-matter
#6
Jeffrey T Howard, Zsolt T Stockinger, Andrew P Cap, Jeffrey A Bailey, Kirby R Gross
BACKGROUND: Tranexamic acid (TXA) has been previously reported to have a mortality benefit in civilian and combat-related trauma, and was thus added to the Joint Theater Trauma System Damage Control Resuscitation Clinical Practice Guideline. As part of ongoing system-wide performance improvement, the use of TXA has been closely monitored. The goal was to evaluate the efficacy and safety of TXA use in military casualties and provide additional guidance for continued use. METHODS: A total of 3,773 casualties were included in this retrospective, observational study of data gathered from a trauma registry...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28590357/rotem-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#7
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood (WB) by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538622/towards-precision-medicine-accurate-predictive-modeling-of-infectious-complications-in-combat-casualties
#8
Christopher J Dente, Matthew Bradley, Seth Schobel, Beverly Gaucher, Timothy Buchman, Allan D Kirk, Eric Elster
BACKGROUND: The biomarker profile of trauma patients may allow for the creation of models to assist bedside decision making & prediction of complications. We sought to determine the utility of modeling in the prediction of bacteremia & pneumonia in combat casualties. METHODS: This is a prospective, observational trial of patients with complex wounds treated at Walter Reed National Military Medical Center (2007-2012). Tissue, serum and wound effluent samples were collected during operative interventions until wound closure...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422894/impact-of-telephone-based-problem-solving-treatment-on-the-use-of-medical-and-psychological-services-in-the-military
#9
John S Richardson, Jesse R Fann, Kathleen R Bell, Nancy Temkin
OBJECTIVE: To explore the impact of problem-solving treatment (PST) for mild traumatic brain injury in active duty service members on the use of medical and psychological services. PARTICIPANTS: Service members who had a mild traumatic brain injury during their last deployment and enrolled in the CONcussion Treatment After Combat Trauma (CONTACT) study. DESIGN: Secondary analysis of a randomized clinical trial. Participants were assigned to telephone-based PST, or e-mailed or mailed education only over the course of 6 months...
April 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28358525/veterans-individual-placement-and-support-towards-advancing-recovery-methods-and-baseline-clinical-characteristics-of-a-multisite-study
#10
Lori L Davis, Tassos C Kyriakides, Alina Suris, Lisa Ottomanelli, Robert E Drake, Pamela E Parker, Lisa Mueller, Sandra G Resnick, Richard Toscano, Catherine M Blansett, Kimberly P McCall, Grant D Huang
OBJECTIVE: This article describes the methodology and the baseline characteristics of veterans with posttraumatic stress disorder (PTSD) enrolled in a multisite trial comparing supported employment individual placement and support (IPS) to a stepwise vocational transitional work program (TWP). METHOD: The Veterans Affairs Cooperative Studies Program randomized 541 veterans with PTSD across 12 Veterans Affairs Medical Centers to either IPS or TWP. Demographic and clinical characteristics were evaluated at baseline...
March 30, 2017: Psychiatric Rehabilitation Journal
https://www.readbyqxmd.com/read/28294318/impact-of-killing-in-war-a-randomized-controlled-pilot-trial
#11
Shira Maguen, Kristine Burkman, Erin Madden, Julie Dinh, Jeane Bosch, Jessica Keyser, Martha Schmitz, Thomas C Neylan
OBJECTIVE: The purpose of this pilot study was to test the effectiveness of Impact of Killing (IOK), a novel, cognitive-behavioral treatment (CBT) aimed at reducing mental health symptoms and functional impairment. METHOD: Participants were 33 combat Veterans with a posttraumatic stress disorder (PTSD) diagnosis who had completed trauma-focused psychotherapy and reported distress regarding killing or feeling responsible for the deaths of others in war. Veterans were randomized to either IOK treatment or a 6-week waitlist condition, after which Veterans could receive IOK...
September 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28290958/comparative-assessment-of-three-approaches-of-teaching-nonmedically-trained-persons-in-the-handling-of-supraglottic-airways-a-randomized-controlled-trial
#12
Mario Hensel, Willi Schmidbauer, Michael Benker, Paula Schmieder, Thoralf Kerner
BACKGROUND: The use of supraglottic airways has been recommended in combat trauma airway management. To ensure an adequate airway management on the battlefield, suitable training concepts are sought to efficiently teach as many soldiers as possible. Our aim was to compare three approaches of teaching laypersons in the handling of supraglottic airways in a mannequin model. METHODS: In this prospective randomized blinded study, 285 military service men without any medical background were divided into three groups and trained in the use of the Laryngeal Mask Airway Supreme (LMA) and the Laryngeal Tube Disposable (LT-D)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28285476/resuscitative-endovascular-balloon-occlusion-of-the-aorta-pushing-care-forward
#13
William Teeter, Anna Romagnoli, Jacob Glaser, Andrew D Fisher, Jason Pasley, Brian Scheele, Melanie Hoehn, Megan Brenner
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), used to temporize noncompressible and junctional hemorrhage, may be deployable to the forward environment. Our hypothesis was that nonsurgeon physicians and high-level military medical technicians would be able to learn the theory and insertion of REBOA. METHODS: US Army Special Operations Command medical personnel without prior endovascular experience were included. All participants received didactic instruction of the Basic Endovascular Skills for Trauma Course™ together, with individual evaluation of technical skills...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28068141/ethnoracial-differences-in-ptsd-symptoms-and-trauma-related-cognitions-in-treatment-seeking-active-duty-military-personnel-for-ptsd
#14
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/27861458/combat-related-multifaceted-trauma-focused-group-therapy-a-pilot-study
#15
Ofir Levi, Ilan Wald, Vlad Svetlitsky, Sergei Zusmanovitz, Eli Parasha, Yael Shoval-Zuckerman, Gal Afik, Gal Haikin, Eyal Fruchter
The efficacy of combat-related trauma-focused group therapy (TFGT) was tested using a unique technique that combines principles from prolonged exposure, cognitive processing therapy, and art therapy. Eighty Israeli male veterans exposed to traumatic events participated in the study. They were divided into eight therapeutic groups led by four pairs of trained therapists. Posttraumatic stress disorder and depression symptoms and levels of functioning were taken at pretherapy, end of therapy, and 6 months posttherapy...
February 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/27822278/prazosin-for-trauma-nightmares-and-sleep-disturbances-in-combat-veterans-with-post-traumatic-stress-disorder
#16
Habibolah Khazaie, Marzie Nasouri, Mohammad Rasoul Ghadami
BACKGROUND: Prazosin is significantly effective to reduce sleep disturbance and trauma nightmare in patients with post-traumatic stress disorder (PTSD); however, results of different studies were evaluated. OBJECTIVES: The current randomized clinical trial aimed to assess the effects of prazosin on sleep parameters and nightmares among veterans with chronic PTSD. MATERIALS AND METHODS: Thirty-two veterans with chronic war-induced PTSD and distressing nightmares were randomized into prazosin and placebo groups for eight weeks...
September 2016: Iranian Journal of Psychiatry and Behavioral Sciences
https://www.readbyqxmd.com/read/27739388/parent-child-relationship-quality-and-family-transmission-of-parent-posttraumatic-stress-disorder-symptoms-and-child-externalizing-and-internalizing-symptoms-following-fathers-exposure-to-combat-trauma
#17
James Snyder, Abigail Gewirtz, Lynn Schrepferman, Suzanne R Gird, Jamie Quattlebaum, Michael R Pauldine, Katie Elish, Osnat Zamir, Charles Hayes
Transactional cascades among child internalizing and externalizing symptoms, and fathers' and mothers' posttraumatic stress disorder (PTSD) symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents' positive engagement and coercive interaction with their child, and family members' emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and nondeployed mothers and their 4- to 13-year-old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child's symptoms...
November 2016: Development and Psychopathology
https://www.readbyqxmd.com/read/27695657/cognitive-behavioral-therapy-for-insomnia-and-imagery-rehearsal-in-combat-veterans-with-comorbid-posttraumatic-stress-a-case-series
#18
Todd M Bishop, Peter C Britton, Kerry L Knox, Wilfred R Pigeon
Disrupted sleep is common among combat veterans and can negatively impact response to mental health treatments. A trial of cognitive behavioral therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT) for nightmares was conducted with 14 combat veterans diagnosed with insomnia, and who were experiencing posttraumatic stress and/or depression. In the case-series that follows veterans experienced clinically significant changes in sleep, and statistically significant reductions in insomnia, nightmare, depression and posttraumatic stress severity following treatment...
2016: Military Behavioral Health
https://www.readbyqxmd.com/read/27532142/the-incidence-of-thromboembolism-formation-following-the-use-of-recombinant-factor-viia-in-patients-suffering-from-blunt-force-trauma-compared-with-penetrating-trauma-a-systematic-review
#19
Raymond Devlin, Laura Bonanno, Jennifer Badeaux
BACKGROUND: Rapid replacement of blood loss is critical in patients suffering from traumatic hemorrhage. When the availability of blood products is limited, certain interventions have shown promise in conserving blood supplies. Recombinant factor (rF) VIIa has been administered, as an off-label use, to assist in controlling hemorrhage in trauma patients. Although rFVIIa has a tendency to remain localized to areas of vascular insult, there may be an increase in thromboembolism formation when patients suffer multiple sites of injury as seen in blunt force trauma...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27472747/structured-approach-therapy-for-combat-related-ptsd-in-returning-u-s-veterans-complementary-mediation-by-changes-in-emotion-functioning
#20
Frederic J Sautter, Shirley M Glynn, Julia J Becker-Cretu, Damla Senturk, Aaron P Armelie, Dustin B Wielt
To address the impact of combat-related posttraumatic stress disorder (PTSD) on U.S. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans, the investigators developed a 12-session manualized PTSD treatment for couples called structured approach therapy (SAT). A randomized controlled trial had shown that 29 OEF/OIF veterans with combat-related PTSD who had participated in SAT showed significantly greater reductions in PTSD compared to 28 veterans receiving a 12-session PTSD family education intervention (Sautter, Glynn, Cretu, Senturk, & Vaught, 2015)...
August 2016: Journal of Traumatic Stress
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