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Sample records for war injuries retrospective

  1. Penetrating eye injury in war.

    PubMed

    Biehl, J W; Valdez, J; Hemady, R K; Steidl, S M; Bourke, D L

    1999-11-01

    The percentage of penetrating eye injuries in war has increased significantly in this century compared with the total number of combat injuries. With the increasing use of fragmentation weapons and possibly laser weapons on the battle-field in the future, the rate of eye injuries may exceed the 13% of the total military injuries found in Operations Desert Storm/Shield. During the Iran-Iraq War (1980-1988), eye injuries revealed that retained foreign bodies and posterior segment injuries have an improved prognosis in future military ophthalmic surgery as a result of modern diagnostic and treatment modalities. Compared with the increasing penetrating eye injuries on the battlefield, advances in ophthalmic surgery are insignificant. Eye armor, such as visors that flip up and down and protect the eyes from laser injury, needs to be developed. Similar eye protection is being developed in civilian sportswear. Penetrating eye injury in the civilian sector is becoming much closer to the military model and is now comparable for several reasons. PMID:10578588

  2. Eye injuries associated with war games.

    PubMed

    Easterbrook, M; Pashby, T J

    1985-09-01

    War games, an outdoor activity combining recreation, military maneuvers and fantasy, are becoming a popular recreational sport. Increasing numbers of players are suffering eye injuries. In the last year 26 cases of serious eye injuries were reported to Canadian ophthalmologists; in 15 eyes vision was reduced to 6/24 or less. Although eyeguards are provided, all the injuries had occurred when the participants were not wearing them. Methods of preventing eye injuries in war games are discussed. PMID:4027807

  3. Management of war-related vascular injuries: experience from the second gulf war

    PubMed Central

    2013-01-01

    Aim To study the biomechanism, pattern of injury, management, and outcome of major vascular injuries treated at Mubarak Al-Kabeer Teaching Hospital, Kuwait during the Second Gulf War. Methods This is a descriptive retrospective study. War-related injured patients who had major vascular injuries and were treated at Mubarak Al-Kabeer Teaching Hospital from August 1990 to September 1991 were studied. Studied variables included age, gender, anatomical site of vascular injury, mechanism of injury, associated injuries, type of vascular repair, and clinical outcome. Results 36 patients having a mean (SD) age of 29.8 (10.2) years were studied. 32 (89%) were males and 21 (58%) were civilians. Majority of injuries were caused by bullets (47.2%) and blast injuries (47.2%). Eight patients (22%) presented with shock. There were 31 arterial injuries, common and superficial femoral artery injuries were most common (10/31). Arterial repair included interposition saphenous vein graft in seven patients, thrombectomy with end-to-end / lateral repair in twelve patients, vein patch in two patients, and arterial ligation in four patients. Six patients had arterial ligation as part of primary amputation. 3/21 (14.3%) patients had secondary amputation after attempted arterial vascular repair of an extremity. There were a total of 17 venous injuries, 13 managed by lateral suture repair and 4 by ligation. The median (range) hospital stay was 8 (1–76) days. 5 patients died (14%). Conclusions Major vascular injuries occurred in 10% of hospitalized war-related injured patients. Our secondary amputation rate of extremities was 14%. The presence of a vascular surgeon within a military surgical team is highly recommended. Basic principles and techniques of vascular repair remain an essential part of training general surgeons because it may be needed in unexpected wars. PMID:23816260

  4. Missile war injuries of the face.

    PubMed

    Kummoona, Raja K

    2011-11-01

    In a society struggling to rebuild its country after 3 decades of years of dictatorships and wars, Iraqi maxillofacial and craniofacial surgeons play a critical role in treatment of many most serious terrorist missile injuries of the face by ongoing conflict in Iraq. This study reflects our surgical techniques of treating explosive missile injuries and other combat- and terrorism-related injuries and also evaluates the immediate and secondary phase managements of patients with missile injuries. This study includes 235 patients with missile war injuries of the face during a period of 4 years; all injured patients were treated in the Maxillofacial Unit of Surgical Specialties Hospital, Medical City, Baghdad. There were 195 men and 40 women; their ages ranged from 1 to 70 years (mean, 39.5 years). Posttraumatic missile facial deformities were classified as follows: 95 patients (40.43%) had bone loss; 72 patients (30.64%) had soft tissue loss; 33 patients (14.05%) had orbital injuries; and 35 patients (14.90%) had other deformities of scar contracture, fistula, and sinus formation. Two techniques were used for reconstruction of the bony defect, either by bone chips carried by osteomesh tray harvested from the iliac crest or by free block of corticocancellous bone graft from the iliac crest. Soft tissue reconstruction was done by local flaps and regional flaps such as lateral cervical and cervicofacial flaps, and the orbit was reconstructed by bone graft, lyophilized dura, and sialastic implant. Scar contracture was treated by scar revision and sinus tract excised at the same time of scar revision. In conclusion, the primary phase required an urgent airway management, controlling an active bleeding by surgical intervention; most entrance and exit wounds as well as retained missiles were located in the cheek, chin, and mandibular body, with few cases of mortality due to complications related to head injuries. The secondary phase management of deformities of the face as a

  5. War injuries during the Gulf War: experience of a teaching hospital in Kuwait.

    PubMed Central

    Behbehani, A.; Abu-Zidan, F.; Hasaniya, N.; Merei, J.

    1994-01-01

    The war injuries of 361 patients admitted to Mubarak Al-Kabeer Teaching Hospital, during the Gulf War are reported. More abdominal and chest injuries were seen in this series in comparison with other conflicts owing to the short evacuation time. Of the injuries, 54% were caused by gunshots, 34% were fragment injuries and 5.5% were glass and stab injuries. Civilians accounted for 50% of the injured. Wound infection rate was 7%, average hospital stay was 8.8 days and hospital mortality was 5.5%. We advocate radical wound excision, exploration of penetrating wounds of neck and abdomen, and mainly conservative management of chest injuries that do not involve the mediastinum. PMID:7702326

  6. An overview of war-related thermal injuries.

    PubMed

    Roeder, Rosiane Alfinito; Schulman, Carl I

    2010-07-01

    Thermal injuries have always been a source of morbidity and mortality in times of war. Historically, they constitute 5% to 20% of all injuries and approximately 4% mortality. Although burn patients constitute a small number of casualties, they consume a disproportionate amount of resources and require specialized care. The current conflicts in the Middle East report similar numbers for thermal injuries despite improvement in predeployment education to reduce noncombat-related burns, flame retardant military clothing, and decline of war patterns usually associated with increased thermal injuries. However, the increased use of improvised explosive devices and vehicle-borne improvised explosive devices presents a new source of potential thermal injury. Indeed, the burden of explosion-related burns has increased as has its associated Injury Severity Score. As has been the case in previous conflicts, most burns are hand and head burns. Although usually not life threatening, burns to hands and face lead to significant physical and psychologic morbidities. In this paper, we will review the currently available literature on war-related thermal injuries in Operation Iraqi and Operation Enduring Freedom. We will describe the epidemiology of burn injuries, prewar preparation to prevent and treat thermal injuries, and the assessment, triage, and final treatment of burn patients. In addition, we will discuss the associated physical and psychologic morbidities and, finally, the role of plastic surgeon in burn rehabilitation and reconstruction. PMID:20613571

  7. Treatment of Bone Defects in War Wounds: Retrospective Study

    PubMed Central

    Grubor, Predrag; Milicevic, Snjezana; Grubor, Milan; Meccariello, Luigi

    2015-01-01

    Introduction: Results of the treatment of open fractures primarily depend on the treatment of connected soft tissue injuries. Objective: The aim was to present the experience and methods gained during the treatment of diaphyseal bone defects as a consequence of gunshot fracture soft war trauma. Patients and Methods: The study consisted of 116 patients with the diaphyseal bone defect who were treated with the usage of primary and delayed autotransplantation of bones, transplants of the fibula and Ilizarov distraction osteogenesis. Results: The results of compensation of bone defect less than 4 cm and conducted by an early cortico-spongioplastics were as follows: good in 8 respondents (45%), satisfactory in 6 (34%) and poor in 4 respondents (21%). In cases of delayed cortico-spongioplastics, the above mentioned results were: good in 36 (41%) respondents, satisfactory in 24 (34%) and poor in 16 (25%) respondents. The results of compensation of bone defect greater than 4 cm with the usage of fibular transplant were as follows: good in 3 (38%) respondents, satisfactory in 3 (38%) and poor in 2 (24%), and with the usage of using the Ilizarov method, the results were as follows: good in 8 (57%) respondents, satisfactory in 3 (21.5%) and poor in 3(21.5%) respondents. Conclusion: The results showed that, in cases of compensation of bone defects less than 4 cm, the advantage is given to the primary spongioplastics over the delayed one. In cases of compensation of bone defects greater than 4 cm, the advantage is given to the Ilizarov distraction osteogenesis when compared to the fibular transplant. PMID:26543315

  8. [Surgical management of war injuries involving soft tissue defects].

    PubMed

    Stanec, Z; Skrbić, S; Depina, I; Hulina, D; Ivrlac, R; Unusić, J; Montani, D; Prpić, I; Unusić, I

    1993-01-01

    In this article, the authors emphasize that the knowledge of terminal ballistics is important for understanding of the pathophysiology of war wounds. They present their own experiences in the treatment of war wounds in 126 casualties, treated in the Institute of Plastic and Reconstructive Surgery, Department of Surgery, Clinical Hospital Center, Zagreb. About 96% of the wounded sustained extremity injuries, while head, neck and thoracoabdominal injuries appeared in a significantly smaller number of cases. War wound were divided into four main categories with regard to type of injury and extension of soft-tissue defect, thus showing the differences in primary excision and in reconstruction of the wounds; 78.6% of head and neck injuries were treated by primary or early primary reconstruction (within three to five days after the injuries have been sustained), while 45.4% of thoracoabdominal injuries were treated by a secondary closure. The greatest number of sophisticated reconstructions were used in extremity injuries (15 wound were reconstructed by local flaps, while free flaps were used in 8 cases). The authors emphasize the importance of proper primary treatment which enables an early reconstruction. This results in significantly shorter hospitalization, so that 87.5% of patients were treated within 20 days and then transferred to early rehabilitation. PMID:8170273

  9. US foreign policy and the CIA: A cold war retrospective

    SciTech Connect

    Not Available

    1994-01-01

    The document consists of three previously announced reports: The CIA under Truman: CIA Cold War Records (PB94-928005); The Cuban Missile Crisis, 1962 (PB92-927906); and Selected Estimates on the Soviet Union (PB93-928112).

  10. [Epidemiology of war injuries, about two conflicts: Iraq and Afghanistan].

    PubMed

    Pasquier, P; de Rudnicki, S; Donat, N; Auroy, Y; Merat, S

    2011-11-01

    Since March 2003, military operations in Iraq "Operation Iraqi Freedom" (OIF) and in Afghanistan "Operation Enduring Freedom" (OEF), have made many wounded and killed in action (KIA). This article proposes to highlight the specific epidemiology of combat casualties, met in these both non-conventional and asymmetric conflicts. Personal protective equipments, Kevlar helmet and body armor, proved their efficiency in changing features of war injuries. Health Force Services organized trauma care system in different levels, with three main objectives: immediate basic medical care in battalion aid station, forward surgery and early aeromedical evacuation. The Joint Theater Trauma Registry (JTTR), a war injury registry, provides medical data, analyzed from the combat theater to the military hospital in United States. This analysis concluded that during modern conflicts, most injuries are caused by explosive devices; injuries are more severe and interestingly more specifically the head region and extremities than the trunk. Hemorrhage is the first cause of death, leading to the concept of avoidable death. Specific databases focused on mechanisms and severity of injuries, diagnostic and treatment difficulties, outcomes can guide research programs to improve war injuries prevention and treatment. PMID:21981845

  11. Musculoskeletal injuries in Homer's Iliad: the War of Troy revisited.

    PubMed

    Kömürcü, Erkam; Tok, Fatih; Simşek, Ayşe; Ozçakar, Levent

    2014-04-01

    Homer's Iliad--the most famous and influential epic poem--has been previously reviewed with respect to head, craniomaxillofacial, neck, thoracic, and hand injuries in the literature. However, to the best of the authors' knowledge, there are no data regarding musculoskeletal injuries. This article describes the musculoskeletal injuries that had ensued during the war of Troy. The Turkish translation of the original epic poem Iliad was reviewed for musculoskeletal injuries, that is, their descriptions, outcome, the weapons used, and the engaged warriors. Extremity injuries were evaluated as regards the affected bones. The pertinent treatment methods were also recorded. In total, 103 musculoskeletal injuries were detected during 81 combats. The most commonly involved areas were the shoulder (15.5%), the head (14.5%), the cervical vertebrae (14.5%), and the thoracic vertebrae (8.7%). The weapons used were spear (n = 52); sword (n = 9); arrow (n = 9); stone (n = 8); and cane, animal, the hand, Chariot race, and broken yoke (n = 1 for each). Fifty-four combats (66.6%) resulted in death. Therapeutic herbs, compound of milk, and essence of fig were used as treatment alternatives. While providing a historic snapshot on the war of Troy, in this article, the authors have reviewed the musculoskeletal injuries and their management in those ancient times. Despite the long period in between, unfortunately, physicians/surgeons are still faced with war injuries in current medical practice. The authors strongly hope that, at least in the near future, physicians will be left with only natural health problems and without those artificially generated by human beings. PMID:24406735

  12. Traumatic brain injury in modern war

    NASA Astrophysics Data System (ADS)

    Ling, Geoffrey S. F.; Hawley, Jason; Grimes, Jamie; Macedonia, Christian; Hancock, James; Jaffee, Michael; Dombroski, Todd; Ecklund, James M.

    2013-05-01

    Traumatic brain injury (TBI) is common and especially with military service. In Iraq and Afghanistan, explosive blast related TBI has become prominent and is mainly from improvised explosive devices (IED). Civilian standard of care clinical practice guidelines (CPG) were appropriate has been applied to the combat setting. When such CPGs do not exist or are not applicable, new practice standards for the military are created, as for TBI. Thus, CPGs for prehospital care of combat TBI CPG [1] and mild TBI/concussion [2] were introduced as was a DoD system-wide clinical care program, the first large scale system wide effort to address all severities of TBI in a comprehensive organized way. As TBI remains incompletely understood, substantial research is underway. For the DoD, leading this effort are The Defense and Veterans Brain Injury Center, National Intrepid Center of Excellence and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. This program is a beginning, a work in progress ready to leverage advances made scientifically and always with the intent of providing the best care to its military beneficiaries.

  13. Extremity War Injuries X: Return to Health and Function.

    PubMed

    Davila, Col Jeffrey N; Swiontkowski, Marc F; Andersen, Col Ret Romney C

    2016-09-01

    The symposium Extremity War Injuries X: Return to Health and Function, presented by the American Academy of Orthopaedic Surgeons, the Orthopaedic Trauma Association, the Society of Military Orthopaedic Surgeons, and the Orthopaedic Research Society, was held in Washington, DC, on January 27 and 28, 2015. Course chairs Marc F. Swiontkowski, MD, and COL Jeffrey N. Davila, MD, presided over 2 days of general session lectures focusing on war/trauma-related musculoskeletal injuries resulting in service member disability, followed by small group discussions, with a goal of identifying knowledge gaps in the treatment of these injuries. Recognized civilian and military clinicians and researchers summarized the current state of knowledge in their topic areas and led these discussion groups with meeting participants. Musculoskeletal conditions discussed included posttraumatic osteoarthritis of the knee, foot, and ankle and their relationship to chronic ligament injuries; back disability; peripheral nerve injury; hand transplantation updates; the role of biologics; and prosthetic acceptance and function. A scientific program highlighting research presented by 12 investigators was led by COL (Ret) Romney C. Andersen, MD. Keynote speaker LT GEN Douglas J. Robb, MD, discussed the future of military research funding and the anticipated consolidation of medical care among the three military branches. Additional presentations referencing the impact of military medical care and the government's continued commitment to funding medical research occurred throughout the symposium and were given by five congressional representatives. PMID:27479834

  14. Technology through a Retrospective Eye: Imaging Practices between the World Wars and Beyond.

    ERIC Educational Resources Information Center

    Zelizer, Barbie

    1995-01-01

    Introduces a symposium in this journal issue: "Technology through a Retrospective Eye: Imaging Practices between the World Wars and Beyond." Notes that each article of the symposium keys into a central moment of expansion of imaging practice and focuses on the debates that accompanied that expansion. (SR)

  15. Facial injuries in Iranian veterans during the Iraq-Iran war (1980-88): differences from recent conflicts.

    PubMed

    Khosravi, M H; Akhavan, A

    2015-12-01

    Our aim was to identify the pattern and mechanism of facial injuries in Iranian veterans during the Iraq-Iran war and to assess the effectiveness of current protective equipment by retrospectively evaluating 100 Iranian veterans of that war. We randomly included veterans with injuries to various parts of the face, with or without injuries to other organs. None died. We recorded anatomical distribution, incidence, and mechanism of injury as well as injury scores using common references scales. Data are expressed as mean (SD) or number. Fragmentation injuries were the most common (n=40) followed by blast (n=37), shock wave (n=18), and gunshots (n=5). Thirty-five patients had mandibular fractures with a mean (SD) score of 3.7 (1.4). Fifteen patients had injuries to the upper face and 79 to the midface. Twenty-four patients had facial lacerations more than 10 cm long, with a mean facial injury score of 2.4 (2.0). Nineteen had ocular injuries with a mean (SD) ocular trauma score of 64.9 (12.9). Despite recent developments in protective equipment we have seen no significant reduction in the incidence of facial injuries in battle, which could indicate that we need better facial support equipment and more effective education in its use. However, using protective equipment such as goggles and a mandibular protector is highly recommended. PMID:26187368

  16. Equine-associated maxillofacial injuries: retrospective 5-year analysis.

    PubMed

    Islam, Shofiq; Gupta, Benjamin; Taylor, Christopher J; Chow, Jeffrey; Hoffman, Gary R

    2014-02-01

    We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management. PMID:24168759

  17. Nine year longitudinal retrospective study of Taekwondo injuries.

    PubMed

    Kazemi, Mohsen; Chudolinski, Artur; Turgeon, Matt; Simon, Aaron; Ho, Eric; Coombe, Lianne

    2009-12-01

    This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence.This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College.The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend to

  18. Analysis of 285 cardiac penetrating injuries in the Lebanon war.

    PubMed

    Zakharia, A T

    1987-01-01

    This study evaluates factors influencing survival in 285 battle cardiac injuries, treated in Lebanon from 1969 to 1982. Survival factors included age (mean 18 years), transportation lag (mean distance 2 miles), wounding agents (shrapnel, gunshot), hospital logistics, and early surgical treatment. The overall survival was 73% (208 patients) compared to 60% from World War II and 67% from recent civilian report. Treatment logistics included a specialized centre with ambulance radio communication. The state of shock at arrival influenced survival: 146 of 188 patients with mild shock survived (78%) with 61% (53 patients) survival in the profound shock group, treated similarly. The site of cardiac injury influenced outcome. Survival was best in the 9 patients with coronary vessel wounds (100%), atrial wounds 80% (56 survivors) but dropped to 46% (17 survivors) in left ventricular injury reflecting pump failure, and 51% (19 survivors) in multiple cardiac wounds. The causes of cardiac mortality and survivor follow-up were evaluated. The study indicates that despite predetermined factors overall survival is significantly improved by early transportation, precise logistics, and urgent surgery. PMID:3597530

  19. Elaboration of the Visual Pathways from the Study of War-Related Cranial Injuries: The Period from the Russo-Japanese War to World War I.

    PubMed

    Lanska, Douglas J

    2016-01-01

    As a result of the wars in the early 20th century, elaboration of the visual pathways was greatly facilitated by the meticulous study of visual defects in soldiers who had suffered focal injuries to the visual cortex. Using relatively crude techniques, often under difficult wartime circumstances, investigators successfully mapped key features of the visual pathways. Studies during the Russo- Japanese War (1904-1905) by Tatsuji Inouye (1881-1976) and during World War I by Gordon Holmes (1876-1965), William Lister (1868-1944), and others produced increasingly refined retinotopic maps of the primary visual cortex, which were later supported and refined by studies during and after World War II. Studies by George Riddoch (1888-1947) during World War I also demonstrated that some patients could still perceive motion despite blindness caused by damage to their visual cortex and helped to establish the concept of functional partitioning of visual processes in the occipital cortex. PMID:27035915

  20. Intractable epilepsy and craniocerebral trauma: analysis of 163 patients with blunt and penetrating head injuries sustained in war.

    PubMed

    Kazemi, Hadi; Hashemi-Fesharaki, Sohrab; Razaghi, Soodeh; Najafi, Masomeh; Kolivand, Peir Hossein; Kovac, Stjepana; Gorji, Ali

    2012-12-01

    Post-traumatic epileptic seizure is a common complication of brain trauma including military injuries. We present clinical characteristics and correlates of post-traumatic epilepsy in 163 head-injured veterans suffering from intractable epilepsy due to blunt or penetrating head injuries sustained during the Iraq-Iran war. The medical records of 163 war veterans who were admitted by the Epilepsy Department of the Shefa Neuroscience Center between 2005 and 2009 were retrospectively reviewed. The mean follow-up period after developing epilepsy was 17.2 years. The time interval between the trauma and the first seizure was shorter and the seizure frequency was higher in epileptic patients suffering from penetrating head trauma. There was no difference in seizure type between epileptic patients traumatised by blunt or penetrating injury. Patients with seizure frequency of more than 30 per month mostly had simple partial seizure. Frontal and parietal semiologies were observed more frequently in patients with penetrating trauma, whereas patients with blunt trauma showed a higher temporal semiology. The most common brain lesion observed by CT scan was encephalomalacia followed by porencephaly and focal atrophy. There was no association between intracerebral retained fragments and different characteristic features of epilepsy. Patients with military brain injury carry a high risk of intractable post-traumatic epilepsy decades after their injury, and thus require a long-term medical follow-up. PMID:22763317

  1. Traumatic Brain Injury Studies in Britain during World War II.

    PubMed

    Lanska, Douglas J

    2016-01-01

    As a result of the wartime urgency to understand, prevent, and treat patients with traumatic brain injury (TBI) during World War II (WWII), clinicians and basic scientists in Great Britain collaborated on research projects that included accident investigations, epidemiologic studies, and development of animal and physical models. Very quickly, investigators from different disciplines shared information and ideas that not only led to new insights into the mechanisms of TBI but also provided very practical approaches for preventing or ameliorating at least some forms of TBI. Neurosurgeon Hugh Cairns (1896-1952) conducted a series of influential studies on the prevention and treatment of head injuries that led to recognition of a high rate of fatal TBI among motorcycle riders and subsequently to demonstrations of the utility of helmets in lowering head injury incidence and case fatality. Neurologists Derek Denny-Brown (1901-1981) and (William) Ritchie Russell (1903-1980) developed an animal model of TBI that demonstrated the fundamental importance of sudden acceleration (i.e., jerking) of the head in causing concussion and forced a distinction between head injury associated with sudden acceleration/deceleration and that associated with crush or compression. Physicist A.H.S. Holbourn (1907-1962) used theoretical arguments and simple physical models to illustrate the importance of shear stress in TBI. The work of these British neurological clinicians and scientists during WWII had a strong influence on subsequent clinical and experimental studies of TBI and also eventually resulted in effective (albeit controversial) public health campaigns and legislation in several countries to prevent head injuries among motorcycle riders and others through the use of protective helmets. Collectively, these studies accelerated our understanding of TBI and had subsequent important implications for both military and civilian populations. As a result of the wartime urgency to understand

  2. Historical perspective: neurological advances from studies of war injuries and illnesses.

    PubMed

    Lanska, Douglas J

    2009-10-01

    Early in the 20th century during the Russo-Japanese War and World War I (WWI), some of the most important, lasting contributions to clinical neurology were descriptive clinical studies, especially those concerning war-related peripheral nerve disorders (eg, Hoffmann-Tinel sign, Guillain-Barré-Strohl syndrome [GBS]) and occipital bullet wounds (eg, the retinal projection on the cortex by Inouye and later by Holmes and Lister, and the functional partitioning of visual processes in the occipital cortex by Riddoch), but there were also other important descriptive studies concerning war-related aphasia, cerebellar injuries, and spinal cord injuries (eg, cerebellar injuries by Holmes, and autonomic dysreflexia by Head and Riddoch). Later progress, during and shortly after World War II (WWII), included major progress in understanding the pathophysiology of traumatic brain injuries by Denny-Brown, Russell, and Holbourn, pioneering accident injury studies by Cairns and Holbourn, promulgation of helmets to prevent motorcycle injuries by Cairns, development of comprehensive multidisciplinary neurorehabilitation by Rusk, and development of spinal cord injury care by Munro, Guttman, and Bors. These studies and developments were possible only because of the large number of cases that allowed individual physicians the opportunity to collect, collate, and synthesize observations of numerous cases in a short span of time. Such studies also required dedicated, disciplined, and knowledgeable investigators who made the most out of their opportunities to systematically assess large numbers of seriously ill and injured soldiers under stressful and often overtly dangerous situations. PMID:19847911

  3. Tug-of-War Injuries: A Case Report and Review of the Literature.

    PubMed

    Chotai, Pranit N; Abdelgawad, Amr A

    2014-01-01

    We report a case of a 10-year-old boy presenting with radial nerve palsy due to injury during a tug-of-war game. Patient was managed nonoperatively and regained radial nerve function. Tug-of-war is a globally popular noncontact sport. Injuries during this game are inevitable and may range from simple sprains to life and limb threatening trauma. Combined hip and knee injuries and soft-tissue injuries involving the back are most frequent. Most injuries occur when tug-of-war was played in an informal setting and where the tug-of-war International Federation rules were less likely to be followed. Measures should be taken to increase the awareness about these safety rules and prevention of consequent injuries. Sports physicians, pediatricians, orthopedic surgeons, general physicians, and athletic trainers should be aware of potential injuries resulting from this game while caring for these athletes, so as to be well prepared for apt management of the injuries associated with TOW. PMID:25530897

  4. Psychosocial Adjustment in Siblings of Children with War-Related Injuries

    ERIC Educational Resources Information Center

    Khamis, Vivian

    2013-01-01

    The study assessed the prevalence and predictors of post-traumatic symptomatology and emotional and behavioral difficulties in siblings of children who incurred war-related injuries. It was predicted that injury severity, gender and attributional style would account for a significant amount of the variance in post-traumatic stress symptoms and…

  5. Tug-of-War Injuries: A Case Report and Review of the Literature

    PubMed Central

    Chotai, Pranit N.; Abdelgawad, Amr A.

    2014-01-01

    We report a case of a 10-year-old boy presenting with radial nerve palsy due to injury during a tug-of-war game. Patient was managed nonoperatively and regained radial nerve function. Tug-of-war is a globally popular noncontact sport. Injuries during this game are inevitable and may range from simple sprains to life and limb threatening trauma. Combined hip and knee injuries and soft-tissue injuries involving the back are most frequent. Most injuries occur when tug-of-war was played in an informal setting and where the tug-of-war International Federation rules were less likely to be followed. Measures should be taken to increase the awareness about these safety rules and prevention of consequent injuries. Sports physicians, pediatricians, orthopedic surgeons, general physicians, and athletic trainers should be aware of potential injuries resulting from this game while caring for these athletes, so as to be well prepared for apt management of the injuries associated with TOW. PMID:25530897

  6. Severe and penetrating traumatic brain injury in the context of war.

    PubMed

    Meyer, Kimberly; Helmick, Kathy; Doncevic, Selina; Park, Rachel

    2008-01-01

    Our data suggests that traumatic brain injury (TBI) may account for up to one third of battle-related injuries in today's war. Although the majority of these injuries are classified as mild in severity, service members with severe or penetrating TBI can be faced with many challenges. Injuries sustained on the battlefield require a slightly different approach than the TBI care that is traditionally seen in a civilian setting. This article presents the range of care that occurs beginning on the battlefield and continuing to state-of-the-art rehabilitation within the Department of Defense and Veterans Affairs Polytrauma System of Care. PMID:19092508

  7. Field Marshal Erwin Rommel: the head injury that may have prolonged the Second World War.

    PubMed

    Fuhrman, Heather A; Mullin, Jeffrey P; Sloffer, Chris A

    2016-07-01

    War-related head injury, indeed neurological injury in general, has been a part of the history of humankind for as long as there has been warfare. Such injuries can result in the removal of the individual from combat, thus eliminating any subsequent contribution that he or she might have made to the battle. However, at times, the injuries can have more wide-reaching effects. In the case of commanders or leaders, the impact of their injuries may include the loss of their influence, planning, and leadership, and thus have a disproportionate effect on the battle, or indeed the war. Field Marshal Erwin Rommel was a talented military strategist and leader who was respected by friends and foes alike. He held an honored reputation by the German people and the military leadership. His head injury on July 17, 1944, resulted in his being removed from the field of battle in northern France, but also meant that he was not able to lend his stature to the assassination attempt of Adolph Hitler on July 20. It is possible that, had he been able to lend his stature to the events, Hitler's hold on the nation's government might have been loosened, and the war might have been brought to an end a year earlier. The authors review Rommel's career, his injury, the subsequent medical treatment, and his subsequent death. PMID:27364261

  8. War-wounded refugees: the types of injury and influence of disability on well-being and social integration.

    PubMed

    Hermansson, A C; Thyberg, M; Timpka, T

    1996-01-01

    The aim of this study is to describe the war injuries and investigate the influence of physical disability on well-being and social integration in a group of war-wounded refugees after two years in Sweden. A culturally heterogenous sample of 54 war-wounded refugees was investigated during hospitalization shortly after arrival, and after two years. Quantitative data were covered by physical examinations, interviews and questionnaires. In addition, qualitative data were collected within semi-structured interviews on both occasions. The major types of war injuries were: fractures (22%), traumatic amputations (17%), spinal cord injuries (17%), nerve injuries (11%), combinations of fractures and nerve injuries (9%), bilateral eye injuries (9%), brain injuries (7%), other injuries (7%). Regarding the type of injuries and medical complications, the group studied was representative of small unit operations of war with low access to early medical care. The degree of physical disability was not a salient factor for well-being and social integration after two years in Sweden. The losses and desires to be repatriated were apparent from the qualitative findings, as exemplified by three case reports. The findings of this study are in accordance with previous research on refugees and war-injured ex-combatants, but further multidisciplinary research is needed. The results also imply that resettlement countries should pay continuous attention to the broad needs of their war-wounded refugees. PMID:8953262

  9. [Management of war orthopaedic injuries in recent armed conflicts].

    PubMed

    Frank, M; Mathieu, L

    2013-01-01

    The extremities continue to be the most frequent sites of wounding during armed conflicts despite the change of combat tactics, soldier armour and battlefield medical support. Due to the advances in prehospital care and timely transport to the hospital, orthopaedic surgeons deal with severe and challenging injuries of the limbs. In contrast to civilian extremity trauma, the most combat-related injuries are open wounds that often have infection-related complications. Data from two recent large armed conflicts (Iraq, Afghanistan) show that extremity injuries are associated with a high complication rate, morbidity and healthcare utilization. A systematic approach that consists of sequential surgical care and good transport capabilities can reduce the complication rate of these injuries. New medical technologies have been implemented in the treatment strategy during the last decade. This article reviews the published scientific data and current opinions on combat-related extremity injuries. Key words: extremity, combat, trauma, medical support system. PMID:23777944

  10. [War injuries of the thorax. Aggressors and wound balistics].

    PubMed

    Jourdan, P; Jancovici, R

    1990-02-01

    War chest wounds are very common, but wound balistic notions are not known of physicians. Different threats are being listed, and we might retain the important rate of shrapnels wounds. Concerning the bullet behavior in soft tissue, one can discern full jacketed war bullets which may tumble after a variable "neck", and non jacketed missiles which cause wound through "mushrooming" and/or fragmentation effect. Buckshot wounds obey the rule of "all or none". Body reactions, particularly the clash with a hard material like bone, may overturn everything described in soft tissues. Every kind of possible chest wounds are analyzed from a ballistic point of view. We insist on the effects of so called terrible high velocity little bullets which do not wound because of an "explosive" shock wave, but with a fragmentation effect. The treatment sums up to the advice of good common sense which has had such a good effect on our masters. PMID:2187894

  11. The Natural History of Acute Recovery of Blast-Induced Mild Traumatic Brain Injury: A Case Series During War.

    PubMed

    Larres, David T; Carr, Walter; Gonzales, Elizandro G; Hawley, Jason S

    2016-05-01

    Traumatic brain injury (TBI) secondary to blast exposure is a common injury in the Global War on Terrorism, but little is known about the acute effects, recovery, pathophysiology, and neuropathology of blast-induced mild TBI (mTBI) in humans in a battlefield environment. Moreover, there is ongoing debate whether blast-induced mTBI is a different injury with a unique pathophysiology compared with mTBI from blunt trauma. In the case series reported here from Craig Joint Theater Hospital at Bagram Airfield, Afghanistan, 15 military service members with acute concussion/mTBI associated with blast exposure were evaluated within the first 24 hours after concussion and on days 2, 3, 5, and 7 with a Graded Symptom Checklist and a balance assessment, the Balance Error Scoring System. These data suggest that the recovery in blast-induced mTBI follows the pattern of recovery in sports-related concussion reported in The National Collegiate Athletic Association Concussion Study. In this retrospective case series, we provide the first description of the natural history of acute recovery in blast-induced mTBI, and we suspect, given our experience treating military service members, that further observations of the natural history of recovery in blast-induced mTBI will continue to mirror the natural history of recovery in sports concussion. PMID:27168549

  12. Musculoskeletal Injuries in Iraq and Afghanistan: Epidemiology and Outcomes Following a Decade of War.

    PubMed

    Belmont, Philip J; Owens, Brett D; Schoenfeld, Andrew J

    2016-06-01

    The combined wars in Afghanistan and Iraq represent the longest ongoing conflicts in American military history, with a combined casualty estimate of >59,000 service members. The nature of combat over the last decade has led to precipitous increases in severe orthopaedic injuries, including traumatic amputations and injuries to the spine. Nearly 75% of all injuries sustained in combat now are caused by explosive mechanisms, and fractures comprise 40% of all musculoskeletal injuries. Injuries to the axial skeleton are more frequent among personnel exposed to combat, and spinal trauma is identified in nearly 40% of those killed. Musculoskeletal injuries are expensive and generate some of the highest rates of long-term disability. Noncombat musculoskeletal injuries are endemic within deployed military service members and occur at a greater than threefold rate compared with combat musculoskeletal injuries. Service members with musculoskeletal injuries or behavioral health conditions, such as posttraumatic stress disorder, depression, and psychosis, and those occupying a low socioeconomic status, have an increased risk of inferior outcomes. PMID:27115793

  13. Famous head injuries of the first aerial war: deaths of the "Knights of the Air".

    PubMed

    Koul, Prateeka; Mau, Christine; Sabourin, Victor M; Gandhi, Chirag D; Prestigiacomo, Charles J

    2015-07-01

    World War I advanced the development of aviation from the concept of flight to the use of aircraft on the battlefield. Fighter planes advanced technologically as the war progressed. Fighter pilot aces Francesco Baracca and Manfred von Richthofen (the Red Baron) were two of the most famous pilots of this time period. These courageous fighter aces skillfully maneuvered their SPAD and Albatros planes, respectively, while battling enemies and scoring aerial victories that contributed to the course of the war. The media thrilled the public with their depictions of the heroic feats of fighter pilots such as Baracca and the Red Baron. Despite their aerial prowess, both pilots would eventually be shot down in combat. Although the accounts of their deaths are debated, it is undeniable that both were victims of traumatic head injury. PMID:26126404

  14. Urethral and penile war injuries: The experience from civil violence in Iraq

    PubMed Central

    Al-Azzawi, Issam S.; Koraitim, Mamdouh M.

    2014-01-01

    Objective To determine the incidence, mechanism of injury, wounding pattern and surgical management of urethral and penile injuries sustained in civil violence during the Iraq war. Patients and methods In all, 2800 casualties with penetrating trauma to the abdomen and pelvis were received at the Al-Yarmouk Hospital, Baghdad, from January 2004 to June 2008. Of these casualties 504 (18%) had genitourinary trauma, including 45 (8.9%) with urethral and/or penile injuries. Results Of 45 patients, 29 (64%) were civilians and 16 (36%) were Iraqi military personnel. The injury was caused by an improvised explosive device (IED) in 25 (56%) patients and by individual firearms in 20 (44%). Of the patients, 24 had penile injuries, 15 had an injury to the bulbar urethra and six had an injury to the posterior urethra. Anterior urethral injuries were managed by primary repair, while posterior urethral injuries were managed by primary realignment in five patients and by a suprapubic cystostomy alone in one. An associated injury to major blood vessels was the cause of death in eight of nine patients who died soon after surgery (P < 0.001). Conclusion Urethral and penile injuries were caused by IEDs and individual firearms with a similar frequency. Most of the casualties were civilians and a minority were military personnel. Injuries to the anterior urethra can be managed by primary repair, while injuries to the posterior urethra can be managed by primary realignment. An associated trauma to major blood vessels was the leading cause of death in these casualties. PMID:26019940

  15. The development of military medical care for peripheral nerve injuries during World War I.

    PubMed

    Hanigan, William

    2010-05-01

    Although the clinical and electrical diagnoses and treatments of peripheral nerve injuries (PNIs) had been described prior to World War I, many reports were fragmented and incomplete. Individual physicians' experiences were not extensive, and in 1914 the patient with a PNI remained a subject of medical curiosity, and was hardly a focus of comprehensive care. World War I altered these conditions; casualties with septic wounds and PNIs swamped the general hospitals. By 1915, specialized hospitals or wards were developed to care for neurological injuries. In the United Kingdom, Sir Robert Jones developed the concept of Military Orthopedic Centres, with coordinated specialized care and rehabilitation. Military appointments of neurologists and electrotherapists sharpened clinical diagnoses and examinations. Surgical techniques were introduced, then discarded or accepted as surgeons developed skills to meet the new conditions. The US Surgeon General, William Gorgas, and his consultant in neurosurgery, Charles Frazier, went a step further, with the organization of a research laboratory as well as the establishment of a Peripheral Nerve Commission and Registry. Despite these developments and good intentions, postwar follow-up for PNIs remained incomplete at best. Records were lost, personnel transferred, and patients discharged from the system. The lack of a standardized grading system seriously impaired the ability to record clinical changes and compare outcomes. Nevertheless, specialized treatment of a large number of PNIs during World War I established a foundation for comprehensive care that influenced military medical services in the next world war. PMID:20568941

  16. Sequelae of an injury from the Second World War treated by free flap transfer.

    PubMed

    Kletenský, J; Tvrdek, M; Nejedlý, A; Pros, Z; Lebeda, V; Prokopová, J; Stĕnhová, H

    1993-01-01

    The authors present the case-history of patients with chronic osteomyelitis of the proximal third of the tibia-resulting from an injury during the Second World War. The defect of bone and soft tissues was treated by free transfer of a musculocutaneous flap. The behaviour of the flap in the osteomyelitic cavity is followed up and checked by repeated CT and NMR examinations. PMID:7515540

  17. Moral injury: a mechanism for war-related psychological trauma in military family members.

    PubMed

    Nash, William P; Litz, Brett T

    2013-12-01

    Recent research has provided compelling evidence of mental health problems in military spouses and children, including post-traumatic stress disorder (PTSD), related to the war-zone deployments, combat exposures, and post-deployment mental health symptoms experienced by military service members in the family. One obstacle to further research and federal programs targeting the psychological health of military family members has been the lack of a clear, compelling, and testable model to explain how war-zone events can result in psychological trauma in military spouses and children. In this article, we propose a possible mechanism for deployment-related psychological trauma in military spouses and children based on the concept of moral injury, a model that has been developed to better understand how service members and veterans may develop PTSD and other serious mental and behavioral problems in the wake of war-zone events that inflict damage to moral belief systems rather by threatening personal life and safety. After describing means of adapting the moral injury model to family systems, we discuss the clinical implications of moral injury, and describe a model for its psychological treatment. PMID:23852334

  18. Head injury in heroes of the Civil War and its lasting influence.

    PubMed

    Sabourin, Victor M; Holland, Ryan; Mau, Christine; Gandhi, Chirag D; Prestigiacomo, Charles J

    2016-07-01

    The Civil War era was an age-defining period in the history of the United States of America, the effects of which are still seen in the nation today. In this era, the issue of head injury pervaded society. From the president of the United States, Abraham Lincoln, to the officers and soldiers of the Union and Confederate armies, and to the population at large, head injury and its ramifications gripped the nation. This article focuses on 3 individuals: Major General John Sedgwick, First Lieutenant Alonzo Cushing, and Harriet Tubman, as examples of the impact that head injury had during this era. These 3 individuals were chosen for this article because of their lasting legacies, contributions to society, and interesting connections to one another. PMID:27364257

  19. Blunt Cardiac Injury in the Severely Injured – A Retrospective Multicentre Study

    PubMed Central

    Hanschen, Marc; Kanz, Karl-Georg; Kirchhoff, Chlodwig; Khalil, Philipe N.; Wierer, Matthias; van Griensven, Martijn; Laugwitz, Karl-Ludwig; Biberthaler, Peter; Lefering, Rolf; Huber-Wagner, Stefan

    2015-01-01

    Background Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients. Methods In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009), characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6), the revised injury severity score (RISC) allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6) (2.3% of patients). Results Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%). The overall mortality rate was 13.9%, minor cardiac injury (AIS 1) and severe cardiac injury (AIS 2-6) are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6) is associated with a higher mortality (OR 2.79 and 4.89, respectively) as compared to the predicted average mortality (OR 2.49) of the study collective. Conclusion Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients’ outcome is dependent on the severity of cardiac injury. PMID:26136126

  20. Jaw injuries of independence victims from the 1991 War in Croatia.

    PubMed

    Susić, Mato; Brozović, Juraj; Zore, Irina Filipović; Milenović, Aleksandar; Strinović, Davor; Brkić, Hrvoje; Pandurić, Dragana Gabrić

    2014-03-01

    In the aetiology of maxillofacial injuries, car accidents, violence, sports injuries and lately war injuries are frequently mentioned. The purpose of this study was to exhibit and analyse types of jaw injuries on bodies exhumed from massive and individual graves located in regions temporarily occupied during the War in Croatia that lasted from 1991 to 1995. The sample was the post-mortal documentation of the orofacial region (set of teeth, photographs, radiographic images) of 1068 victims exhumed from massive grave sites in Croatia. The jaw traumatism was analysed on the whole sample as well as on individual graves, whilst the analysis of trauma frequency was performed separately. Descriptive statistics were computed and the value of P < .05 was accepted as statistically significant. Results of this study showed that out of 1068 examined corpses, 332 had midface and lower face fractures, which was 31.1% of the total number. Lower face fractures were more frequent with 28.1%. Age related frequency analysis showed a significant dependency. There were 34.6% of fractures in the under 30 age group, 34.2% in those aged 30-60, while 21.3% of fractures were noted in the over 60 age group. Female bodies had the lowest number of jaw fractures regardless of the osteoporotic changes. The results of this study suggest that younger and middle aged persons were molested more. Jaw fractures suggest ante-mortal molestation. In females, the more likely fracture causes were the falls of the bodies into the graves or body to body hits. PMID:24851626

  1. Injuries in a Professional Ballet Dance Company: A 10-year Retrospective Study.

    PubMed

    Ramkumar, Prem N; Farber, Joseph; Arnouk, Johnny; Varner, Kevin E; Mcculloch, Patrick C

    2016-03-01

    Ballet dancers are high-performance athletes who are particularly susceptible to a wide variety of musculoskeletal injuries. However, they are relatively understudied, and data on their injury rates are lacking. This retrospective study features the largest aggregate data on professional ballet dancers to date and aims to identify the most common diagnoses and areas of injury in this unique population to better direct preventative and clinical practices. The study encompassed a 10-year period from January 2000 to December 2010 of dancers from a single company. Data regarding the dancers' age, gender, location of injury, and diagnosis were collected from workers' compensation claims, company records, and medical records maintained by the treating doctors. These were analyzed to determine metrics on injury incidence, frequency, and diagnosis. Over the 10-year span, 574 injuries occurred. There were approximately 52 dancers per year for a total of 153 who danced at least one complete season during the study period. The average age was 27, and 53% were female. Given turnover with retirement and replacements, the total number of dancer-years was 520, indicating an injury incidence per annum of 1.10 (574 injuries per 520 dancer-years). The most common locations of injury were foot and ankle and the lumbar spine, with the three most common diagnoses making up greater than a third (37%) of the total. As the current largest study in professional ballet, the findings set the benchmark metrics for musculoskeletal injury to the foot, ankle, and lumbar spine sites. Future studies should aim to identify injury risk factors and modalities for prevention of these injuries. PMID:27025450

  2. Publications on Peripheral Nerve Injuries during World War I: A Dramatic Increase in Knowledge.

    PubMed

    Koehler, Peter J

    2016-01-01

    Publications from French (Jules Tinel and Chiriachitza Athanassio-Bénisty), English (James Purves-Stewart, Arthur Henry Evans and Hartley Sidney Carter), German (Otfrid Foerster and Hermann Oppenheim) and American (Charles Harrison Frazier and Byron Stookey) physicians from both sides of the front during World War I (WWI) contributed to a dramatic increase in knowledge about peripheral nerve injuries. Silas Weir Mitchell's original experience with respect to these injuries, and particularly causalgia, during the American Civil War was further expanded in Europe during WWI. Following the translation of one of his books, he was referred to mainly by French physicians. During WWI, several French books were in turn translated into English, which influenced American physicians, as was observed in the case of Byron Stookey. The establishment of neurological centres played an important role in the concentration of experience and knowledge. Several eponyms originated during this period (including the Hoffmann-Tinel sign and the Froment sign). Electrodiagnostic tools were increasingly used. PMID:27035152

  3. Epidemiology of Spinal Cord Injuries and Risk Factors for Complete Injuries in Guangdong, China: A Retrospective Study

    PubMed Central

    Wang, Peng; Huang, Lin; Tang, Yong; Wang, Wenhao; Chen, Keng; Ye, Jichao; Lu, Ciyong; Wu, Yanfeng; Shen, Huiyong

    2014-01-01

    Background Spinal cord injuries are highly disabling and deadly injuries. Currently, few studies focus on non-traumatic spinal cord injuries, and there is little information regarding the risk factors for complete injuries. This study aims to describe the demographics and the injury characteristics for both traumatic and non-traumatic spinal cord injuries and to explore the risk factors for complete spinal cord injuries. Methods A retrospective study was performed by reviewing the medical records of 3,832 patients with spinal cord injuries who were first admitted to the sampled hospitals in Guangdong, China. The demographics and injury characteristics of the patients were described and compared between the different groups using the chi-square test. Logistic regression was conducted to analyze the risk factors for complete spinal cord injuries. Results The proportion of patients increased from 7.0% to 14.0% from 2003 to 2011. The male-to-female ratio was 3.0∶1. The major cause of spinal cord injuries was traffic accidents (21.7%). Many of the injured were workers (36.2%), peasants (22.8%), and unemployed people (13.9%); these occupations accounted for 72.9% of the total sample. A multivariate logistic regression model revealed that the OR (95% CI) for male gender compared to female gender was 1.25 (1.07–1.89), the OR (95%CI) for having a spinal fracture was 1.56 (1.35–2.60), the OR (95%CI) for having a thoracic injury was 1.23 (1.10–2.00), and the OR (95%CI) for having complications was 2.47 (1.96–3.13). Conclusion The proportion of males was higher than the proportion of females. Workers, peasants and the unemployed comprised the high-risk occupational categories. Male gender, having a spinal fracture, having a thoracic injury, and having complications were the major risk factors for a complete injury. We recommend that preventive measures should focus on high-risk populations, such as young males. PMID:24489652

  4. Dental trauma involving root fracture and periodontal ligament injury: a 10-year retrospective study.

    PubMed

    Panzarini, Sônia Regina; Pedrini, Denise; Poi, Wilson Roberto; Sonoda, Celso Koogi; Brandini, Daniela Atili; Monteiro de Castro, José Carlos

    2008-01-01

    The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion) treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09%) was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86%). There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed. PMID:18949308

  5. Retrospective examination of injuries and physical fitness during Federal Bureau of Investigation new agent training

    PubMed Central

    2011-01-01

    Background A retrospective examination was conducted of injuries, physical fitness, and their association among Federal Bureau of Investigation (FBI) new agent trainees. Methods Injuries and activities associated with injuries were obtained from a review of medical records in the medical clinic that served the new agents. A physical fitness test (PFT) was administered at Weeks 1, 7 and 14 of the 17-week new agent training course. The PFT consisted of push-ups, sit-ups, pull-ups, a 300-meter sprint, and a 1.5-mile run. Injury data were available from 2000 to 2008 and fitness data were available from 2004 to early 2009. Results During the survey period, 37% of men and 44% of women experienced one or more injuries during the new agent training course (risk ratio (women/men) = 1.18, 95% confidence interval = 1.07-1.31). The most common injury diagnoses were musculoskeletal pain (not otherwise specified) (27%), strains (11%), sprains (10%), contusions (9%), and abrasions/lacerations (9%). Activities associated with injury included defensive tactics training (48%), physical fitness training (26%), physical fitness testing (6%), and firearms training (6%). Over a 6-year period, there was little difference in performance of push-ups, sit-ups, pull-ups, or the 300-meter sprint; 1.5-mile run performance was higher in recent years. Among both men and women, higher injury incidence was associated with lower performance on any of the physical fitness measures. Conclusion This investigation documented injury diagnoses, activities associated with injury, and changes in physical fitness, and demonstrated that higher levels of physical fitness were associated with lower injury risk. PMID:21981817

  6. Bony injuries in homicide cases (1994-2014). A retrospective study.

    PubMed

    Flieger, Alexander; Kölzer, Sarah C; Plenzig, Stefanie; Heinbuch, Sara; Kettner, Mattias; Ramsthaler, Frank; Verhoff, Marcel A

    2016-09-01

    Even when human skeletal remains are found in contexts indicative of body disposal after homicide, none of the bones may manifest injuries. When skeletons are incomplete, there are two possibilities, the injured bones are missing or none were injured. This leads to the question how frequently bones are injured during homicide, where the injuries tend to be placed, and whether the frequency of injury is related to the type of homicide. To answer these questions, the postmortem reports from all autopsies performed for homicide victims at the Institute of Legal Medicine at the University Hospital in Frankfurt am Main, Germany, between 1994 and 2014, were retrospectively evaluated for bony injuries discovered during autopsy. In 90 cases, a preliminary postmortem computed tomography (pmCT) examination had been performed. The cases were categorized into the following five groups by type of fatal trauma: blunt force, sharp force, gunshot injury, strangulation, or other. In total, the postmortem reports for 897 homicides (527 male, 370 female) were evaluated. The number of victims per trauma category were sharp force, 309; blunt force, 179; gunshot injury, 242; strangulation, 92; and other, 75. Bony injuries had been reported in 70.9 % of the homicides. The "gunshot" category contained the highest proportion of victims with bony injuries (92.6 %). With 80.4 %, the second-highest proportion of victims with bony injuries was in the "blunt force" category, followed by 66.3 % of victims in the "sharp force" group. In contrast, with 53.3 %, the second-lowest proportion of victims with bony injuries was in the "strangulation" category, which contained a preponderance of female victims, followed by 17.3 % of victims with bony injuries in the "other" category. Bony injuries thus occurred in the majority of homicides. Forensic osteological analysis should, therefore, always be performed on badly decomposed human remains. Where necessary, the additional use of visualization

  7. Relationship of early-life trauma, war-related trauma, personality traits, and PTSD symptom severity: a retrospective study on female civilian victims of war

    PubMed Central

    Stevanović, Aleksandra; Frančišković, Tanja; Vermetten, Eric

    2016-01-01

    Background Consequences of war-related traumatisation have mostly been investigated in military and predominant male populations, while research on female civilian victims of war has been neglected. Furthermore, research of post-war posttraumatic stress disorder (PTSD) in women has rarely included early-life trauma in their prediction models, so the contribution of trauma in childhood and early youth is still unexplored. Objective To examine the relationship of early-life trauma, war-related trauma, personality traits, and symptoms of posttraumatic stress among female civilian victims of the recent war in Croatia. Method The cross-sectional study included 394 participants, 293 war-traumatised adult women civilians, and 101 women without war-related trauma. Participants were recruited using the snowball sampling method. The applied instruments included the Clinician-Administrated PTSD Scale (CAPS), the NEO Personality Inventory-Revised (NEO-PI-R), the War Stressors Assessment Questionnaire (WSAQ), and the Early Trauma Inventory Self Report-Short Form (ETISR-SF). A hierarchical multiple regression analysis was performed to assess the prediction model of PTSD symptom severity measured by CAPS score for current PTSD. Results The prevalence of current PTSD (CAPS cut-off score=65) in this cohort was 20.7%. The regression model that included age, early-life trauma, war-related trauma, neuroticism, and extraversion as statistically significant predictors explained 45.8% of variance in PTSD symptoms. Conclusions Older age, exposure to early-life trauma, exposure to war-related traumatic events, high neuroticism, and low extraversion are independent factors associated with higher level of PTSD symptoms among women civilian victims of war. PMID:27056034

  8. Porcupine quill injuries in dogs: a retrospective of 296 cases (1998-2002).

    PubMed

    Johnson, Matthew D; Magnusson, Kristenn D; Shmon, Cindy L; Waldner, Cheryl

    2006-07-01

    The purpose of this retrospective study was to identify factors associated with quill injury in dogs. A second objective was to determine the risk of complications and any factors that would predict the likelihood of complications. Hospital records of 296 porcupine quill injuries in dogs from 1998 to 2002 were studied. There was an increased occurrence of porcupine encounters in the spring and fall months; Siberian huskies, rottweilers, and German shepherd crosses were significantly overrepresented for quill injuries. There was no association between risk of complications and either number of quills or antimicrobial use. Increasing time between quill injury and presentation was associated with an increased risk of complications. Because of the increased frequency of complication with a longer interval until presentation, clients should be strongly encouraged to bring the dog in as soon as the quill injury is discovered. Patients presented after 24 hours should be monitored closely during the first 3 weeks after injury, as most complications occurred during this time. PMID:16898110

  9. The War of Independence: a surgical algorithm for the treatment of head injury in the continental army.

    PubMed

    Sabourin, Victor M; Shah, Manan; Yick, Frederick; Gandhi, Chirag D; Prestigiacomo, Charles J

    2016-01-01

    The American Revolution was a gruesome warthat resulted in the independence of the United States of America from the British crown and countless casualties to both belligerents. However, from these desperate times, the treatment of traumatic head injury was elucidated, as were the origins of American neurosurgery in the 18th century. During the war, the surgical manual used by military field surgeons was titled Plain Concise Practical Remarks on the Treatment of Wounds and Fractures, by Dr. John Jones. This manual explains the different types of cranial injuries understood at that time as well as the relevant surgical treatment. This article seeks to review the surgical treatment of head injury in the Revolutionary War as outlined by Dr. Jones's manual. PMID:26274994

  10. E-Bike Injuries: Experience from an Urban Emergency Department—A Retrospective Study from Switzerland

    PubMed Central

    Papoutsi, Sylvana; Martinolli, Luca; Braun, Christian Tasso; Exadaktylos, Aristomenis K.

    2014-01-01

    Background. Between 2005 and 2012, annual sales of E-bikes in Switzerland increased from 1,792 to 52,941. This continuous and rapid transition from human-powered bicycles to an electric bicycle technology may indicate the increasing demand for low-cost transportation technology in combination with a healthy lifestyle. Material and Methods. In the present study, from April 2012 to September 2013, we retrospectively analysed E-bike accidents treated in the Emergency Department of our hospital by focusing on the following parameters: age, gender, time, period, and cause of the accident, as well as injury and outcome. Results. Patients were predominantly male. The mean age of injured E-cyclists was 47.5 years. The main causes of injury were self-accident. Most injuries were to the head/neck. The mean ISS was 8.48. The outcome showed that 9 patients were treated as outpatients, 9 were inpatients, and 5 patients were kept in the Intensive Care Unit (ICU). Only six patients underwent surgery (S). Discussion. This is the first attempt to evaluate E-bike injuries in Switzerland in an acute hospital setting. Since there is increasing popular preference for E-bikes as means of transportation and injuries to the head or neck are prevalent among E-cyclists, the hazard should not to be underestimated. PMID:24778880

  11. E-bike injuries: experience from an urban emergency department-a retrospective study from Switzerland.

    PubMed

    Papoutsi, Sylvana; Martinolli, Luca; Braun, Christian Tasso; Exadaktylos, Aristomenis K

    2014-01-01

    Background. Between 2005 and 2012, annual sales of E-bikes in Switzerland increased from 1,792 to 52,941. This continuous and rapid transition from human-powered bicycles to an electric bicycle technology may indicate the increasing demand for low-cost transportation technology in combination with a healthy lifestyle. Material and Methods. In the present study, from April 2012 to September 2013, we retrospectively analysed E-bike accidents treated in the Emergency Department of our hospital by focusing on the following parameters: age, gender, time, period, and cause of the accident, as well as injury and outcome. Results. Patients were predominantly male. The mean age of injured E-cyclists was 47.5 years. The main causes of injury were self-accident. Most injuries were to the head/neck. The mean ISS was 8.48. The outcome showed that 9 patients were treated as outpatients, 9 were inpatients, and 5 patients were kept in the Intensive Care Unit (ICU). Only six patients underwent surgery (S). Discussion. This is the first attempt to evaluate E-bike injuries in Switzerland in an acute hospital setting. Since there is increasing popular preference for E-bikes as means of transportation and injuries to the head or neck are prevalent among E-cyclists, the hazard should not to be underestimated. PMID:24778880

  12. A Retrospective Audit of Hundred Patients of Orbitozygomatic Fractures with Brain Injury

    PubMed Central

    Gulzar, Gupta; Sanjeev, Uppal; Rajinder, Mittal; Ranabir, Pal; Nikhil, Garg

    2014-01-01

    Background: Orbitozygomatic fracture that most commonly accompanies craniofacial injury is a challenge for medical science to reduce complications and to attain aesthetically satisfying results. Objective: To summarize our experiences with the optimum management of orbito-zygomatic fractures. Materials and Methods: This retrospective study was aimed at investigating indications and surgical approaches for orbitozygomatic fractures with clinical follow-up, particularly with regard to postoperative complications. Since 2010, 100 cases with faciomaxillary injury were assessed for Orbitozygomatic fractures with the help of physical examination, non-invasive investigations including computed tomography of the orbit. Patients were retrospectively analysed for data, such as mechanism of injury, classification of fracture, and complications. Results: Amongst 100 consecutive patients with orbito-zygomatic fractures an overwhelming majority were males (n=83). In the age distribution a great majority (45%) were in 30-45 years age group, followed by 15-30 years (22%) and 45-60 years (18%). So in the productive age group i.e. 15-60 years age group were affected mostly (85%) in our series. Among different injury mechanism, Road traffic accident affected most (69%) that landed up in orbito-zygomatic fractures followed by altercations (22%). We preferred Open reduction and internal fixation (ORIF) for 68% of the patients with orbito- zygomatic fractures, followed by closed reduction (12%). Conclusion: Ophthalmology consultation is recommended for all patients presenting with orbitozygomatic fractures, and is essential for patients with orbital blowout fractures, based on the high incidence of clinical ocular findings and injuries in this subgroup of patients. PMID:25177598

  13. Injury-related mortality in South Africa: a retrospective descriptive study of postmortem investigations

    PubMed Central

    Prinsloo, Megan; Pillay-van Wyk, Victoria; Gwebushe, Nomonde; Mathews, Shanaaz; Martin, Lorna J; Laubscher, Ria; Abrahams, Naeemah; Msemburi, William; Lombard, Carl; Bradshaw, Debbie

    2015-01-01

    Abstract Objective To investigate injury-related mortality in South Africa using a nationally representative sample and compare the results with previous estimates. Methods We conducted a retrospective descriptive study of medico-legal postmortem investigation data from mortuaries using a multistage random sample, stratified by urban and non-urban areas and mortuary size. We calculated age-specific and age-standardized mortality rates for external causes of death. Findings Postmortem reports revealed 52 493 injury-related deaths in 2009 (95% confidence interval, CI: 46 930–58 057). Almost half (25 499) were intentionally inflicted. Age-standardized mortality rates per 100 000 population were as follows: all injuries: 109.0 (95% CI: 97.1–121.0); homicide 38.4 (95% CI: 33.8–43.0; suicide 13.4 (95% CI: 11.6–15.2) and road-traffic injury 36.1 (95% CI: 30.9–41.3). Using postmortem reports, we found more than three times as many deaths from homicide and road-traffic injury than had been recorded by vital registration for this period. The homicide rate was similar to the estimate for South Africa from a global analysis, but road-traffic and suicide rates were almost fourfold higher. Conclusion This is the first nationally representative sample of injury-related mortality in South Africa. It provides more accurate estimates and cause-specific profiles that are not available from other sources. PMID:26229201

  14. Neonatal Injury at Cephalic Vaginal Delivery: A Retrospective Analysis of Extent of Association with Shoulder Dystocia

    PubMed Central

    Iskender, Cantekin; Kaymak, Oktay; Erkenekli, Kudret; Ustunyurt, Emin; Uygur, Dilek; Yakut, Halil Ibrahim; Danisman, Nuri

    2014-01-01

    Purpose To describe the risk factors and labor characteristics of Clavicular fracture (CF) and brachial plexus injury (BPI); and compare antenatal and labor characteristics and prognosis of obstetrical BPI associated with shoulder dystocia with obstetrical BPI not associated with shoulder dystocia. Methods This retrospective study consisted of women who gave birth to an infant with a fractured clavicle or BPI between January 2009 and June 2013. Antenatal and neonatal data were compared between groups. The control group (1300) was composed of the four singleton vaginal deliveries that immediately followed each birth injury. A multivariable logistic regression model, with backward elimination, was constructed in order to find independent risk factors associated with BPI and CF. A subgroup analysis involved comparison of features of BPI cases with or without associated shoulder dystocia. Results During the study period, the total number of vaginal deliveries was 44092. The rates of CF, BPI and shoulder dystocia during the study period were 0,6%, 0,16% and 0,29%, respectively. In the logistic regression model, shoulder dystocia, GDM, multiparity, gestational age >42 weeks, protracted labor, short second stage of labor and fetal birth weight greater than 4250 grams increased the risk of CF independently. Shoulder dystocia and protracted labor were independently associated with BPI when controlled for other factors. Among neonates with BPI whose injury was not associated with shoulder dystocia, five (12.2%) sustained permanent injury, whereas one neonate (4.5%) with BPI following shoulder dystocia sustained permanent injury (p = 0.34). Conclusion BPI not associated with shoulder dystocia might have a higher rate of concomitant CF and permanent sequelae. PMID:25144234

  15. If Hunters End Up in the Emergency Room: A Retrospective Analysis of Hunting Injuries in a Swiss Emergency Department

    PubMed Central

    Bestetti, Valentina; Fisher, Emma E.; Srivastava, David S.; Ricklin, Meret E.; Exadaktylos, Aristomenis K.

    2015-01-01

    Aim. to characterize the mechanisms, patterns, and outcomes of nonfatal hunting-related injuries in patients presenting to Bern University Hospital, Switzerland, and compare these to reports of hunting injuries worldwide. Methods. patients presenting with hunting-related injuries to the Emergency Department at Bern University hospital from 2000 to 2014 were identified by retrospectively searching the department database using the keyword “hunt.” Each case was analyzed in terms of the patient age and gender, the mechanism and pattern of injury, and management and patient follow-up. Results. 19 patients were identified. 16 were male with a mean age of 50 years (range: 16–74). Mechanisms of injury included firearm-related injuries, falls, and knife wounds. The most common patterns of injury were head injuries (7), followed by injuries to the upper (5) or lower limb (5) and trunk (2). Over half of the patients were admitted, and nine required emergency surgery. Conclusion. Nonfatal hunting accidents in Bern, Switzerland, are largely caused by firearms and falls and tend to occur in male hunters with a mean age of 50 years. The most common patterns of injury are orthopedic and head injuries, often requiring surgery. These findings are consistent with international studies of nonfatal hunting accidents. PMID:25834746

  16. Clinical case histories and sketches of gun-shot injuries from the Carlist War.

    PubMed

    Kaufman, M H

    2001-10-01

    The Anatomical Museum of the University of Edinburgh contains a substantial collection of human osteological preparations that display the effects of musket-ball and sabre injuries. Most of these formerly belonged to the Museum Collection associated with the class of Military Surgery. This collection had principally been amassed by Sir George Ballingall to illustrate his lectures when he was Regius Professor of Military Surgery in the University of Edinburgh from 1822-55. About half of the osteological preparations in his collection had been purchased from Dr Rutherford Alcock in 1843. Alcock had collected them when he was Deputy Inspector General of Hospitals to the British Auxiliary Legion in Spain during the Carlist War of 1835-37. Just under 60% of the osteological preparations purchased from Alcock still remain on display in the Anatomy Museum of the University of Edinburgh. Previously, the only information on these items was that published in Ballingall's Catalogue of the Museum attached to the Class of Military Surgery, published in 1855. Very recently, twelve volumes of manuscript material, consisting principally of clinical case records prepared by Alcock and his medical officers have been located in the Special Collections Section of Edinburgh University Library. This has now enabled the full clinical case records of the majority of the individuals whose osteological preparations are still available in the collection to be studied. This manuscript material provides a unique record of the treatment of the sick and wounded men in this campaign. It also allows the clinical records of men wounded by musket-ball to be studied with their associated bony lesions. PMID:11697696

  17. Alpine skiing injuries in Finland – a two-year retrospective study based on a questionnaire among Ski racers

    PubMed Central

    2014-01-01

    Background Alpine skiing is one of the most popular winter sports in the world. Nevertheless, it has always been associated with a high risk of injury. There are however, only a few studies that have examined the risk of injury of competitive skiers, especially of the junior ski racers. Methods The inclusion criterion was an injury in alpine skiing resulting in a pause in training longer than one week. Athletes of all ages were included. The study period was from the start of the season of 2008–2009 to end of the season of 2009–2010 (two years). Results The average annual number of ski racers in Finland was 661. There were 61 injuries (36 males with a median age of 14 years, 25 females with a median age of 14) fulfilling the inclusion criteria. Ligamentous knee injury was the most frequent (17) and lower leg fracture the second common (16) injury, respectively. There was a female dominance in the ACL injuries. Only one major abdominal injury and no major head injuries were observed. The overall training pause was 26 weeks after the ACL injury and 17 weeks after the lower leg fracture, respectively. Conclusion The most common and most disabling injuries affect the knee and the lower leg. The high number of lower leg and ACL injuries is alarming. A continuous and careful monitoring of injuries needs to be established to assess this trend. A systematic review of injuries is the appropriate way to monitor the effects of changes made in terms of safety. The present retrospective two-year pilot study forms a base for a continuous alpine ski injury survey in Finland. PMID:24565467

  18. Pulsatile lavage for pressure ulcer management in spinal cord injury: a retrospective clinical safety review.

    PubMed

    Bogie, Kath M; Ho, Chester H

    2013-03-01

    Pressure ulcers are major complications of reduced mobility and/or sensation. Pulsatile lavage therapy delivers localized hydrotherapy directly to the wound utilizing a pulsatile pressurized stream of normal saline. The purpose of this study was to evaluate the clinical safety of pulsatile lavage therapy, provided daily at the bedside, in routine management of Stage III and Stage IV pressure ulcers. Charts from 28 male patients with Stage III and Stage IV pressure ulcers and spinal cord injury (SCI) or spinal cord disorders (SCD) were retrospectively reviewed for documentation of adverse events/safety concerns. Mean therapy duration was 46 days (SD 37 days, range 6-152 days). Treatment was interrupted for 6 days in one patient due to minor wound bleeding. No other adverse events, including backsplash injuries, were documented. The results of this chart review suggest pulsatile lavage therapy can be administered at the patient's bedside without adverse events if appropriate protocols are followed. Additional research to confirm the efficacy and effectiveness of this treatment modality in a broader subject population is warranted. PMID:23475450

  19. Management of war-related burn injuries: lessons learned from recent ongoing conflicts providing exceptional care in unusual places.

    PubMed

    Atiyeh, Bishara S; Hayek, Shady N

    2010-09-01

    Thermal injury is a sad but common and obligatory component of armed conflicts. Although the frequency of noncombat burns has decreased, overall incidence of burns in current military operations has nearly doubled during the past few years. Burn injuries in the military environment do not need to be hostile in nature. Burns resulting from carelessness outnumber those resulting from hostile action. Unfortunately, civilians are becoming the major targets in modern-day conflicts; they account for more than 80% of those killed and wounded in present-day conflicts. The provision of military burn care mirrors the civilian standards; however, several aspects of treatment of war-related burn injuries are peculiar to the war situation itself and to the specific conditions of each armed conflict. Important aspects of management of burned military personnel include triage to ensure that available medical care resources are matched to the severity of burn injury and the number of burn casualties, initial management and resuscitation in the combat zone, and subsequent evacuation to higher echelons of medical care, each with increasing medical capabilities. Care of military victims is usually well structured and follows strict guidelines for first aid and evacuation to field hospitals by military personnel usually having had some form of training in first aid and resuscitation and for which necessary equipment and material for such interventions are more or less available. Options available for civilian injury intervention in wartime, however, are limited. Of all pre-hospital transport of civilian victims, 70% are done by lay public and 93% receive in the field, or during transport, some form of basic first aid administered by relatives, friends, or other first responders not trained for such interventions. Civilian casualties frequently represents 60% to 80% of all injured admitted to the level III facilities of overseas forces stationed throughout the host country. Unlike

  20. The prevalence and severity of injuries in field hockey drag flickers: a retrospective cross-sectional study.

    PubMed

    Ng, Leo; Sherry, Dorianne; Loh, Wei Bing; Sjurseth, Andreas Myhre; Iyengar, Shrikant; Wild, Catherine; Rosalie, Simon

    2016-09-01

    The drag flick is the preferred method of scoring during a penalty corner in field hockey. Performing the drag flick requires a combination of strength, coordination and timing, which may increase susceptibility to injuries. However, injury prevalence in drag flickers has not previously been investigated. Therefore, this study compared the injury prevalence and severity of lower limb and lower back injuries between drag flickers and non-drag flickers in field hockey. A total of 432 local, national and international adult field hockey players (242 males, 188 females) completed an online questionnaire to retrospectively determine the 3-month prevalence and severity of ankle, knee, hip and lower back injuries. Of this group, 140 self-identified as drag flickers and 292 as non-drag flickers. The results showed that drag flickers had significantly higher prevalence of hip (OR: 1.541; 95% CI: 1.014, 2.343) and lower back injury (OR: 1.564; 95% CI: 1.034, 2.365) compared to non-drag flickers. No significant differences were observed between drag flickers and non-drag flickers in injury prevalence at the ankle and knee. There were no significant between-group differences in injury severity scores. Overall, the prevalence of hip and lower back injuries was significantly higher in drag flickers compared to non-drag flickers. PMID:26760078

  1. Medical Efforts and Injury Patterns of Military Hospital Patients Following the 2013 Lushan Earthquake in China: A Retrospective Study.

    PubMed

    Kang, Peng; Tang, Bihan; Liu, Yuan; Liu, Xu; Liu, Zhipeng; Lv, Yipeng; Zhang, Lulu

    2015-09-01

    The aim of this paper is to investigate medical efforts and injury profiles of victims of the Lushan earthquake admitted to three military hospitals. This study retrospectively investigated the clinical records of 266 admitted patients evacuated from the Lushan earthquake area. The 2005 version of the Abbreviated Injury Scale (AIS-2005) was used to identify the severity of each injury. Patient demographic data, complaints, diagnoses, injury types, prognosis, means of transportation, and cause of injury were all reviewed individually. The statistical analysis of the study was conducted primarily using descriptive statistics. Of the 266 patients, 213 (80.1%) were admitted in the first two days. A total of 521 injury diagnoses were recorded in 266 patients. Earthquake-related injuries were primarily caused by buildings collapsing (38.4%) and victims being struck by objects (33.8%); the most frequently injured anatomic sites were the lower extremities and pelvis (34.2%) and surface area of the body (17.9%). Fracture (41.5%) was the most frequent injury, followed by soft tissue injury (27.5%), but crush syndrome was relatively low (1.2%) due to the special housing structures in the Lushan area. The most commonly used procedure was suture and dressings (33.7%), followed by open reduction and internal fixation (21.9%).The results of this study help formulate recommendations to improve future disaster relief and emergency planning in remote, isolated, and rural regions of developing countries. PMID:26334286

  2. Medical Efforts and Injury Patterns of Military Hospital Patients Following the 2013 Lushan Earthquake in China: A Retrospective Study

    PubMed Central

    Kang, Peng; Tang, Bihan; Liu, Yuan; Liu, Xu; Liu, Zhipeng; Lv, Yipeng; Zhang, Lulu

    2015-01-01

    The aim of this paper is to investigate medical efforts and injury profiles of victims of the Lushan earthquake admitted to three military hospitals. This study retrospectively investigated the clinical records of 266 admitted patients evacuated from the Lushan earthquake area. The 2005 version of the Abbreviated Injury Scale (AIS-2005) was used to identify the severity of each injury. Patient demographic data, complaints, diagnoses, injury types, prognosis, means of transportation, and cause of injury were all reviewed individually. The statistical analysis of the study was conducted primarily using descriptive statistics. Of the 266 patients, 213 (80.1%) were admitted in the first two days. A total of 521 injury diagnoses were recorded in 266 patients. Earthquake-related injuries were primarily caused by buildings collapsing (38.4%) and victims being struck by objects (33.8%); the most frequently injured anatomic sites were the lower extremities and pelvis (34.2%) and surface area of the body (17.9%). Fracture (41.5%) was the most frequent injury, followed by soft tissue injury (27.5%), but crush syndrome was relatively low (1.2%) due to the special housing structures in the Lushan area. The most commonly used procedure was suture and dressings (33.7%), followed by open reduction and internal fixation (21.9%).The results of this study help formulate recommendations to improve future disaster relief and emergency planning in remote, isolated, and rural regions of developing countries. PMID:26334286

  3. Injury epidemiology after the 2001 Gujarat earthquake in India: a retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster

    PubMed Central

    Phalkey, Revati; Reinhardt, Jan D.; Marx, Michael

    2011-01-01

    Background The number of injured far exceeds those dead and the average injury to mortality ratio in earthquakes stands at 3:1. Immediate effective medical response significantly influences injury outcomes and thus the overall health impact of earthquakes. Inadequate or mismanagement of injuries may lead to disabilities. The lack of precise data from immediate aftermath is seen as a remarkable weak point in disaster epidemiology and warrants evidence generation. Objective To analyze the epidemiology of injuries and the treatment imparted at a secondary rural hospital in the Kutch district, Gujarat, India following the January 26, 2001 earthquake. Design/Methods Discharge reports of patients admitted to the hospital over 10 weeks were analyzed retrospectively for earthquake-related injuries. Results Orthopedic injuries, (particularly fractures of the lower limbs) were predominant and serious injuries like head, chest, abdominal, and crush syndrome were minimal. Wound infections were reported in almost 20% of the admitted cases. Surgical procedures were more common than conservative treatment. The most frequently performed surgical procedures were open reduction with internal fixation and cleaning and debridement of contaminated wounds. Four secondary deaths and 102 transfers to tertiary care due to complications were reported. Conclusion The injury epidemiology reported in this study is in general agreement with most other studies reporting injury epidemiology except higher incidence of distal orthopedic injuries particularly to the lower extremities. We also found that young males were more prone to sustaining injuries. These results warrant further research. Inconsistent data reporting procedures against the backdrop of inherent disaster data incompleteness calls for urgent standardization of reporting earthquake injuries for evidence-based response policy planning. PMID:21799668

  4. Incidence of Soft-Tissue Injuries in Patients with Posterolateral Tibial Plateau Fractures: A Retrospective Review from 2009 to 2014.

    PubMed

    Wang, Yanqing; Cao, Fujiang; Liu, Minghui; Wang, Jiantao; Jia, Shikong

    2016-08-01

    Objective The goal of this study was to determine the incidence of soft-tissue injuries in patients with posterolateral tibial plateau fractures. Methods The data of 265 patients who had sustained posterolateral tibial plateau fractures between May 2009 and Aug 2014 were retrospectively reviewed using a picture archiving and communication system. Fractures were classified according to the Schatzker, AO/OTA, and quadrant classification systems. Soft-tissue injuries, including anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), medial collateral ligament (MCL), lateral meniscus, and medial meniscus injuries, were assessed using magnetic resonance imaging (MRI) data. Results The overall incidence of ACL and PCL tears was 80 and 36%, respectively. Nine (36%) patients sustained ACL footprint avulsions and three (12%) had complete ACL tears. A total of 19 (76%) patients had LCL injuries, and 15 (64%) had MCL injuries. The incidence of lateral meniscus tears was 48%, while that of medial meniscus tears was 4%. Conclusion Posterolateral tibial plateau fractures were associated with a high incidence of soft-tissue injuries, especially ACL footprint avulsions and lateral meniscus tears. The preoperative MRI examination was important for surgeons to decide whether the ligament and meniscal injuries should be treated simultaneously with the repair of the bone fractures. PMID:27183240

  5. Epidemiology of training injuries in amateur taekwondo athletes: a retrospective cohort study.

    PubMed

    Lystad, R P; Graham, P L; Poulos, R G

    2015-09-01

    The objectives of this study were to estimate the incidence and describe the pattern and severity of training injuries in taekwondo, and to compare pattern and severity of training injuries with competition injuries. One hundred and fifty-two active Australian amateur taekwondo athletes, aged 12 years or over, completed an online survey comprising questions on training exposure and injury history over the preceding 12 months. The main outcome measures were: overall injury incidence rate per athlete-year; training injury incidence rate per athlete-year, per 1000 athlete-training-sessions, and per 1000 athlete-hours of training; injury severity; and injury proportions by anatomical region and by type of injury. Injury incidence rates were calculated with 95% confidence intervals using standard methods, while injury proportions were compared using Fisher's exact test. The vast majority (81.5%) of taekwondo injuries in an average athlete-year occurred during training. The training injury incidence rate was estimated to be 1.6 (95% CI: 1.4, 1.9) per athlete-year, 11.8 (95% CI: 10.4, 13.4) per 1000 athlete-training-sessions, and 7.0 (95% CI: 6.1, 7.9) per 1000 athlete-hours of training. Among athletes with five or fewer injuries, the severity and injury pattern of training injuries were, by and large, the same as for competition injuries. Approximately sixty percent (60.3%) of training injuries required treatment by a health professional. Considering the burden of training injuries exceeds that of competition injuries, taekwondo governing bodies and stakeholders are encouraged to devote more efforts towards the identification of risk factors for, and prevention of, training injuries in the sport of taekwondo. PMID:26424924

  6. Epidemiology of training injuries in amateur taekwondo athletes: a retrospective cohort study

    PubMed Central

    Graham, PL; Poulos, RG

    2015-01-01

    The objectives of this study were to estimate the incidence and describe the pattern and severity of training injuries in taekwondo, and to compare pattern and severity of training injuries with competition injuries. One hundred and fifty-two active Australian amateur taekwondo athletes, aged 12 years or over, completed an online survey comprising questions on training exposure and injury history over the preceding 12 months. The main outcome measures were: overall injury incidence rate per athlete-year; training injury incidence rate per athlete-year, per 1000 athlete-training-sessions, and per 1000 athlete-hours of training; injury severity; and injury proportions by anatomical region and by type of injury. Injury incidence rates were calculated with 95% confidence intervals using standard methods, while injury proportions were compared using Fisher's exact test. The vast majority (81.5%) of taekwondo injuries in an average athlete-year occurred during training. The training injury incidence rate was estimated to be 1.6 (95% CI: 1.4, 1.9) per athlete-year, 11.8 (95% CI: 10.4, 13.4) per 1000 athlete-training-sessions, and 7.0 (95% CI: 6.1, 7.9) per 1000 athlete-hours of training. Among athletes with five or fewer injuries, the severity and injury pattern of training injuries were, by and large, the same as for competition injuries. Approximately sixty percent (60.3%) of training injuries required treatment by a health professional. Considering the burden of training injuries exceeds that of competition injuries, taekwondo governing bodies and stakeholders are encouraged to devote more efforts towards the identification of risk factors for, and prevention of, training injuries in the sport of taekwondo. PMID:26424924

  7. Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis

    PubMed Central

    Mallhi, Tauqeer Hussain; Khan, Amer Hayat; Adnan, Azreen Syazril; Sarriff, Azmi; Khan, Yusra Habib; Jummaat, Fauziah

    2015-01-01

    Background Dengue induced acute kidney injury (AKI) imposes heavy burden of illness in terms of morbidity and mortality. A retrospective study was conducted to investigate incidence, characteristics, risk factors and clinical outcomes of AKI among dengue patients. Methodology A total 667 dengue patients (2008–2013) were retrospectively evaluated and were stratified into AKI and non-AKI groups by using AKIN criteria. Two groups were compared by using appropriate statistical methods. Results There were 95 patients (14.2%) who had AKI, with AKIN-I, AKIN-II and AKIN-III in 76.8%, 16.8% and 6.4% patients, respectively. Significant differences (P<0.05) in demographics and clinico-laboratory characteristics were observed between patients with and without AKI. Presence of dengue hemorrhagic fever [OR (95% CI): 8.0 (3.64–17.59), P<0.001], rhabdomyolysis [OR (95% CI): 7.9 (3.04–20.49)], multiple organ dysfunction [OR (95% CI): 34.6 (14.14–84.73), P<0.001], diabetes mellitus [OR (95% CI): 4.7 (1.12–19.86), P = 0.034], late hospitalization [OR (95% CI): 2.1 (1.12–19.86), P = 0.033] and use of nephrotoxic drugs [OR (95% CI): 2.9 (1.12–19.86), P = 0.006] were associated with AKI. Longer hospital stay (>3 days) was also observed among AKI patients (OR = 1.3, P = 0.044). Additionally, 48.4% AKI patients had renal insufficiencies at discharge that were signicantly associated with severe dengue, secondary infection and diabetes mellitus. Overall mortality was 1.2% and all fatal cases had AKI. Conclusions The incidence of AKI is high at 14.2% among dengue patients, and those with AKI portended significant morbidity, mortality, longer hospital stay and poor renal outcomes. Our findings suggest that AKI in dengue is likely to increase healthcare burden that underscores the need of clinicians’ alertness to this highly morbid and potentially fatal complication for optimal prevention and management. PMID:26421839

  8. Returning Veterans on Campus with War Related Injuries and the Long Road Back Home

    ERIC Educational Resources Information Center

    Church, Thomas E.

    2009-01-01

    This article reviews the growing numbers of returning military personnel attending higher education based on emerging national trends, including the new GI Educational Bill, amendments to the ADA, and the rising unemployment rate. The trauma of war and the high survival rate have resulted in a high percentage of veterans returning from the Global…

  9. Outcome and Predicting Factor Following Severe Traumatic Brain Injury: A Retrospective Cross-Sectional Study

    PubMed Central

    Khajavikhan, Javaher; Vasigh, Aminolah; Khani, Ali; Kokhazade, Taleb

    2016-01-01

    Introduction Severe traumatic brain injury (TBI) is a major and challenging problem in critical care medicine. Aim To assess the outcome and predicting factor following severe TBI. Materials and Methods This is a retrospective and cross-sectional study. Data were collected from two sections; one section consisting of a questionnaire answered by the patients and other section from the patient records. The instruments used included the Glasgow Outcome Scale (GOS), SF-36 and the Hospital Anxiety and Depression Scale (HAD). Results The mortality rate of the patients was 46.2%. The quality of life (QOL) of the patients in most dimension were impaired and (58%) of patients had unfavourable QOL. About (37.5%) of patients with anxiety and (27.5%) had a depression. A significant correlation was found between age, GCS arrival, length of ICU stay, mechanical ventilation, VAP & ARDS and pupil reactivity with QOL, GOS, HAD-A and HAD-D (p<0.05, p< 0.001). GCS arrival a predicate factor for QOL and GOS (p <0.001, OR: 1.75, 1.94 respectively); length of ICU stay a predicate factor for QOL and GOS (p <0.05, OR : 1.11, 1.28 respectively); mechanical ventilation a predicate factor for GOS (p <0.001, OR : 1.78); ventilation associated pneumonia (VAP) & acute respiratory distress syndrome (ARDS) and pupil reactivity a predicate factor for GOS (p <0.05, OR : 1.36; p<0.001, OR: 1.94 respectively). The GCS arrival and ICU stay a predicate factor for HAD-A (p<0.05, OR: 1.73, 1.38 respectively). Conclusion With respect to results advanced in pre hospital, medical and surgical care for the decrease in mortality rates of Head trauma (HT), the use of trauma triage tools and strict enforcement of traffic rules are necessary. PMID:27042518

  10. Retrospective Analysis of Levetiracetam Compared to Phenytoin for Seizure Prophylaxis in Adults with Traumatic Brain Injury

    PubMed Central

    Caballero, G. Christina; Hughes, Darrel W.; Maxwell, Pamela R.; Green, Kay; Gamboa, Conrado D.; Barthol, Colleen A.

    2013-01-01

    Background: Phenytoin is standard of care for seizure prophylaxis following traumatic brain injury (TBI). Levetiracetam, an alternative antiepileptic drug, is utilized for seizure prophylaxis despite limited data supporting its use. Objective: Our primary outcome was post-TBI seizure activity measured by electroencephalogram (EEG) for levetiracetam versus phenytoin. Secondary outcomes were length of intensive care unit (ICU) stay, requirement for additional antiepileptic drugs (AED), and drug and monitoring costs. Methods: A retrospective review was performed of patients admitted to neurosurgical or surgical trauma ICU. Adult patients with at least 1 day of EEG monitoring were included. Patients were excluded if they had history of epilepsy, prior TBI, less than 48 hours of AED therapy, or additional AED prior to EEG monitoring. Results: A total 90 patients met inclusion criteria, with 18 receiving levetiracetam and 72 receiving phenytoin. Prevalence of EEG-confirmed seizure activity was similar between the levetiracetam and phenytoin groups (28% vs 29%; P = .99). ICU length of stay (13 vs 18 days; P = .28), time to EEG-confirmed seizure activity (4 vs 6 days; P = .24), and duration of seizure prophylaxis (9 vs 14 days; P = .18) were also similar. The median daily cost of levetiracetam therapy was $43 compared to $55 for phenytoin therapy and monitoring (P = .08). When all anticonvulsant therapy and monitoring were included, costs were lower for the levetiracetam group ($45 vs $83; P = .02). Conclusion: Levetiracetam may provide an alternative treatment option for seizure prevention in TBI patients in the ICU. Total antiepileptic drug and monitoring costs were lower for levetiracetam patients. PMID:24421550

  11. Identifying future ‘unexpected’ survivors: a retrospective cohort study of fatal injury patterns in victims of improvised explosive devices

    PubMed Central

    Singleton, James A G; Gibb, Iain E; Hunt, Nicholas C A; Bull, Anthony M J; Clasper, Jonathan C

    2013-01-01

    Objectives To identify potentially fatal injury patterns in explosive blast fatalities in order to focus research and mitigation strategies, to further improve survival rates from blast trauma. Design Retrospective cohort study. Participants UK military personnel killed by improvised explosive device (IED) blasts in Afghanistan, November 2007–August 2010. Setting UK military deployment, through NATO, in support of the International Security Assistance Force (ISAF) mission in Afghanistan. Data sources UK military postmortem CT records, UK Joint Theatre Trauma Registry and associated incident data. Main outcome measures Potentially fatal injuries attributable to IEDs. Results We identified 121 cases, 42 mounted (in-vehicle) and 79 dismounted (on foot), at a point of wounding. There were 354 potentially fatal injuries in total. Leading causes of death were traumatic brain injury (50%, 62/124 fatal injuries), followed by intracavity haemorrhage (20.2%, 25/124) in the mounted group, and extremity haemorrhage (42.6%, 98/230 fatal injuries), junctional haemorrhage (22.2%, 51/230 fatal injuries) and traumatic brain injury (18.7%, 43/230 fatal injuries) in the dismounted group. Conclusions Head trauma severity in both mounted and dismounted IED fatalities indicated prevention and mitigation as the most effective strategies to decrease resultant mortality. Two-thirds of dismounted fatalities had haemorrhage implicated as a cause of death that may have been anatomically amenable to prehospital intervention. One-fifth of the mounted fatalities had haemorrhagic trauma which currently could only be addressed surgically. Maintaining the drive to improve all haemostatic techniques for blast casualties, from point of wounding to definitive surgical proximal vascular control, alongside the development and application of novel haemostatic interventions could yield a significant survival benefit. Prospective studies in this field are indicated. PMID:23906957

  12. Spectrum of ocular firework injuries in children: A 5-year retrospective study during a festive season in Southern India

    PubMed Central

    John, Deepa; Philip, Swetha Sara; Mittal, Rashmi; John, Sheeja Susan; Paul, Padma

    2015-01-01

    Purpose: Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. Materials and Methods: A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days - the day of Diwali, 1 day before, and 1 day after Diwali - were included in this study. Results: Eighty-four children presented with firework-related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty-four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval - 2–13%). Conclusion: Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered. PMID:26669336

  13. Patterns of maxillofacial injuries caused by terrorist attacks in Iraq: retrospective study.

    PubMed

    Gataa, I S; Muassa, Q H

    2011-01-01

    Over the past 5 years, Iraq has witnessed daily terrorist attacks mainly using improvised explosive devices. The aim of this study was to analyze the patterns of maxillofacial injuries caused by terrorist attacks in a sample of Iraqi casualties. Records from two hospitals, including 551 patients who sustained maxillofacial injuries due to terrorists attacks, were analyzed according to the patients' age, sex, site of injury, type of injury and cause of injury. Concomitant injuries and mortality were also considered. The most common age group affected was those aged 15-29 years. Most of these injuries were caused by improvised explosive devices (71%). More than one facial zone was injured in 212 patients (38%). Isolated soft tissues injuries were detected in (54%) of victims. Pure maxillofacial injuries comprised 33%. The most common injuries associated with this type of trauma were eye injuries (29%). The mortality rate was 2% from pure maxillofacial injuries. Terrorist attacks cause unique maxillofacial injuries, which should be considered a new entity in the trauma field. PMID:20728310

  14. Differences in Injury Pattern and Prevalence of Cartilage Lesions in Knee and Ankle Joints: A Retrospective Cohort Study

    PubMed Central

    Aurich, Matthias; Hofmann, Gunther O.; Rolauffs, Bernd; Gras, Florian

    2014-01-01

    Osteoarthritis (OA) is more common in the knee compared to the ankle joint. This can not be explained exclusively by anatomical and biomechanical differences. The aim of this study is to analyze and compare the injury pattern (clinically) and the cartilage lesions (arthroscopically) of knee and ankle joints in a cohort of patients from the same catchment area. A retrospective study of the clinical data of 3122 patients (2139 outpatients and 983 inpatients) was performed, who were treated due to an injury of the knee and ankle joint. Statistical analysis was performed using SigmaStat 3.0 (SPSS Inc, Chicago, USA). There is a higher prevalence of injuries in the ankle as compared to the knee joint in this population from the same catchment area. In contrast, high-grade cartilage lesions are more prevalent in the knee, whereas low grade cartilage lesions are equally distributed between knee and ankle. From this data it can be concluded that the frequency of injuries and the injury pattern of knee versus ankle joints do not correlate with the severity of cartilage lesions and may therefore have no direct influence on the differential incidence of OA in those two joints. PMID:25568732

  15. Differences in injury pattern and prevalence of cartilage lesions in knee and ankle joints: a retrospective cohort study.

    PubMed

    Aurich, Matthias; Hofmann, Gunther O; Rolauffs, Bernd; Gras, Florian

    2014-10-27

    Osteoarthritis (OA) is more common in the knee compared to the ankle joint. This can not be explained exclusively by anatomical and biomechanical differences. The aim of this study is to analyze and compare the injury pattern (clinically) and the cartilage lesions (arthroscopically) of knee and ankle joints in a cohort of patients from the same catchment area. A retrospective study of the clinical data of 3122 patients (2139 outpatients and 983 inpatients) was performed, who were treated due to an injury of the knee and ankle joint. Statistical analysis was performed using SigmaStat 3.0 (SPSS Inc, Chicago, USA). There is a higher prevalence of injuries in the ankle as compared to the knee joint in this population from the same catchment area. In contrast, high-grade cartilage lesions are more prevalent in the knee, whereas low grade cartilage lesions are equally distributed between knee and ankle. From this data it can be concluded that the frequency of injuries and the injury pattern of knee versus ankle joints do not correlate with the severity of cartilage lesions and may therefore have no direct influence on the differential incidence of OA in those two joints. PMID:25568732

  16. Risk Factors for Acute Kidney Injury in Older Adults With Critical Illness: A Retrospective Cohort Study

    PubMed Central

    Kane-Gill, Sandra L.; Sileanu, Florentina E.; Murugan, Raghavan; Trietley, Gregory S.; Handler, Steven M.; Kellum, John A.

    2014-01-01

    Background Risk for acute kidney injury (AKI) in older adults has not been systematically evaluated. We sought to delineate the determinants of risk for AKI in older compared to younger adults. Study Design Retrospective analysis of patients hospitalized in July 2000–September 2008. Setting & Participants We identified all adult patients admitted to an intensive care unit (ICU) (n=45,655) in a large tertiary care university hospital system. We excluded patients receiving dialysis or kidney transplant prior to hospital admission, and patients with baseline creatinine ≥ 4 mg/dl, liver transplantation, indeterminate AKI status, or unknown age, leaving 39,938 patients. Predictor We collected data on multiple susceptibilities and exposures including age, sex, race, body mass, comorbid conditions, severity of illness, baseline kidney function, sepsis, and shock. Outcomes We defined AKI according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria. We examined susceptibilities and exposures across age strata for impact on development of AKI. Measurements We calculated area under the receiver operating characteristic curve (AUC) for prediction of AKI across age groups. Results 25,230 patients (63.2%) were aged 55 years or older. Overall 25,120 patients (62.9%) developed AKI (69.2% aged 55 years or older). Examples of risk factors for AKI in the oldest age category (75 years or older) were drugs (vancomycin, aminoglycosides, nonsteroidal anti-inflammatories), history of hypertension (OR, 1.13; 95% CI, 1.02–1.25) and sepsis (OR, 2.12; 95% CI, 1.68–2.67). Fewer variables remained predictive of AKI as age increased and the model for older patients was less predictive (p<0.001). For the age categories 18–54, 55–64, 65–74, and 75 years or older, the AUCs were 0.744 (95% CI, 0.735–0.752), 0.714 (95% CI, 0.702–0.726), 0.706 (95% CI, 0.693–0.718), and 0.673 (95% CI, 0.661–0.685), respectively. Limitations Analysis may not apply to non-ICU patients

  17. A 2-year retrospective analysis of facial injuries in patients treated at department of oral and maxillofacial surgery, IGGDC, Jammu, India

    PubMed Central

    Lone, Parveen; Singh, Amrit Pal; Kour, Indumeet; Kumar, Misha

    2014-01-01

    Introduction: The incidence of maxillofacial injuries is on the rise due to motor vehicle accidents and increased incidence of violence in recent times. The aim of this retrospective study was to determine the incidence, etiology, and the pattern of fractures in the maxillofacial region. Materials and Methods: After obtaining permission from the concerned authorities, a predesigned questionnaire was used to collect the necessary data from the department. A retrospective analysis of 787 patients, who suffered trauma and were managed in the Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College (IGGDC), Jammu over a period of 2 years was carried out. Results: Road traffic accident (RTA) was the common cause of maxillofacial injuries. Men sustained more injuries as compared to women. Injuries were most commonly sustained in the age group of 11-40 years, constituting about 76% of all injuries, mandibular fractures were the most common. Conclusion: RTAs were the commonest cause for the maxillofacial injuries. PMID:25937724

  18. Can a Specific Neck Strengthening Program Decrease Cervical Spine Injuries in a Men's Professional Rugby Union Team? A Retrospective Analysis

    PubMed Central

    Naish, Robert; Burnett, Angus; Burrows, Sally; Andrews, Warren; Appleby, Brendyn

    2013-01-01

    Cervical spine injuries in Rugby Union are a concerning issue at all levels of the game. The primary aim of this retrospective analysis conducted in a professional Rugby Union squad was to determine whether a 26-week isometric neck strengthening intervention program (13-week strengthening phase and 13-week maintenance phase) was effective in reducing the number and severity of cervical spine injuries. The secondary aim was to determine whether at week five, where the program had been the similar for all players, there was increased isometric neck strength. All 27 players who were common to both the 2007-2008 and 2008-2009 seasons were included in this analysis and data was extracted from a Sports Medicine/Sports Science database which included the squad's injury records. Primary outcome variables included; the number of cervical spine injuries and the severity of these injuries as determined by the total number of days lost from training and competition. Secondary outcome variables included isometric neck strength in flexion, extension and left and right lateral flexion. Using non-parametric statistical methods, no significant differences were evident for the total number of cervical spine injuries (n = 8 in 2007-2008, n = 6 in 2008-2009) or time loss due to these injuries (100 days in 2007-2008, 40 days in 2008-2009). However, a significant (p = 0.03) reduction in the number of match injuries was evident from 2007-2008 (n = 11) to 2008-09 (n = 2). Non-significant increases in isometric neck strength were found in all directions examined. A significant reduction in the number of match injuries was evident in this study. However, no other significant changes to primary outcome variables were achieved. Further, no significant increases in isometric neck strength were found in this well-trained group of professional athletes. Key Points While many authors have proposed that neck strengthening could be an effective strategy in preventing cervical spine injuries in

  19. Non-minor injuries among children sustained in an outdoor environment--a retrospective register study.

    PubMed

    Gyllencreutz, Lina; Rolfsman, Ewa; Saveman, Britt-Inger

    2015-01-01

    The aim was to investigate non-minor injuries sustained during outdoor activities among 0-12 year old children and to explore self-reported circumstances surrounding these incidents. During 2007-2009, the Umeå University Hospital injury database (IDB) registered 795 children with moderate (n = 778) and serious (n = 17) injuries, such as fractures. The IDB includes data from a questionnaire completed in the emergency department by the injured child or a parent. The open-ended questions catch the injured child's description of what circumstances precede the injury incident. The most commonly reported activities contributing to injuries were play, sport, and transport. Surface impacts were also reported as contributing factors along with products such as trampolines, bicycles, and downhill skis. By achieving a deeper knowledge about the activities and circumstances that precede non-minor injury incidents, creating safer outdoor environments may be feasible. PMID:24024526

  20. Childhood casualties during civil war: Syrian experience.

    PubMed

    Çelikel, Adnan; Karbeyaz, Kenan; Kararslan, Bekir; Arslan, M Mustafa; Zeren, Cem

    2015-08-01

    In war areas a lot of children die as well as adults. According to UNICEF, almost 2 million children have died in the wars took place in the last 10 years. In this study, we aimed to evaluate demographical data and injury characteristics of Syrian children who were wounded in Syria Civil War and died while being treated in Turkey. Postmortem examination and autopsy reports of 985 forensic deaths from Hatay -a Syrian neighborhood city of Turkey-between January 2012 and August 2014 were analyzed retrospectively. Among 763 Syrian people who were wounded in the war and died while being treated in Turkey, 140 cases (18.3%) who were younger than 18 years of age were taken into the scope of this study. Among those cases 77.9% (n = 109) were male and 22.1% were female. Median ages of female cases are 14 (min-max: 2-18) and median age of female cases are 9 (min-max: 1-18). Frequency distribution is highest between 13 and 18 years of age (n: 71, 50.7%). In 70% (n: 98) of cases, cause of death is bombing and shrapnel injuries, 13.6% (19) of them were killed by gunshot wounds. According to injury sites most of the injuries were reported to be on multiple body parts (54.3%, n: 76) and only head and neck injuries (%30). Cause of death was intracranial bleeding and cerebral parenchymal injury in most of the cases (n: 66, %47.1) followed by vascular damage with external bleeding (n: 15, %10.7) and internal organ damage with internal bleeding (n: 15, %10.7). The cases had very high level Abbreviated Injury Scales and Injury Severity Sores. In conclusion, a lot of children have died in the Civil War of Syria. Their average abbreviated injury scale and injury severity score values reported very high. Children that we evaluated were mostly died of head and neck injuries predominantly caused by bombing attacks and Autopsies of them revealed fatal intracranial hemorrhages and parenchymal injuries. PMID:26165650

  1. In the line of fire--21st-century approach to an ancient war injury.

    PubMed

    Frank, Matthias; Rademacher, Grit; Schmucker, Uli; David, Stephan; Ekkernkamp, Axel

    2009-03-01

    Authentic black-powder muzzle-loader weapons or replicas are used today primarily for re-enactments of historic battles. A lay actor playing the role of a Prussian infantryman sustained life-threatening gunshot injuries during a recent re-enactment of a historic battle of the Sixth Coalition. As only blank historic muzzle-loading weaponry was used, the origin of the missile causing the wounding was initially unclear. Further investigation revealed a ramrod that had been propelled out of the barrel of another gunner's smooth-bore gun as cause of injury. The ramrod was hurled on a trajectory of more than 20 m, breaking the victim's shouldered barrel and hitting the victim resulting in severe abdominal, thoracic, and upper limb injuries. The critical incidents while handling muzzle-loading weaponry leading to premature discharge are elucidated. Furthermore, this report demonstrates how actual diagnostics and subsequent surgical treatment enabled this infantryman to survive an injury to which his comrades-in-arms would have succumbed 200 years ago. PMID:19207285

  2. Multicenter retrospective evaluation of the validity of the Thoracolumbar Injury Classification and Severity Score system in children.

    PubMed

    Sellin, Jonathan N; Steele, William J; Simpson, Lauren; Huff, Wei X; Lane, Brandon C; Chern, Joshua J; Fulkerson, Daniel H; Sayama, Christina M; Jea, Andrew

    2016-08-01

    OBJECTIVE The Thoracolumbar Injury Classification and Severity Score (TLICS) system was developed to streamline injury assessment and guide surgical decision making. To the best of the authors' knowledge, external validation in the pediatric age group has not been undertaken prior to this report. METHODS This study evaluated the use of the TLICS in a large retrospective series of children and adolescents treated at 4 pediatric medical centers (Texas Children's Hospital, Children's Healthcare of Atlanta, Riley Children's Hospital, and Doernbecher Children's Hospital). A total of 147 patients treated for traumatic thoracic or lumbar spine trauma between February 1, 2002, and September 1, 2015, were included in this study. Clinical and radiographic data were evaluated. Injuries were classified using American Spinal Injury Association (ASIA) status, Denis classification, and TLICS. RESULTS A total of 102 patients (69%) were treated conservatively, and 45 patients (31%) were treated surgically. All patients but one in the conservative group were classified as ASIA E. In this group, 86/102 patients (84%) had Denis type compression injuries. The TLICS in the conservative group ranged from 1 to 10 (mean 1.6). Overall, 93% of patients matched TLICS conservative treatment recommendations (score ≤ 3). No patients crossed over to the surgical group in delayed fashion. In the surgical group, 26/45 (58%) were ASIA E, whereas 19/45 (42%) had neurological deficits (ASIA A, B, C, or D). One of 45 (2%) patients was classified with Denis type compression injuries; 25/45 (56%) were classified with Denis type burst injuries; 14/45 (31%) were classified with Denis type seat belt injuries; and 5/45 (11%) were classified with Denis type fracture-dislocation injuries. The TLICS ranged from 2 to 10 (mean 6.4). Eighty-two percent of patients matched TLICS surgical treatment recommendations (score ≥ 5). No patients crossed over to the conservative management group. Eight patients (8

  3. Injury survey in scuba divers of British Sub-Aqua Club: A retrospective study

    PubMed Central

    Hyun, Gwang-Suk; Jee, Yong-Seok; Park, Jung-Min; Cho, Nam-Heung; Cha, Jun-Youl

    2015-01-01

    Scuba diving itself is generally known as a safe sports. However, various injury accidents can happen, and the incidences vary depending on divers’ education grade levels about the risks. Therefore, the study set out to identify and analyze the causes and patterns of injuries depending on the divers’ safety education grade levels through a questionnaire survey targeting ocean divers (n=12), sports divers (n=16), and dive leaders (n=15), all of whom belong to the British Sub-Aqua Club. After conducting a frequency analysis on the collected questionnaires, the conclusions are made as follows. First, in terms of diving depth, the most frequent diving depth was 15–20 m among ocean divers, 20–25 m among sports divers, and 15–20 m in case of dive leaders. Second, with regard to the causes of injuries, the most frequently answered causes are ‘overtension’ and ‘low skill’ among ocean divers; ‘low skill’ among sports divers; ‘overaction’ among dive leaders. Third, in terms of injury patterns, the most frequently answered injury patterns are ‘ear’ injuries among ocean divers; ‘ankle’ injuries among sports divers; ‘ankle’ and ‘calf’ injuries among dive leaders. Fourth, with regard to who performed first-aid when an injury accident happened, the most frequent answers are ‘instructor’ among ocean divers; ‘instructor’ and ‘self’ among sports divers; ‘self’ among dive leaders. We might suggest that more efforts need to be made to improve divers’ low dependence on specialists for treatment and consultation so that we can prevent an injury from leading to the second injury accident. PMID:26730384

  4. Injury survey in scuba divers of British Sub-Aqua Club: A retrospective study.

    PubMed

    Hyun, Gwang-Suk; Jee, Yong-Seok; Park, Jung-Min; Cho, Nam-Heung; Cha, Jun-Youl

    2015-12-01

    Scuba diving itself is generally known as a safe sports. However, various injury accidents can happen, and the incidences vary depending on divers' education grade levels about the risks. Therefore, the study set out to identify and analyze the causes and patterns of injuries depending on the divers' safety education grade levels through a questionnaire survey targeting ocean divers (n=12), sports divers (n=16), and dive leaders (n=15), all of whom belong to the British Sub-Aqua Club. After conducting a frequency analysis on the collected questionnaires, the conclusions are made as follows. First, in terms of diving depth, the most frequent diving depth was 15-20 m among ocean divers, 20-25 m among sports divers, and 15-20 m in case of dive leaders. Second, with regard to the causes of injuries, the most frequently answered causes are 'overtension' and 'low skill' among ocean divers; 'low skill' among sports divers; 'overaction' among dive leaders. Third, in terms of injury patterns, the most frequently answered injury patterns are 'ear' injuries among ocean divers; 'ankle' injuries among sports divers; 'ankle' and 'calf' injuries among dive leaders. Fourth, with regard to who performed first-aid when an injury accident happened, the most frequent answers are 'instructor' among ocean divers; 'instructor' and 'self' among sports divers; 'self' among dive leaders. We might suggest that more efforts need to be made to improve divers' low dependence on specialists for treatment and consultation so that we can prevent an injury from leading to the second injury accident. PMID:26730384

  5. Metals detected by ICP/MS in wound tissue of war injuries without fragments in Gaza

    PubMed Central

    2010-01-01

    Background The amount and identity of metals incorporated into "weapons without fragments" remain undisclosed to health personnel. This poses a long-term risk of assumption and contributes to additional hazards for victims because of increased difficulties with clinical management. We assessed if there was evidence that metals are embedded in "wounds without fragments" of victims of the Israeli military operations in Gaza in 2006 and 2009. Methods Biopsies of "wounds without fragments" from clinically classified injuries, amputation (A), charred (C), burns (B), multiple piercing wounds by White Phosphorus (WP) (M), were analyzed by ICP/MS for content in 32 metals. Results Toxic and carcinogenic metals were detected in folds over control tissues in wound tissues from all injuries: in A and C wounds (Al, Ti, Cu, Sr, Ba, Co, Hg, V, Cs and Sn), in M wounds (Al, Ti, Cu, Sr, Ba, Co and Hg) and in B wounds (Co, Hg, Cs, and Sn); Pb and U in wounds of all classes; B, As, Mn, Rb, Cd, Cr, Zn in wounds of all classes, but M; Ni was in wounds of class A. Kind and amounts of metals correlate with clinical classification of injuries, exposing a specific metal signature, similar for 2006 and 2009 samples. Conclusions The presence of toxic and carcinogenic metals in wound tissue is indicative of the presence in weapon inducing the injury. Metal contamination of wounds carries unknown long term risks for survivors, and can imply effects on populations from environmental contamination. We discuss remediation strategies, and believe that these data suggest the need for epidemiological and environmental surveys. PMID:20579349

  6. Investigation of characteristics and risk factors of sports injuries in young soccer players: a retrospective study

    PubMed Central

    2013-01-01

    Background The participation of children and adolescents in sports has become increasingly frequent, including soccer. This growing involvement gives rise to concerns regarding the risk of sports injuries. Therefore, the aim of the present study was to describe the musculoskeletal injuries in young soccer players. Methods 301 male soccer players with a mean age 14.67 ± 2.08 years were randomly recruited. The Referred Condition Inquiry was used to collect information on the mechanism of injury and anatomic site affected as well as personal data on the participants. The variables were analyzed based on the degree of association using Goodman’s test for contrasts between multinomial populations, with the p < 0.05. Results Among the 301 athletes, 24.25% reported at least one injury. With regard to height, taller individuals reported more injuries than shorter individuals (62.5% and 37.5%, respectively; p < 0.05). Injuries were more frequent among players with a training duration greater than five years (69.65%) in comparison to those who trained for a shorter duration (30.35%) (p < 0.05). The lower limbs, especially the ankle/foot and knee, were the most affected anatomic sites. Impact was the most common mechanism of injury. Conclusion The young practitioners of soccer analyzed had low rates of injury. The main causal mechanism was the impact. A taller height and longer exposure to training were the main risk factors for injury among young soccer players. PMID:23602027

  7. Pattern of Head Injuries (Cranio-cerebral) due to Homicide in Association with Other Injuries: A Retrospective Post-mortem Study Autopsied at Dhaka Medical College Morgue House.

    PubMed

    Akber, E B; Alam, M T; Rahman, K M; Jahan, I; Musa, S A

    2016-04-01

    Annually, homicide contributes to a greater number of the total head injury cases. This retrospective study was conducted from 1(st) January 2009 to 31(st)December 2011 at Dhaka Medical College Mortuary. During this study period of three years a total of 15300 autopsies were done of which 5649 cases (36.84%) were of head injuries. Of them 747(13.22%) were of homicidal, 4080(72.22%) road-traffic accidents, 502(8.88%) accidental and 320(5.66%) cases of fall from heights. Three hundred ninety eight (398) urban cases (53.27%) out numbered 307 rural cases (41.09%) followed by 42 unknown cases (5.62%). Most cases belong to the younger age group i.e. 21-40 years (43.34%) with male preponderance 470(63.10%). Defense wounds were present in 281 cases (37.82%) out of the total 747 homicidal head injuries. There were 206(27.57%) upper limb, 176(23.56%) spinal, 139(18.60%) abdominal, 135(18.07%) thoracic, 58(7.76%) lower limb and 33(4.41%) pelvic injuries found as associated injury. There were 258(34.53%) fractures of occipital followed by 209(28.29%) parietal, 113(15.01%) frontal, 104(13.75%) temporal, 24(3.21%) ant. Cranial fossa, 23(3.07%) post. Cranial fossa and 16(2.08%) of middle cranial fossa fractures. Extradural haemorrhage was more i.e. 434 cases (58.43%) followed by subdural, combination of all, subarachnoid and intra-cerebral haemorrhages. Cases of concussion were more common i.e. 445(59.75%) than lacerated and combination of them. Blunt weapon tops the list of causative weapons i.e. 669(89.22%) than firearms 59(8.07%) and sharp pointed weapons 19(2.68%). PMID:27277363

  8. Pattern and epidemiology of pediatric musculoskeletal injuries in Kashmir valley, a retrospective single-center study of 1467 patients.

    PubMed

    Hussain, Shahid; Dar, Tahir; Beigh, Asif Qayoom; Dhar, Shabir; Ahad, Humayun; Hussain, Imtiyaz; Ahmad, Sharief

    2015-05-01

    This work aimed to study the pattern and epidemiology of pediatric musculoskeletal trauma and consequent morbidity in Kashmir Valley and compare the results with other studies and to formulate preventive measures and devise management strategies. This was a retrospective study of 1467 pediatric orthopedic trauma patients who presented to our hospital over a 3-year period between September 2005 and August 2008. Information was recorded in a prescribed proforma including the following: age, sex, mode of trauma, type of fracture/injury, radiological study, final diagnosis, intervention performed, and complications. The information was collected from the Medical Records Department of the hospital. The children's ages ranged from 0 to 16 years; there were 996 males and 471 females, with males outnumbering females in every age group (the overall male-to-female ratio was 2.12:1). Most fractures occurred in children aged 7-12 years [n=816 (53.96%)] and decreased in younger and older children beyond this age group. The left side was involved in 762 cases, 612 injuries involved the right side, 24 were bilateral, and 69 patients presented with multiple injuries. In children aged 0-6 years, the most common site of injury was the elbow, whereas in children aged 7-16 years, it was the forearm. In descending order, most injuries were sustained because of fall while playing (34.76%), fall from height (33.74%), road traffic accidents (14.92%), and fall from standing height (7.97%). The majority of injuries were caused by unintentional trauma (94.48 vs. 5.52%). The places where injury occurred were the home [603 (41.10%)], play field and orchards near the home [450 (30.67%)], roads [219 (14.92%)], school [183 (12.47%)], and unknown [12 (0.81%)]. The pattern and epidemiology of pediatric trauma differs from those in adults. The majority of musculoskeletal injuries are because of unintentional trauma in this young age group and hence preventable. Enhanced supervision at home and

  9. A retrospective analysis of gunshot injuries to the maxillo-facial region.

    PubMed

    Kassan, A H; Lalloo, R; Kariem, G

    2000-07-01

    This study analysed the prevalence, demography, soft- and hard-tissue injury patterns, management and complications of gunshot injuries to the maxillo-facial region in 301 patients treated at Groote Schuur Hospital, Cape Town. The number of patients presenting with maxillo-facial injuries caused by gunshot increased over the 15-year study period. The majority were caused by civilian type low-velocity hand-guns and were purposefully and intentionally inflicted by others. Males in their third decade of life and of low socioeconomic status were most often the victims. The wounding effects of these low-velocity injuries were characteristic--small rounded entrance wounds, causing fragmentation of teeth and comminution of the underlying bone, usually without any exit wounds. A comminuted displaced type of fracture pattern was most frequently observed. Special investigations included plain film radiographs with more sophisticated investigations being requested where indicated. Definitive surgical management was initiated by early soft-tissue debridement. Both the mandibular and maxillary fractures had more open than closed reductions. Bone continuity defects as a result of the initial injury were usually reconstructed secondarily using free autogenous bone grafts. All the patients received anti-tetanus toxoid on admission and the majority received antibiotic treatment. The most common complications were sepsis, ocular and neurological complications and limitation of mouth opening. The postoperative sepsis rate was high (19%). The wounding effects of these low-velocity missile injuries are devastating and pose a treatment challenge to the maxillo-facial surgeon. PMID:12608195

  10. Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study

    PubMed Central

    2009-01-01

    Background Acute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT) presents a high mortality rate. Consequently, we studied a Spanish cohort of patients to assess the risk factors for RRT in cardiac surgery-associated acute kidney injury (CSA-AKI). Methods A retrospective case-cohort study in 24 Spanish hospitals. All cases of RRT after cardiac surgery in 2007 were matched in a crude ratio of 1:4 consecutive patients based on age, sex, treated in the same year, at the same hospital and by the same group of surgeons. Results We analyzed the data from 864 patients enrolled in 2007. In multivariate analysis, severe acute kidney injury requiring postoperative RRT was significantly associated with the following variables: lower glomerular filtration rates, less basal haemoglobin, lower left ventricular ejection fraction, diabetes, prior diuretic treatment, urgent surgery, longer aortic cross clamp times, intraoperative administration of aprotinin, and increased number of packed red blood cells (PRBC) transfused. When we conducted a propensity analysis using best-matched of 137 available pairs of patients, prior diuretic treatment, longer aortic cross clamp times and number of PRBC transfused were significantly associated with CSA-AKI. Patients requiring RRT needed longer hospital stays, and suffered higher mortality rates. Conclusion Cardiac-surgery associated acute kidney injury requiring RRT is associated with worse outcomes. For this reason, modifiable risk factors should be optimised and higher risk patients for acute kidney injury should be identified before undertaking cardiac surgery. PMID:19772621

  11. Examination for sexual assault: Is the documentation of physical injury associated with the laying of charges? A retrospective cohort study

    PubMed Central

    McGregor, M J; Le, G; Marion, S A; Wiebe, E

    1999-01-01

    BACKGROUND: Few studies have examined whether there is an association between individual medical findings and legal outcome in cases of sexual assault. This study was undertaken to determine the relation between the extent of documented physical injury and a positive legal outcome in cases of sexual assault and to determine other factors associated with the laying of charges in such cases. METHODS: In this retrospective cohort study, the authors reviewed the charts and medicolegal reports for all cases of sexual assault that were handled by the BC Women's Sexual Assault Service in 1992 for which a police report had been filed. Information on patients' characteristics, the nature of the assault and the extent of injury was extracted from these records. A system for scoring clinical injury was developed by 4 of the physicians at the Sexual Assault Service, and a clinical injury score was assigned for each case by one physician. The relation between the outcome (in terms of whether charges were laid) and the circumstances of the case was examined by logistic regression. RESULTS: A total of 95 cases with complete medical records and information about legal outcome were identified during the 1992 calendar year. After adjustment for income level and the patient's knowledge of the assailant (either as an acquaintance or as his or her partner), the odds ratio (OR) for charge-laying in a sexual assault case with documented moderate to severe injury was 3.33 (95% confidence interval [CI] 1.06-10.42). Socioeconomic status above the group median (defined as annual income greater than $21,893) (OR 3.26, 95% CI 1.09-9.71) and knowledge of the assailant (OR 4.58, 95% CI 1.52-13.79) were also associated with charge-laying. Presence of genital injury per se, age of the patient and detection of sperm by microscopy at the time of examination were not associated with the laying of charges. INTERPRETATION: The results of this study show that the extent of documented injury is

  12. Blast From the Past: A Retrospective Analysis of Blast-induced Head Injury.

    PubMed

    Yu, Kristin E; Murphy, Justin M; Tsao, Jack W

    2016-03-01

    Because of the sharp increase in the number of military personnel exposed to explosive blasts in combat, research has been dedicated toward understanding the impact of explosions on the brain. It is important to consider that potential injuries that military personnel sustain may be both in the form of physical injury as well as "invisible" neuronal and psychological damage. Since the inception of the study of blast science in the Medieval and Renaissance eras, significant improvements have been made in the historical record keeping and biomedical analysis of blast injuries. This editorial comments on the evolution of blast science and the recognition of neurological sequelae from both the historical and scientific perspectives. PMID:26926849

  13. Traumatic injury pattern analysis in a light rail transit death: a retrospective case study.

    PubMed

    Kendell, Ashley E; Fleischman, Julie M; Fulginiti, Laura C

    2015-05-01

    Within the context of medical examiner's offices, forensic anthropologists are increasingly being asked to assist with the interpretation of traumatic skeletal injury. This case study presents an example of trauma analysis performed by forensic anthropologists at the Maricopa County Forensic Science Center in Phoenix, Arizona. The primary goal of this study is to document an uncommon pattern of traumatic injury-severe grinding abrasions of the lower appendage that macroscopically resemble sharp force trauma, especially as observed in dismemberment cases-resulting from an individual being dragged beneath a Light Rail train for c. 1.7 miles. The abraded skeletal elements include a femoral shaft fragment, a femoral head portion, and the right foot. Second, this study aims to illustrate the efficacy of forensic anthropological analysis of patterned skeletal trauma. Finally, this study demonstrates the critical importance of analyzing scene information before drawing conclusions as to the etiology of a traumatic injury pattern. PMID:25689938

  14. Protective and risk factors in amateur equestrians and description of injury patterns: A retrospective data analysis and a case - control survey

    PubMed Central

    2011-01-01

    Background In Switzerland there are about 150,000 equestrians. Horse related injuries, including head and spinal injuries, are frequently treated at our level I trauma centre. Objectives To analyse injury patterns, protective factors, and risk factors related to horse riding, and to define groups of safer riders and those at greater risk Methods We present a retrospective and a case-control survey at conducted a tertiary trauma centre in Bern, Switzerland. Injured equestrians from July 2000 - June 2006 were retrospectively classified by injury pattern and neurological symptoms. Injured equestrians from July-December 2008 were prospectively collected using a questionnaire with 17 variables. The same questionnaire was applied in non-injured controls. Multiple logistic regression was performed, and combined risk factors were calculated using inference trees. Results Retrospective survey A total of 528 injuries occured in 365 patients. The injury pattern revealed as follows: extremities (32%: upper 17%, lower 15%), head (24%), spine (14%), thorax (9%), face (9%), pelvis (7%) and abdomen (2%). Two injuries were fatal. One case resulted in quadriplegia, one in paraplegia. Case-control survey 61 patients and 102 controls (patients: 72% female, 28% male; controls: 63% female, 37% male) were included. Falls were most frequent (65%), followed by horse kicks (19%) and horse bites (2%). Variables statistically significant for the controls were: Older age (p = 0.015), male gender (p = 0.04) and holding a diploma in horse riding (p = 0.004). Inference trees revealed typical groups less and more likely to suffer injury. Conclusions Experience with riding and having passed a diploma in horse riding seem to be protective factors. Educational levels and injury risk should be graded within an educational level-injury risk index. PMID:21294862

  15. The Select Panel for the Promotion of Child Health: Injury. Recommendations in Retrospect.

    ERIC Educational Resources Information Center

    Butler, John A.; Mitrovich, Kimberly A.

    1987-01-01

    In 1980 recommendations were made to prevent child injuries. They addressed the following topics: (1) motor vehicle safety; (2) home and neighborhood safety; and (3) the development of a national data base from which policy can be formulated. There is evidence that progress has been made since the morbidity and mortality rates for accidents have…

  16. Inferior alveolar nerve injuries associated with mandibular fractures at risk: a two-center retrospective study.

    PubMed

    Boffano, Paolo; Roccia, Fabio; Gallesio, Cesare; Karagozoglu, K; Forouzanfar, Tymour

    2014-12-01

    The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments-Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement (p = 0.03), isolated mandibular fractures (p = 0.01), and angle fractures (p = 0.004). A statistically significant association was also found between IAN injury and assaults (p = 0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions. PMID:25383147

  17. The Change in Nutritional Status in Traumatic Brain Injury Patients: A Retrospective Descriptive Study

    NASA Astrophysics Data System (ADS)

    Masha'al, Dina A.

    There is a high prevalence in malnutrition among traumatic brain injury (TBI) due to the hypermetabolism and hypercatabolism which develop post injury. Traumatic brain injury patients are different, even among themselves, in their energy requirements and response to nutritional therapy. This implies that there are other factors that affect the energy intake of these patients and enhance the incidence of malnutrition. This dissertation study examines the nutritional status of TBI patients upon admission to the intensive care unit (ICU) and during their hospital stay to describe baseline status, detect changes in nutritional status over 7 days, and identify the factors affecting the adequacy of energy intake and the change in nutritional status as a consequence. Anthropometric measurements, biomedical measurements, measures of severity of illness, daily health status, level of brain injury severity, and other data were collected from the medical records of 50 patients, who were ≥ 18 years old, mechanically ventilated in the first 24 hours of ICU admission, and had a Glasgow Coma Scale score between 3-12. These data were used to examine the previous relationships. Although there was no statistically significant change found in body mass index and weight, there was a significant change detected in other nutritional markers, including hemoglobin, albumin, and total lymphocyte levels over the 7 days of ICU and hospital stay. No significant relationship was found between the adequacy of energy intake and total prescribed energy, severity of illness, level of brain injury severity, daily health status, patient age, intracranial pressure, or time of feeding initiation. Findings may be used to develop and test interventions to improve nutritional status during the acute phase of TBI. This will lay a foundation for health care providers, including nurses, to establish standards for practice and nutrition protocols to assure optimal nutrition assessment and intervention in a

  18. The role of the plastic surgeon in dealing with soft tissue injuries: experience from the second Israel-Lebanon war, 2006.

    PubMed

    Sharony, Zach; Eldor, Liron; Klein, Yuval; Ramon, Yitzchak; Rissin, Yaron; Berger, Yosef; Lerner, Alexander; Ullmann, Yehuda

    2009-01-01

    During the 2006 war between Israel and Lebanon, 282 Israeli soldiers were evacuated to Rambam Health Care Campus. Of these, 210 were admitted for observation or treatment, and 15 of these were admitted to the Department of Plastic and Reconstructive Surgery. Thirty-five other soldiers, hospitalized in other departments, required the care of Plastic Surgeons, either for conservative or surgical treatment. The injury profile observed was consistent with data from previous low-intensity warfare, which demonstrated that over 80% of injuries were produced by fragmentation weapons, such as artillery, mortarshells, rockets, and missiles. It differs, however, from our experience in previous wars and our expectations regarding burn wounds, both in incidence and severity, which were significantly lower as compared with the past. This article presents our management of extensive soft tissue injuries, and details 3 representative cases. It highlights the role of the Plastic Surgeon as part of the whole treatment in this type of injury and helps to predict the needs of the medical system in preparation for the future. PMID:19131724

  19. Arthroscopic verification of objectivity of the orthopaedic examination and magnetic resonance imaging in intra-articular knee injury. Retrospective study

    PubMed Central

    Skowronek, Michał; Skowronek, Paweł; Dutka, Łukasz

    2011-01-01

    Introduction Arthroscopy of the knee joint is regarded as the most objective diagnostic method in intra-articular knee joint lesions. Aim The purpose of this study was to assess the objectivity and diagnostic value of orthopaedic examination (OE) and magnetic resonance imaging (MRI) in reference to the arthroscopic result. Material and methods In a group of 113 patients treated by arthroscopic surgery for post-traumatic knee pathology between 2008 and 2010 in our department, accuracy of clinical and MRI findings that preceded surgery were studied retrospectively using a statistical method. Sensitivity, specificity, accuracy and predictive negative and positive values were the subject of analysis. Results In the presented trial, sensitivity values of the orthopaedic examination for injuries of the anterior cruciate ligament (ACL), meniscus medialis (MM), meniscus lateralis (ML) and chondral injuries (ChI) were 86%, 65%, 38% and 51%, respectively. Specificity values were 90%, 65%, 100% and 100%, respectively. The MR sensitivity and specificity values were 80%, 88%, 44% and 32%, and 86%, 64%, 93% and 97%, respectively. Conclusions Assessment of intra-articular knee joint lesions is a difficult diagnostic problem. In making a decision about arthroscopy of the knee joint, an appropriate sequence of examinations should be carried out: OE, MRI and arthroscopy. The improvement in the effectiveness of the orthopaedic examination and MRI can limit the too high frequency of diagnostic arthroscopies, which generates the risk of operation treatment and costs. PMID:23255995

  20. Causes and incidence of maxillofacial injuries in India: 12-year retrospective study of 4437 patients in a tertiary hospital in Gujarat.

    PubMed

    Weihsin, Hu; Thadani, Sandeep; Agrawal, Mohit; Tailor, Suket; Sood, Ramita; Langalia, Akshay; Patel, Twinkle

    2014-10-01

    Maxillofacial injuries are unique because of the anatomical complexity of the area and their associated psychological effects. An understanding of the epidemiology of these injuries is important if we are to develop preventive measures, increase the efficiency and delivery of health services, improve the skills of healthcare providers, and better distribute resources. We retrospectively evaluated data on 4455 patients (aged between 3 and 84 years) who presented with maxillofacial injuries to a tertiary referral hospital in Ahmedabad, India, between 1 January 1999 and 31 January 2010. Of these, 18 needed only rest and medication so 4437 were included. Data included patients'characteristics and the cause of injury. Details on the presentation and severity of injury, associated injuries including head injuries, the influence of alcohol and other drugs, treatment, and outcome, were also included. Around one-third were aged between 21and 30 years, and the male to female ratio was 5:1. The main causes of injury were road traffic accidents (n=2347, 53%) and interpersonal violence (n=1041, 23%). Most road traffic accidents involved two-wheeled vehicles. Alcohol was associated with 11% of injuries. A total of 2546 patients (57%) had mandibular fractures. To reduce the number of injuries we need better road safety laws with stringent enforcement, and the public, particularly those between 15 and 45 years of age, must be educated about road safety. PMID:25086833

  1. Burn injuries resulting from hot water bottle use: a retrospective review of cases presenting to a regional burns unit in the United kingdom.

    PubMed

    Jabir, Shehab; Frew, Quentin; El-Muttardi, Naguib; Dziewulski, Peter

    2013-01-01

    Introduction. Hot water bottles are commonly used to relieve pain and for warmth during the colder months of the year. However, they pose a risk of serious burn injuries. The aim of this study is to retrospectively review all burn injuries caused by hot water bottles presenting to our regional burns unit. Methods. Patients with burns injuries resulting from hot water bottle use were identified from our burns database between the periods of January 2004 and March 2013 and their cases notes reviewed retrospectively. Results. Identified cases involved 39 children (aged 17 years or younger) and 46 adults (aged 18 years or older). The majority of burns were scald injuries. The mean %TBSA was 3.07% (SD ± 3.40). Seven patients (8.24%) required debridement and skin grafting while 3 (3.60%) required debridement and application of Biobrane. One patient (1.18%) required local flap reconstruction. Spontaneous rupture accounted for 48.20% of injuries while accidental spilling and contact accounted for 33% and 18.80% of injuries, respectively. The mean time to heal was 28.87 days (SD ± 21.60). Conclusions. This study highlights the typical distribution of hot water bottle burns and the high rate of spontaneous rupture of hot water bottles, which have the potential for significant burn injuries. PMID:24455234

  2. Burn Injuries Resulting from Hot Water Bottle Use: A Retrospective Review of Cases Presenting to a Regional Burns Unit in the United Kingdom

    PubMed Central

    Frew, Quentin; El-Muttardi, Naguib; Dziewulski, Peter

    2013-01-01

    Introduction. Hot water bottles are commonly used to relieve pain and for warmth during the colder months of the year. However, they pose a risk of serious burn injuries. The aim of this study is to retrospectively review all burn injuries caused by hot water bottles presenting to our regional burns unit. Methods. Patients with burns injuries resulting from hot water bottle use were identified from our burns database between the periods of January 2004 and March 2013 and their cases notes reviewed retrospectively. Results. Identified cases involved 39 children (aged 17 years or younger) and 46 adults (aged 18 years or older). The majority of burns were scald injuries. The mean %TBSA was 3.07% (SD ± 3.40). Seven patients (8.24%) required debridement and skin grafting while 3 (3.60%) required debridement and application of Biobrane. One patient (1.18%) required local flap reconstruction. Spontaneous rupture accounted for 48.20% of injuries while accidental spilling and contact accounted for 33% and 18.80% of injuries, respectively. The mean time to heal was 28.87 days (SD ± 21.60). Conclusions. This study highlights the typical distribution of hot water bottle burns and the high rate of spontaneous rupture of hot water bottles, which have the potential for significant burn injuries. PMID:24455234

  3. Risk factors for traumatic blunt cerebrovascular injury diagnosed by computed tomography angiography in the pediatric population: a retrospective cohort study.

    PubMed

    Ravindra, Vijay M; Riva-Cambrin, Jay; Sivakumar, Walavan; Metzger, Ryan R; Bollo, Robert J

    2015-06-01

    OBJECT Computed tomography angiography (CTA) is frequently used to examine patients for blunt cerebrovascular injury (BCVI) after cranial trauma, but the pediatric population at risk for BCVI is poorly defined. Although CTA is effective for BCVI screening in adults, the increased lifetime risk for malignant tumors associated with this screening modality warrants efforts to reduce its use in children. The authors' objective was to evaluate the incidence of BCVI diagnosed by CTA in a pediatric patient cohort and to create a prediction model to identify children at high risk for BCVI. METHODS Demographic, clinical, and radiographic data were collected retrospectively for pediatric patients who underwent CTA during examination for traumatic cranial injury from 2003 through 2013. The primary outcome was injury to the carotid or vertebral artery diagnosed by CTA. RESULTS The authors identified 234 patients (mean age 8.3 years, range 0.04-17 years, 150 [64%] boys) who underwent CTA screening for BCVI. Of these, 24 (10.3%) had a focal neurological deficit, and 153 (65.4%) had intracranial hemorrhage on a head CTA. Thirty-seven BCVIs were observed in 36 patients (15.4%), and 16 patients (6.8%) died. Multivariate regression analysis identified fracture through the carotid canal, petrous temporal bone fracture, Glasgow Coma Scale (GCS) score of < 8, focal neurological deficit, and stroke on initial CT scan as independent risk factors for BCVI. A prediction model for identifying children at high risk for BCVI was created. A score of ≤ 2 yielded a 7.9% probability of BCVI and a score of ≥ 3 a risk of 39.3% for BCVI. CONCLUSIONS For cranial trauma in children, fracture of the petrous temporal bone or through the carotid canal, focal neurological deficit, stroke, and a GCS score of < 8 are independent risk factors for BCVI. PMID:25745952

  4. Human Embryonic Stem Cell Therapy in Chronic Spinal Cord Injury: A Retrospective Study.

    PubMed

    Shroff, G

    2016-06-01

    Human embryonic stem cells (hESCs) have a role in treating neurological disorders. The efficacy and safety of hESC in treating spinal cord injury (SCI) was reported in our previous study. In the present study, we have evaluated the efficacy and safety of hESC therapy in 226 patients with SCI. In the first treatment phase (T1), 0.25 mL hESCs were administered intramuscularly twice daily, 1 mL every 10 days i.v., and 1-5 mL every 7 days. Of 153 patients in the American Spinal Injury Association (ASIA) scale A at the beginning of T1, a significant number of patients (n = 80; 52.3%) moved to lower scales at the end of T1 (p = 0.01). At the end of T2, of 32 patients in ASIA scale A, 12 patients (37.5%) moved to scale B (p = 0.01). Of 19 patients, 3 patients (37.5%) moved to scale B at the end of T3 (p = 0.02). No serious adverse events (AEs) were observed. hESC transplantation is safe and effective. PMID:27144379

  5. Fatal occupational injuries in the South Delhi construction industry: a retrospective study.

    PubMed

    Rautji, R; Lalwani, S; Dogra, T D

    2005-04-01

    One hundred and forty-five unselected autopsy cases of construction site accidents received from South Delhi were studied during the period from 1996--2002. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.61% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, the part of the body involved, the manner of accident, the cause of death and the pattern of injuries in different body regions. Death occurred at the scene of the fatal event in thirty-four cases; forty-three cases were dead on arrival at the hospital; sixty-eight cases died after being admitted to the hospital. Ethanol was detected in the blood of 16% of the cases. PMID:15895644

  6. Nuclear weapons and nuclear war

    SciTech Connect

    Cassel, C.; McCally, M.; Abraham, H.

    1984-01-01

    This book examines the potential radiation hazards and environmental impacts of nuclear weapons. Topics considered include medical responsibility and thermonuclear war, the threat of nuclear war, nuclear weaponry, biological effects, radiation injury, decontamination, long-term effects, ecological effects, psychological aspects, the economic implications of nuclear weapons and war, ethics, civil defense, arms control, nuclear winter, and long-term biological consequences of nuclear war.

  7. Effects of Glycemic Level on Outcome of Patients with Traumatic Brain Injury: A Retrospective Cohort Study

    PubMed Central

    Alvis-Miranda, Hernando Raphael; Navas-Marrugo, Sandy Zuleica; Velasquez-Loperena, Robert Andrés; Adie-Villafañe, Richard José; Velasquez-Loperena, Duffay; Castellar-Leones, Sandra Milena; Alcala- Cerra, Gabriel; Pulido-Gutiérrez, Juan Camilo; Rodríguez-Conde, Javier Ricardo; Moreno-Moreno, María Fernanda; M. Rubiano, Andrés; Moscote-Salazar, Luis Rafael

    2014-01-01

    Objective: To determine the effects of glycemic level on outcome patients with traumatic brain injury. Methods:  From September 2010 to December 2012, all medical records of adult patients with TBI admitted to the Emergency Room of Laura Daniela Clinic in Valledupar City, Colombia, South America were enrolled. Both genders between 18 and 85 years who referred during the first 48 hours after trauma, and their glucose level was determined in the first 24 hours of admission were included. Adults older than 85 years, with absence of Glasgow Coma Scale (GCS) score and a brain Computerized Tomography (CT) scans were excluded. The cut-off value was considered 200 mg/dL to define hyperglycemia. Final GCS, hospital admission duration and complications were compared between normoglycemic and hyperglycemic patients. Results: Totally 217 patients were identified with TBI. Considering exclusion criteria, 89 patients remained for analysis. The mean age was 43.0±19.6 years, the mean time of remission was 5.9±9.4 hours, the mean GCS on admission was 10.5±3.6 and the mean blood glucose level in the first 24 hours was 138.1±59.4 mg/dL. Hyperglycemia was present in 13.5% of patients. The most common lesions presented by patients with TBI were fractures (22.5%), hematoma (18.3%), cerebral edema (18.3%) and cerebral contusion (16.2%). Most of patients without a high glucose level at admission were managed only medically, whereas surgical treatment was more frequent in patients with hyperglycemia (p=0.042). Hyperglycemia was associated with higher complication (p=0.019) and mortality rate (p=0.039). GCS was negatively associated with on admission glucose level (r=0.11; p=0.46). Conclusion: Hyperglycemia in the first 24-hours of TBI is associated with higher rate of surgical intervention, higher complication and mortality rates. So hyperglycemia handling is critical to the outcome of patients with traumatic brain injury. PMID:27162868

  8. Adult patients are more catabolic than children during acute phase after burn injury: a retrospective analysis on muscle protein kinetics

    PubMed Central

    Tuvdendorj, Demidmaa; Chinkes, David L.; Zhang, Xiao-Jun; Ferrando, Arny A.; Elijah, Itoro E.; Mlcak, Ronald P.; Finnerty, Celeste C.; Wolfe, Robert R.; Herndon, David N.

    2011-01-01

    Purpose This study was performed to determine if there is an age-related specificity in the response of muscle protein metabolism to severe burn injury during acute hospitalization. This is a retrospective analysis of previously published data. Methods: Nineteen adult and 58 pediatric burn-injured patients (age 43.3 ± 14.3 vs. 7.2 ± 5.3 years, adult vs. children) participated in stable isotope [ring-2H5]phenylalanine (Phe) infusion studies. Femoral arterial and venous blood samples and muscle biopsy samples were collected throughout the study. Data are presented as means ± standard deviation (SD). A p value less than 0.05 was considered statistically significant. Results Muscle net protein balance (NB) was higher in children (adult vs. children, -43 ± 61 vs. 8 ± 68 nmol Phe/min/100 ml leg volume, p < 0.05). Muscle protein fractional synthesis rate (FSR) was higher in children (adult vs. children, 0.11 ± 0.05 vs. 0.16 ± 0.10 %/h, p < 0.05). Leg muscle protein breakdown was not different between the groups (adult vs. children, 179 ± 115 vs. 184 ± 124 nmol Phe/ min/100 ml leg volume, p < 0.05; synthesis rate was 134 ± 96 and 192 ± 128 nmol Phe/min/100 ml leg volume in adults and children, respectively (p = 0.07). Age significantly correlated with muscle protein NB (p = 0.01) and FSR (p = 0.02); but not with breakdown (p = 0.67) and synthesis (p = 0.07) rates measured by using a three-pool model. Conclusion In burn injury, the muscle protein breakdown may be affected to the same extent in adults and children, whereas synthesis may have age-related specificities, resulting in a better but still low NB in children. PMID:21647721

  9. MICROSURGICAL TRANSFER OF THE GRACILIS MUSCLE FOR ELBOW FLEXION IN BRACHIAL PLEXUS INJURY IN ADULTS: RETROSPECTIVE STUDY OF EIGHT CASES

    PubMed Central

    Kimura, Luiz Koiti; do Nascimento, Alexandre Tadeu; Capócio, Roberto; Mattar, Rames; Rezende, Marcelo Rosa; Wei, Teng Hsiang; Torres, Luciano Ruiz; Moya, Fernando Munhoz

    2015-01-01

    Objective: Treating brachial plexus injuries is a major challenge, especially lesions that are presented late, with more than 12 months of evolution. We retrospectively analyzed patients who underwent one of the possibilities for attempting to restore the function of upper limbs affected under such conditions: microsurgical transfer of the gracilis muscle for elbow flexion. Methods: Eight patients were included, divided into two groups: one in which the procedure consisted of neurorrhaphy of the muscle flap with sural nerve grafting and anastomosis more distally; and the other, in which the neurorrhaphy was performed directly on the spinal accessory nerve, with anastomosis in thoracoacromial vessels. Results: We found a significant difference between the groups. A greater number of satisfactory results (75% M4) were found among patients who underwent direct neurorrhaphy, whereas the procedure using grafts for neurorrhaphy was less successful (25% M4). Conclusion: Patients who underwent microsurgical functional transfer of the gracilis muscle in which vascular anastomoses were performed in thoracoacromial vessels presented better functional outcomes than shown by those whose anastomoses were in the brachial artery with subsequent use of a nerve graft. PMID:27027050

  10. Prevalence and Effects of Child Sexual Abuse in a Poor, Rural Community in El Salvador: A Retrospective Study of Women after 12 Years of Civil War.

    ERIC Educational Resources Information Center

    Leventhal, John M.; Barthauer, Linda M.

    1999-01-01

    A survey found 14 of 83 Salvadoran women had experienced child sexual abuse. The median age of abuse was 14. The majority of perpetrators were strangers, friends, or neighbors. The abused women had more depression, but after controlling for relatives killed in the war, that difference was not significant. (Author/CR)

  11. Incidence, Outcomes, and Risk Factors of Community-Acquired and Hospital-Acquired Acute Kidney Injury: A Retrospective Cohort Study.

    PubMed

    Hsu, Chien-Ning; Lee, Chien-Te; Su, Chien-Hao; Wang, Yu-Ching Lily; Chen, Hsiao-Ling; Chuang, Jiin-Haur; Tain, You-Lin

    2016-05-01

    The disease burden and outcomes of community-acquired (CA-) and hospital-acquired acute kidney injury (HA-AKI) are not well understood. The aim of the study was to investigate the incidence, outcomes, and risk factors of AKI in a large Taiwanese adult cohort.This retrospective cohort study examined 734,340 hospital admissions from a group of hospitals within an organization in Taiwan between January 1, 2010 and December 31, 2014. Patients with AKI at discharge were classified as either CA- or HA-AKI based on the RIFLE (risk, injury, failure, loss of function, end stage of kidney disease) classification criteria. Outcomes were in-hospital mortality, dialysis, recovery of renal function, and length of stay. Risks of developing AKI were determined using multivariate logistic regression based on demographic and baseline clinical characteristics and nephrotoxin use before admission.AKI occurred in 1.68% to 2% hospital discharges among adults without and with preexisting chronic kidney disease (CKD), respectively. The incidence of CA-AKI was 17.25 and HA-AKI was 8.14 per 1000 admissions. The annual rate of CA-AKI increased from 12.43 to 19.96 per 1000 people, but the change in HA-AKI was insignificant. Comparing to CA-AKI, those with HA-AKI had higher levels of in-hospital mortality (26.07% vs 51.58%), mean length of stay (21.25 ± 22.35 vs 35.84 ± 34.62 days), and dialysis during hospitalization (1.45% vs 2.06%). Preexisting systemic diseases, including CKD were associated with increased risks of CA-AKI, and nephrotoxic polypharmacy increased risk of both CA- and HA-AKI.Patients with HA-AKI had more severe outcomes than patients with CA-AKI, and demonstrated different spectrum of risk factors. Although patients with CA-AKI with better outcomes, the incidence increased over time. It is also clear that optimal preventive and management strategies of HA- and CA-AKI are urgently needed to limit the risks in susceptible individuals. PMID:27175701

  12. Does Traumatic Brain Injury Lead to Criminality? A Whole-Population Retrospective Cohort Study Using Linked Data

    PubMed Central

    Schofield, Peter W.; Malacova, Eva; Preen, David B.; D’Este, Catherine; Tate, Robyn; Reekie, Joanne; Wand, Handan; Butler, Tony

    2015-01-01

    Background Traumatic brain injury (TBI) may be a risk factor for criminal behaviour however multiple factors potentially confound the association. Methods Record linkage and Cox proportional hazards regression analyses were used to examine the association between hospital-recorded TBI (n = 7,694) and subsequent first criminal conviction in a retrospective cohort matched 1:3 with 22,905 unaffected community controls and full-sibling controls (n = 2,397). Aboriginality, substance abuse, social disadvantage, and mental illness were included in analyses as potential confounders Results In multivariable models, relative to general population controls, TBI was associated with any conviction (males: Hazard Ratio (HR) = 1·58 (95% CI 1·46 to 1·72); females: HR = 1·52 (95% CI 1·28 to 1·81)); and similar Hazard Ratios were obtained for the sibling analyses in males (HR = 1.68 (95% CI 1.31-2.18)) and females (HR 1.27 (95% CI 0.71-2.29)). TBI was also associated with violent convictions relative to the general population, (males: HR = 1.65 (95% CI 1.42 to 1.92); females HR = 1.73 (95% CI 1.21 to 2.47)), and in analyses with sibling controls in men (HR = 1.89 (95% CI 1.20-3.00)), but not in women (HR 0.73, 95% CI 0.29-1.81)). Conclusion The results support a modest causal link between TBI and criminality after comprehensive adjustment for confounding. Reducing the rate of TBI, a major public health imperative, might have benefits in terms of crime reduction. PMID:26172545

  13. Management of Jaw Injuries in the American Civil War: The Diuturnity of Bean in the South, Gunning in the North

    PubMed Central

    Pollock, Richard A.

    2011-01-01

    James Baxter Bean published a series of articles in the Southern Dental Examiner in 1862 describing his work with “plaster and its manipulations.” This early experience included a new way of managing jaw fractures, with customized splints uniquely based on pretraumatic occlusion. Bean's oral splints and their method of construction, using an articulator, became the standard of care in the Atlanta region during the American Civil War and, by 1864, throughout The Confederacy. In short course, Bean's approach also swept The Union, following in large part the efforts of a colleague in the North, T.B. Gunning. Thus, what began in the early 1860s in a dental laboratory in the southeast swept the continental United States and revolutionized management of jaw-fractures during, and immediately after, the American Civil War. PMID:22655119

  14. Charges associated with pediatric head injuries: a five year retrospective review of 41 pediatric hospitals in the US

    PubMed Central

    Robertson, Brian D.; McConnel, Charles E.; Green, Sally

    2013-01-01

    Abstract: Background: Brain injuries are a significant public health problem, particularly among the pediatric population. Brain injuries account for a significant portion of pediatric injury deaths, and are the highest contributor to morbidity and mortality in the pediatric and young adult populations. Several studies focus on particular mechanisms of brain injury and the cost of treating brain injuries, but few studies exist in the literature examining the highest contributing mechanisms to pediatric brain injury and the billed charges associated with them. Methods: Data were extracted from the Pediatric Health Information System (PHIS) from member hospitals on all patients admitted with diagnosed head injuries and comparisons were made between ICU and non-ICU admissions. Collected data included demographic information, injury information, total billed charges, and patient outcome. Results: Motor vehicle collisions, falls, and assaults/abuse are the three highest contributors to brain injury in terms of total numbers and total billed charges. These three mechanisms of injury account for almost $1 billion in total charges across the five-year period, and account for almost half of the total charges in this dataset over that time period. Conclusions: Research focusing on brain injury should be tailored to the areas of the most pressing need and the highest contributing factors. While this study is focused on a select number of pediatric hospitals located throughout the country, it identifies significant contributors to head injuries, and the costs associated with treating them. PMID:22821220

  15. The Influence of the Two World Wars on the Development of Rehabilitation for Spinal Cord Injuries in the United States and Great Britain.

    PubMed

    Lanska, Douglas J

    2016-01-01

    During World War I, physical and occupational therapies became important adjuncts to surgical practice, particularly for orthopedic casualties, but there was little progress in the management of severe brain and spinal cord injuries (SCIs), largely because of the very high mortality of such injuries at that time. During World War II (WWII), rehabilitation was greatly expanded into an integrated, comprehensive multidisciplinary program in the U.S. military, largely because of the efforts of Howard Rusk (1901-1989), initially in the Army Air Corps and later across all of the services. With Bernard Baruch's (1870-1965) assistance, Rusk was also successful in swaying President Franklin Delano Roosevelt (1882-1945) to support rehabilitation for injured veterans and to give official standing to rehabilitation medicine in the military and the Veterans Administration after WWII. Such WWII developments in rehabilitation medicine had a profound effect on the care, functional outcomes, and survival of veterans with SCIs. Neurosurgeon Donald Munro's (1898-1978) prototype SCI unit at Boston City Hospital in 1936 influenced the U.S. Army to establish several SCI centers during WWII and influenced urologist Ernest Bors (1900-1990) to pioneer SCI care in Veterans Administration medical centers after WWII. In Britain, the organizational leadership of George Riddoch (1888-1947) led to the development of SCI units that saw their greatest development by Ludwig Guttmann (1899-1980) at Stoke-Mandeville Hospital in Aylesbury, near London. These SCI centers provided a comprehensive spectrum of care, including medical, neurological, and surgical management; psychological counseling; and rehabilitation focused on improving self-care, mobility, and re-assimilation into society. After WWII, military developments in comprehensive rehabilitation were promulgated to and developed in the revitalized Veterans Administration and then disseminated to civilian populations. PMID:27035365

  16. Association Between the Neutrophil/Lymphocyte Ratio and Acute Kidney Injury After Cardiovascular Surgery: A Retrospective Observational Study.

    PubMed

    Kim, Won Ho; Park, Ji Young; Ok, Seong-Ho; Shin, Il-Woo; Sohn, Ju-Tae

    2015-10-01

    A high neutrophil-lymphocyte ratio (N/L ratio) was associated with the development of acute kidney injury (AKI) in patients with severe sepsis. We sought to investigate the association between the perioperative N/L ratios and postoperative AKI in patients undergoing high-risk cardiovascular surgery.A retrospective medical chart review was performed of 590 patients who underwent cardiovascular surgeries, including coronary artery bypass, valve replacement, patch closure for atrial or ventricular septal defect and surgery on the thoracic aorta with cardiopulmonary bypass (CPB). Baseline perioperative clinical parameters, including N/L ratios measured before surgery, immediately after surgery, and on postoperative day (POD) one were obtained. Multivariate logistic regression analysis was used to evaluate risk factors.A total of 166 patients (28.1%) developed AKI defined by the KDIGO (kidney disease improving global outcomes) criteria in the first 7 PODs. Independent risk factors for AKI included old age, decreased left ventricular systolic function, preoperative high serum creatinine, low serum albumin and high uric acid levels, intraoperative large transfusion amount, oliguria, hyperglycemia, and elevated N/L ratio measured immediately after surgery and on POD one. The quartiles of immediately postoperative N/L ratio were associated with graded increase in risk of AKI development (fourth quartile [N/L ratio≥10] multivariate odds ratio 5.90, 95% confidence interval [CI] 2.74-12.73; P < 0.001), a longer hospital stay, and a higher in-hospital and 1-year mortality rate (fourth quartile [N/L ratio≥10] adjusted hazard ratio for 1-year mortality [8.40, 95% CI 2.50-28.17]; P < 0.001).In patients undergoing cardiovascular surgery with CPB, elevated N/L ratios in the immediately postoperative period and on POD one were associated with an increased risk of postoperative AKI and 1-year mortality. The N/L ratio, which is easily calculable from routine work-up, can

  17. Frailty as a Predictor of Acute Kidney Injury in Hospitalized Elderly Patients: A Single Center, Retrospective Cohort Study

    PubMed Central

    Baek, Seon Ha; Lee, Sung Woo; Kim, Sun-wook; Ahn, Shin young; Yu, Mi-Yeon; Kim, Kwang-il; Chin, Ho Jun; Na, Ki Young; Chae, Dong-Wan; Kim, Sejoong

    2016-01-01

    Background Elderly patients have an increased risk for acute kidney injury (AKI). However, few studies have reported on predictors for AKI in geriatric patients. Therefore, we aimed at determining the effect of frailty as a predictor of AKI. Methods We retrospectively enrolled 533 hospitalized elderly patients (aged ≥ 65 years) who had their creatinine levels measured (≥ 1 measurement) during admission for a period of 1 year (2013) and conducted a comprehensive geriatric assessment (CGA) within 1 year before the index hospitalization. We examined five variables (activity of daily living [ADL] and instrumental ADL dependence, dementia, nutrition, and polypharmacy) from CGA. We categorized the patients into 3 groups according to the tertile of aggregate frailty scores: Group 1, score 1–2; Group 2, score 3–4; Group 3, score 5–8). Results Fifty-four patients (10.1%) developed AKI (median duration, 4 days). The frailest group (Group 3) showed an increased risk of AKI as compared to Group 1, (hazard ratio [HR] = 3.536, P = 0.002). We found that discriminatory accuracy for AKI improved with the addition of the tertile of aggregate frailty score to covariates (area under the receiver operator characteristics curves [AUROC] 0.641, AUROC 0.739, P = 0.004). Forty-six patients (8.6%) were transferred to nursing facilities and 477 patients (89.5%) were discharged home. The overall 90-day and 1-year mortality for elderly inpatients were 7.9% and 26.3%. The frailest group also demonstrated an increased risk of discharge to nursing facilities, and 90-day and 1-year mortality as compared to Group 1, independent of AKI severity (nursing facilities: odd ratio = 4.843, P = 0.002; 90-day mortality: HR = 6.555, P = 0.002; 1-year mortality: HR = 3.249, P = 0.001). Conclusions We found that frailty may independently predict the development of AKI and adverse outcomes in geriatric inpatients. PMID:27257823

  18. A Retrospective Review of Forensic Odontology Reports Written by the Joint POW/MIA Accounting Command Central Identification Laboratory for Remains Identified from the Korean War.

    PubMed

    Shiroma, Calvin Y

    2016-01-01

    As of August 2014, the Joint POW/MIA Accounting Command has identified the remains of 1980 previously unknown U.S. service members; 280 were from the Korean War. To determine the accuracy and completeness of the available antemortem (AM) dental records, a review of the AM/postmortem (AM/PM) dental record comparisons from 233 Forensic Odontology Reports written in support of remains identified from the Korean War was performed. Seventy-two AM/PM comparisons resulted in exact dental chartings while 161 contained discrepancies which were explainable. Explainable discrepancies include undocumented treatment (103), incorrectly charted third molars as missing (82), differing opinions of specific molars present/missing (20), and erroneous treatment documentation and/or misidentification of teeth present/missing (22, other than molars). Reassessment has revealed varying levels of completeness for our available AM dental records, the need to thoroughly review our computerized comparisons, adjust our comparisons to include molar pattern variations/third molars, and updating our database comparison program. PMID:27404405

  19. The Infectious Diseases Clinical Research Program: addressing the challenge of infections related to war injuries and skin and soft tissues.

    PubMed

    Martin, Gregory J; Tribble, David R

    2010-07-01

    The Infectious Diseases Clinical Research Program (IDCRP) at the Uniformed Services University of the Health Sciences (USU) is a National Institute of Allergy and Infectious Diseases (NIAID)-funded network of military treatment and research facilities coordinated through USU and the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF). IDCRP functions in collaboration with the NIAID, universities, and industry to address infectious diseases threats to the U.S. military and to the nation. Although IDCRP has projects in diseases from HIV to tuberculosis, a major focus has been on skin, soft-tissue, and war-related infections. PMID:23634479

  20. Children and war.

    PubMed

    Pearn, J

    2003-04-01

    Children bear disproportionate consequences of armed conflict. The 21st century continues to see patterns of children enmeshed in international violence between opposing combatant forces, as victims of terrorist warfare, and, perhaps most tragically of all, as victims of civil wars. Innocent children so often are the victims of high-energy wounding from military ordinance. They sustain high-energy tissue damage and massive burns - injuries that are not commonly seen in civilian populations. Children have also been deliberately targeted victims in genocidal civil wars in Africa in the past decade, and hundreds of thousands have been killed and maimed in the context of close-quarter, hand-to-hand assaults of great ferocity. Paediatricians serve as uniformed military surgeons and as civilian doctors in both international and civil wars, and have a significant strategic role to play as advocates for the rights and welfare of children in the context of the evolving 'Laws of War'. One chronic legacy of contemporary warfare is blast injury to children from landmines. Such blasts leave children without feet or lower limbs, with genital injuries, blindness and deafness. This pattern of injury has become one of the post-civil war syndromes encountered by all intensivists and surgeons serving in four of the world's continents. The continued advocacy for the international ban on the manufacture, commerce and military use of antipersonnel landmines is a part of all paediatricians' obligation to promote the ethos of the Laws of War. Post-traumatic stress disorder remains an undertreated legacy of children who have been trapped in the shot and shell of battle as well as those displaced as refugees. An urgent, unfocused and unmet challenge has been the increase in, and plight of, child soldiers themselves. A new class of combatant comprises these children, who also become enmeshed in the triad of anarchic civil war, light-weight weaponry and drug or alcohol addiction. The

  1. Effects of nuclear war

    SciTech Connect

    von Hippel, F.

    1983-01-01

    The author reviews the subject rising the following topics and subtopics: I. Nuclear explosions: heat, nuclear radiation, and radioactive fallout; II. Effects: radiation sickness, burns, blast injuries, and equivalent areas of death; III. Nuclear war: battlefield, regional, intercontinental - counterforce, and intercontinental - counter-city and industry. There are two appendices. 34 references, 32 figures.

  2. Risk of Acute Liver Injury Associated with the Use of Moxifloxacin and Other Oral Antimicrobials: A Retrospective, Population-Based Cohort Study

    PubMed Central

    Kaye, James A; Castellsague, Jordi; Bui, Christine L; Calingaert, Brian; McQuay, Lisa J; Riera-Guardia, Nuria; Saltus, Catherine W; Quinlan, Scott; Holick, Crystal N; Wahl, Peter M; Suzart, Kiliana; Rothman, Kenneth J; Wallander, Mari-Ann; Perez-Gutthann, Susana

    2014-01-01

    Study Objective To estimate the incidence and relative risk of a hospitalization or emergency visit for noninfectious liver injury in users of eight oral antimicrobials—amoxicillin, amoxicillin-clavulanic acid, clarithromycin, cefuroxime, doxycycline, levofloxacin, moxifloxacin, telithromycin—compared with nonusers of these antimicrobials. Design Retrospective, observational cohort study with a nested case-control analysis. Data Source HealthCore Integrated Research Database. Patients Adults with continuous health plan enrollment for at least 6 months before study entry who had a new dispensing of a study antimicrobial between July 1, 2001, and March 31, 2009. Cases had diagnoses indicating noninfectious liver injury during follow-up. To control for potentially confounding risk factors, 10 controls at risk for liver injury during follow-up were matched to each case by age, sex, and event date (liver injury date of the case), and analyses were adjusted for medical history, concomitant drugs, and health care service use. Measurements and Main Results Two physician reviewers (blind to exposure) validated the cases. Among 1.3 million antimicrobial users, we identified 607 cases of liver injury, including 82 cases of severe hepatocellular injury and 11 cases of liver failure. Liver injury incidence in nonusers of study antimicrobials was 35/100,000 person-years (95% confidence interval [CI] 29–42/100,000 person-years). For valid cases, the adjusted relative risk among current users of multiple antimicrobials was 3.2 (95% CI 1.6–6.7). Levofloxacin had the highest relative risk for current single use (3.2, 95% CI 1.8–5.8). Relative risks were also elevated for amoxicillin-clavulanic acid (2.5, 95% CI 1.3–5.0), doxycycline (2.5, 95% CI 1.2–5.2), moxifloxacin (2.3, 95% CI 1.1–4.7), and amoxicillin (2.3, 95% CI 1.1–4.7). Conclusion The results support a comparatively high adjusted relative risk of liver injury among patients exposed concurrently to

  3. Injuries suffered by dogs from riding in the back of open pickup trucks: a retrospective review of seventy cases.

    PubMed

    Houston, D M; Fries, C L; Alcorn, M J; Thomas, S S

    1995-08-01

    Case records of 70 dogs injured while riding in the back of open pickup trucks during the period January 1, 1982, to May 1, 1993, were reviewed. Most dogs were young (mean age 2.4 y) and of medium to large size (average weight 22.6 kg). Sixty-five dogs (93%) were injured during the months of April through October. Forty-nine dogs (70%) had single injuries and 21 dogs (30%) sustained multiple injuries. Fractures were the most frequent injury incurred, with fractures of the femur the most common. Surgical repair was recommended in all but 2 cases. PMID:7585438

  4. A Retrospective Observational Study Examining the Effect of Thoracic Epidural and Patient Controlled Analgesia on Short-term Outcomes in Blunt Thoracic Trauma Injuries

    PubMed Central

    Baker, Edward James; Lee, Geraldine Ann

    2016-01-01

    Abstract Effective analgesia in the early stages after any major traumatic event remains pivotal to optimal trauma management. For patients with significant thoracic injuries, this is paramount to ensure ongoing efficient respiratory function. The aim of this study was to investigate the use of analgesic modes in the management of patients with a primary thoracic injury and blunt mechanism of injury. By understanding variables that influence the use of varying analgesic modes and influence the development of pulmonary complications, there should be more uniform evidence-based prescription in the future. This retrospective study considered analgesic use in patients admitted after blunt thoracic injuries at one major trauma center over a 2-year period. Pulmonary complications measured included both infective and ventilator-associated failure. Univariate and multivariate analyses were used to identify patient and injury severity characteristics and their association with respiratory complications. A total of 401 cases were reviewed and analyzed: 159 received Patient Controlled Analgesia (PCA), 32 received PCA and epidural analgesia (EA), 6 received EA alone, and 204 received interval-administered analgesia. There were no significant differences in the rates of complication when compared between analgesic modes. Patients who developed pneumonia had significantly increased number of thoracic fractures and underlying organ injury (P < 0.05). Logistic regression analysis highlighted duration of intercostal drain insertion (OR 1.377, P = 0.001) and premorbid cardiac disease (OR 2.624, P = 0.042) and ICU length of stay (OR: 1.146, P < 0.001) as significant predictors of developing pneumonia in this patient group. Examining the different analgesic modes, this study failed to identify a particular analgesic mode that was more effective in preventing pulmonary complications in blunt thoracic injuries. However, variables that may influence usage of different

  5. Injury of the Arcuate Fasciculus in the Dominant Hemisphere in Patients With Mild Traumatic Brain Injury: A Retrospective Cross-Sectional Study.

    PubMed

    Jang, Sung Ho; Lee, Ah Young; Shin, So Min

    2016-03-01

    Little is known about injury of the arcuate fasciculus (AF) in patients with mild traumatic brain injury (TBI). We investigated injury of the AF in the dominant hemisphere in patients with mild TBI, using diffusion tensor tractography (DTT). We recruited 25 patients with injury of the left AF among 64 right-handed consecutive patients with mild TBI and 20 normal control subjects. DTTs of the left AF were reconstructed, and fractional anisotropy (FA), apparent diffusion coefficient (ADC), and fiber number of the AF were measured. Among 64 consecutive patients, 25 (39%) patients showed injury of the left AF. The patient group showed lower FA value and fiber number with higher ADC value than the control group (P < 0.05). On K-WAB evaluation, aphasia quotient and language quotient were 95.9 ± 4.1 (range 85-100) and 95.0 ± 5.4 (range 80-100), respectively. However, 23 (92.0%) of 25 patients complained of language-related symptoms after TBI; paraphasia in 12 (48.0%) patients, deficits of comprehension in 4 (16.0%) patients, deficits of speech production in 1 (4.0%) patient, and >2 language symptoms in 6 (24.0%) patients. We found that a significant number (39%) of patients with mild TBI had injury of the AF in the dominant hemisphere and these patients had mild language deficit. These results suggest that DTT could provide useful information in detecting injury of the AF and evaluation of the AF using DTT would be necessary even in the case of a patient with mild TBI who complains of mild language deficit. PMID:26945425

  6. Neuroimaging, Behavioral, and Psychological Sequelae of Repetitive Combined Blast/Impact Mild Traumatic Brain Injury in Iraq and Afghanistan War Veterans

    PubMed Central

    Cross, Donna J.; Yarnykh, Vasily L.; Richards, Todd; Martin, Nathalie M.; Pagulayan, Kathleen; Hoff, David; Hart, Kim; Mayer, Cynthia; Tarabochia, Matthew; Raskind, Murray A.; Minoshima, Satoshi; Peskind, Elaine R.

    2014-01-01

    Abstract Whether persisting cognitive complaints and postconcussive symptoms (PCS) reported by Iraq and Afghanistan war veterans with blast- and/or combined blast/impact-related mild traumatic brain injuries (mTBIs) are associated with enduring structural and/or functional brain abnormalities versus comorbid depression or posttraumatic stress disorder (PTSD) remains unclear. We sought to characterize relationships among these variables in a convenience sample of Iraq and Afghanistan-deployed veterans with (n=34) and without (n=18) a history of one or more combined blast/impact-related mTBIs. Participants underwent magnetic resonance imaging of fractional anisotropy (FA) and macromolecular proton fraction (MPF) to assess brain white matter (WM) integrity; [18F]-fluorodeoxyglucose positron emission tomography imaging of cerebral glucose metabolism (CMRglu); structured clinical assessments of blast exposure, psychiatric diagnoses, and PTSD symptoms; neurologic evaluations; and self-report scales of PCS, combat exposure, depression, sleep quality, and alcohol use. Veterans with versus without blast/impact-mTBIs exhibited reduced FA in the corpus callosum; reduced MPF values in subgyral, longitudinal, and cortical/subcortical WM tracts and gray matter (GM)/WM border regions (with a possible threshold effect beginning at 20 blast-mTBIs); reduced CMRglu in parietal, somatosensory, and visual cortices; and higher scores on measures of PCS, PTSD, combat exposure, depression, sleep disturbance, and alcohol use. Neuroimaging metrics did not differ between participants with versus without PTSD. Iraq and Afghanistan veterans with one or more blast-related mTBIs exhibit abnormalities of brain WM structural integrity and macromolecular organization and CMRglu that are not related to comorbid PTSD. These findings are congruent with recent neuropathological evidence of chronic brain injury in this cohort of veterans. PMID:24102309

  7. Traumatic brain injury produced by exposure to blasts, a critical problem in current wars: biomarkers, clinical studies, and animal models

    NASA Astrophysics Data System (ADS)

    Dixon, C. Edward

    2011-06-01

    Traumatic brain injury (TBI) resulting from exposure to blast energy released by Improvised Explosive Devices (IEDs) has been recognized as the "signature injury" of Operation Iraqi Freedom and Operation Enduring Freedom. Repeated exposure to mild blasts may produce subtle deficits that are difficult to detect and quantify. Several techniques have been used to detect subtle brain dysfunction including neuropsychological assessments, computerized function testing and neuroimaging. Another approach is based on measurement of biologic substances (e.g. proteins) that are released into the body after a TBI. Recent studies measuring biomarkers in CSF and serum from patients with severe TBI have demonstrated the diagnostic, prognostic, and monitoring potential. Advancement of the field will require 1) biochemical mining for new biomarker candidates, 2) clinical validation of utility, 3) technical advances for more sensitive, portable detectors, 4) novel statistical approach to evaluate multiple biomarkers, and 5) commercialization. Animal models have been developed to simulate elements of blast-relevant TBI including gas-driven shock tubes to generate pressure waves similar to those produced by explosives. These models can reproduce hallmark clinical neuropathological responses such as neuronal degeneration and inflammation, as well as behavioral impairments. An important application of these models is to screen novel therapies and conduct proteomic, genomic, and lipodomic studies to mine for new biomarker candidates specific to blast relevant TBI.

  8. Using the Reverse Shock Index at the Injury Scene and in the Emergency Department to Identify High-Risk Patients: A Cross-Sectional Retrospective Study

    PubMed Central

    Lai, Wei-Hung; Rau, Cheng-Shyuan; Hsu, Shiun-Yuan; Wu, Shao-Chun; Kuo, Pao-Jen; Hsieh, Hsiao-Yun; Chen, Yi-Chun; Hsieh, Ching-Hua

    2016-01-01

    Background: The ratio of systolic blood pressure (SBP) to heart rate (HR), called the reverse shock index (RSI), is used to evaluate the hemodynamic stability of trauma patients. A SBP lower than the HR (RSI < 1) indicates the probability of hemodynamic shock. The objective of this study was to evaluate whether the RSI as evaluated by emergency medical services (EMS) personnel at the injury scene (EMS RSI) and the physician in the emergency department (ED RSI) could be used as an additional variable to identify patients who are at high risk of more severe injury. Methods: Data obtained from all 16,548 patients added to the trauma registry system at a Level I trauma center between January 2009 and December 2013 were retrospectively reviewed. Only patients transferred by EMS were included in this study. A total of 3715 trauma patients were enrolled and subsequently divided into four groups: group I patients had an EMS RSI ≥1 and an ED RSI ≥1 (n = 3485); group II an EMS RSI ≥ 1 and an ED RSI < 1 (n = 85); group III an EMS RSI < 1 and an ED RSI ≥ 1 (n = 98); and group IV an EMS RSI < 1 and a ED RSI < 1 (n = 47). A Pearson’s χ2 test, Fisher’s exact test, or independent Student’s t-test was conducted to compare trauma patients in groups II, III, and IV with those in group I. Results: Group II and IV patients had a higher injury severity score, a higher incidence of commonly associated injuries, and underwent more procedures (including intubation, chest tube insertion, and blood transfusion in the ED) than patients in group I. Group II and IV patients were also more likely to receive a severe injury to the thoracoabdominal area. These patients also had worse outcomes regarding the length of stay in hospital and intensive care unit (ICU), the proportion of patients admitted to ICU, and in-hospital mortality. Group II patients had a higher adjusted odds ratio for mortality (5.8-times greater) than group I patients. Conclusions: Using an RSI < 1 as a threshold

  9. Effects of closure of an urban level I trauma centre on adjacent hospitals and local injury mortality: a retrospective, observational study

    PubMed Central

    Crandall, Marie; Sharp, Douglas; Wei, Xiong; Nathens, Avery; Hsia, Renee Y

    2016-01-01

    Objective To determine the association of the Martin Luther King Jr Hospital (MLK) closure on the distribution of admissions on adjacent trauma centres, and injury mortality rates in these centres and within the county. Design Observational, retrospective study. Setting Non-public patient-level data from the state of California were obtained for all trauma patients from 1999 to 2009. Geospatial analysis was used to visualise the redistribution of trauma patients to other hospitals after MLK closed. Variance of observed to expected injury mortality using multivariate logistic regression was estimated for the study period. Participants A total of 37 131 trauma patients were admitted to the five major south Los Angeles trauma centres from the MLK service area between 1999 and 2009. Main outcome measures (1) Number and type of trauma admissions to trauma centres in closest proximity to MLK; (2) inhospital injury mortality of trauma patients after the trauma centre closure. Results During and after the MLK closure, trauma admissions increased at three of the four nearby hospitals, particularly admissions for gunshot wounds (GSWs). This redistribution of patient load was accompanied by a dramatic change in the payer mix for surrounding hospitals; one hospital's share of uninsured more than tripled from 12.9% in 1999 to 44.6% by 2009. Overall trauma mortality did not significantly change, but GSW mortality steadily and significantly increased after the closure from 5.0% in 2007 to 7.5% in 2009. Conclusions Though local hospitals experienced a dramatic increase in trauma patient volume, overall mortality for trauma patients did not significantly change after MLK closed. PMID:27165650

  10. Neurology in the Vietnam War.

    PubMed

    Gunderson, Carl H; Daroff, Robert B

    2016-01-01

    Between December 1965 and December 1971, the United States maintained armed forces in Vietnam never less than 180,000 men and women in support of the war. At one time, this commitment exceeded half a million soldiers, sailors, and airmen from both the United States and its allies. Such forces required an extensive medical presence, including 19 neurologists. All but two of the neurologists had been drafted for a 2-year tour of duty after deferment for residency training. They were assigned to Vietnam for one of those 2 years in two Army Medical Units and one Air Force facility providing neurological care for American and allied forces, as well as many civilians. Their practice included exposure to unfamiliar disorders including cerebral malaria, Japanese B encephalitis, sleep deprivation seizures, and toxic encephalitis caused by injection or inhalation of C-4 explosive. They and neurologists at facilities in the United States published studies on all of these entities both during and after the war. These publications spawned the Defense and Veterans Head Injury Study, which was conceived during the Korean War and continues today as the Defense and Veterans Head Injury Center. It initially focused on post-traumatic epilepsy and later on all effects of brain injury. The Agent Orange controversy arose after the war; during the war, it was not perceived as a threat by medical personnel. Although soldiers in previous wars had developed serious psychological impairments, post-traumatic stress disorder was formally recognized in the servicemen returning from Vietnam. PMID:27035455

  11. Lingual nerve injury subsequent to wisdom teeth removal--a 5-year retrospective audit from a high street dental practice.

    PubMed

    Malden, N J; Maidment, Y G

    2002-08-24

    Lingual nerve damage subsequent to lower wisdom tooth removal affects a small number of patients, sometimes producing permanent sensory loss or impairment. A number of surgical techniques have been described which are associated with low incidences of this distressing post-operative complication. When a technique is adopted by an individual clinician then a personal audit may be prudent to establish how effective it is in relation to established nerve injury rates. This audit looks at a technique involving the minimal interference of lingual soft tissues during lower wisdom tooth removal in a high street practice situation for patients having mild to moderate impacted wisdom teeth removed under local anaesthetic. It was concluded that the technique employed was associated with a low incidence of lingual nerve trauma, comparable with that reported elsewhere. PMID:12222906

  12. Incidence and Risk Factors for Acute Kidney Injury Following Mannitol Infusion in Patients With Acute Stroke: A Retrospective Cohort Study.

    PubMed

    Lin, Shin-Yi; Tang, Sung-Chun; Tsai, Li-Kai; Yeh, Shin-Joe; Shen, Li-Jiuan; Wu, Fe-Lin Lin; Jeng, Jiann-Shing

    2015-11-01

    Mannitol, an osmotic diuretic, is commonly used to treat patients with acute brain edema, but its use also increases the risk of developing acute kidney injury (AKI). In this study, we investigated the incidence and risk factors of mannitol-related AKI in acute stroke patients.A total of 432 patients (ischemic stroke 62.3%) >20 years of age who were admitted to the neurocritical care center in a tertiary hospital and received mannitol treatment were enrolled in this study. Clinical parameters including the scores of National Institutes of Health Stroke Scale (NIHSS) at admission, vascular risk factors, laboratory data, and concurrent nephrotoxic medications were registered. Acute kidney injury was defined as an absolute elevation in the serum creatinine (Scr) level of ≥0.3 mg/dL from the baseline or a ≥50% increase in Scr.The incidence of mannitol-related AKI was 6.5% (95% confidence interval, 4.5%-9.3%) in acute stroke patients, 6.3% in patients with ischemic stroke, and 6.7% in patients with intracerebral hemorrhage. Multivariate analysis revealed that diabetes, lower estimated glomerular filtration rate at baseline, higher initial NIHSS score, and concurrent use of diuretics increased the risk of mannitol-related AKI. When present, the combination of these elements displayed an area under the receiver operating characteristic curve of 0.839 (95% confidence interval, 0.770-0.909). In conclusion, mannitol-related AKI is not uncommon in the treatment of acute stroke patients, especially in those with vulnerable risk factors. PMID:26632702

  13. A retrospective, multi-center cohort study evaluating the severity- related effects of cerebrolysin treatment on clinical outcomes in traumatic brain injury.

    PubMed

    Muresanu, Dafin F; Ciurea, Alexandru V; Gorgan, Radu M; Gheorghita, Eva; Florian, Stefan I; Stan, Horatiu; Blaga, Alin; Ianovici, Nicolai; Iencean, Stefan M; Turliuc, Dana; Davidescu, Horia B; Mihalache, Cornel; Brehar, Felix M; Mihaescu, Anca S; Mardare, Dinu C; Anghelescu, Aurelian; Chiparus, Carmen; Lapadat, Magdalena; Pruna, Viorel; Mohan, Dumitru; Costea, Constantin; Costea, Daniel; Palade, Claudiu; Bucur, Narcisa; Figueroa, Jesus; Alvarez, Anton

    2015-01-01

    Traumatic brain injury (TBI) is a leading cause of death and disability for which there is currently no effective drug therapy available. Because drugs targeting a single TBI pathological pathway have failed to show clinical efficacy to date, pleiotropic agents with effects on multiple mechanisms of secondary brain damage could represent an effective option to improve brain recovery and clinical outcome in TBI patients. In this multicenter retrospective study, we investigated severity-related efficacy and safety of the add-on therapy with two concentrations (20 ml/day or 30 ml/day) of Cerebrolysin (EVER Neuro Pharma, Austria) in TBI patients. Adjunctive treatment with Cerrebrolysin started within 48 hours after TBI and clinical outcomes were ranked according to the Glasgow Outcome Scale and the Modified Rankin Disability Score at 10 and 30 days post-TBI. Analyses of efficacy were performed separately for subgroups of patients with mild, moderate or severe TBI according to Glasgow Coma Scale scores at admission. Compared to standard medical care alone (control group), both doses of Cerebrolysin were associated with improved clinical outcome scores at 10 days post-TBI in mild patients and at 10 and 30 days in moderate and severe cases. A dose-dependent effect of Cerebrolysin on TBI recovery was supported by the dose-related differences and the significant correlations with treatment duration observed for outcome measures. The safety and tolerability of Cerebrolysin in TBI patients was very good. In conclusion, the results of this large retrospective study revealed that early Cerebrolysin treatment is safe and is associated to improved TBI outcome. PMID:25924999

  14. Care and meaning in war zone nursing.

    PubMed

    Cuellar, Ernestine Tina

    2009-12-01

    During the past century, nurses have served as caregivers for United States military personnel in every major theater of war. Military nurses in the war zone deliver patient care while working in austere conditions, and are under constant threat of personal danger. This article gives a historical overview of the role of nurses in war zones, followed by a review from the perspectives of environment, safety, the nature of injuries, and treatment of military personnel and civilians. PMID:19850184

  15. How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis

    PubMed Central

    Hsieh, Ting-Min; Tsai, Tsung-Cheng; Liu, Yueh-Wei; Hsieh, Ching-Hua

    2016-01-01

    Background: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. Methods: High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher’s exact or Pearson’s chi-square tests were used to compare categorical data, unpaired Student’s t-test was used to analyze normally distributed continuous data, and Mann–Whitney’s U test was used to compare non-normally distributed data. Results: In this study, the majority (76%, 101/133) of high-grade BHSI were due to motorcycle crashes. Car occupants had a significantly higher injury severity score (ISS; 26.8 ± 10.9 vs. 20.7 ± 10.4, respectively, p = 0.005) and organ injured score (OIS; 3.8 ± 1.0 vs. 3.4 ± 0.6, respectively, p = 0.033), as well as a significantly longer hospital length of stay (LOS; 21.2 days vs. 14.6 days, respectively, p = 0.038) than did motorcyclists. Car occupants with high-grade BHSI also had worse clinical presentations than their motorcyclist counterparts, including a significantly higher incidence of hypotension, hyperpnea, tube thoracostomy, blood transfusion >4 units, LOS in intensive care unit >5 days, and complications. However, there were no differences in the percentage of angiography or laparotomy performed or mortality rate between these two groups of patients. Conclusions: This study demonstrated that car occupants with high-grade BHSI were injured more severely, had a higher incidence of worse clinical presentation, had a longer hospital LOS, and had a higher incidence of

  16. The characteristics and clinical outcome of drug-induced liver injury in a Chinese hospital: A retrospective cohort study.

    PubMed

    Chen, Sheng-Sen; Yu, Kang-Kang; Huang, Chong; Li, Ning; Zheng, Jian-Ming; Bao, Su-Xia; Chen, Ming-Quan; Zhang, Wen-Hong

    2016-08-01

    The aim of this cohort study was to determine the characteristics and clinical outcome of 287 patients with drug-induced liver injury (DILI) in a Chinese hospital.Between January 2008 and January 2013, individuals who were diagnosed with DILI were selected. The complete medical records of each case were reviewed, and factors for the outcome of patients with DILI were extracted and analyzed using univariate and multivariate analysis.Two hundred eighty-seven cases identified as DILI were included in the study. A total of 105 different drugs were considered to be related to the hepatotoxicity. The main causative group of drugs was Chinese herb (n = 111). Liver failure developed in 9 (3.1%) patients, and 2 died (0.7%). Overall, complete recovery occurred in 92 (32.1%) patients. Univariate analysis and binary logistic regression analysis identified the digestive symptoms, jaundice, total bilirubin (TBIL), and direct bilirubin (DBIL) as independent factors for the non-recovery of DILI. Then the prediction model, including digestive symptoms, jaundice, TBIL, and DBIL, was built by using binary logistic regression analysis again. Receiver operating characteristic curve validated the strong power (area under the curve (AUC) = 0.907) of prediction model for predicting the DILI non-recovery.DILI is an important cause of liver test abnormalities, and Chinese herb represented the most common drug group. The factors such as digestive symptoms, jaundice, TBIL, and DBIL have effect on DILI outcomes. The prediction model, including digestive symptoms, jaundice, TBIL, and DBIL, established in this study is really an excellent predictive tool for non-recovery of DILI patients. PMID:27559976

  17. Effects of topiramate on aggressive, self-injurious, and disruptive/destructive behaviors in the intellectually disabled: an open-label retrospective study.

    PubMed

    Janowsky, David S; Kraus, John E; Barnhill, Jarrett; Elamir, Belal; Davis, John M

    2003-10-01

    This study reviews the treatment response to the antiepileptic drug topiramate (Topamax-mean dose 202 mg/d, range 150-350 mg/d) of a group of 22 institutionalized intellectually disabled adults (8 males, 14 females, mean age 46.5 years, age range 25-70 years). These individuals were predominantly classified as having severe or profound intellectual disability and as having a mood disorder. The individuals studied were treated for aggression, self-injurious behaviors, destructive/disruptive behaviors or a combination of these, and/or other challenging and maladaptive behaviors. All subjects were receiving concurrent psychotropic and/or anticonvulsant medications. Effectiveness was determined by retrospective review of summaries of quarterly multidisciplinary Neuropsychiatric Behavioral Reviews. Assignment of global severity scores and evaluation of longitudinal behavioral graphs of target symptoms occurred. Overall, statistically significant decreases in global severity scores and in the cumulative aggression and worst behavior rates occurred in the subjects, especially when the 3 months before and the 3 to 6 months after starting topiramate were compared. The overall subject group showed no significant weight changes. One subject developed delirium, 1 developed hypoglycemia, 1 developed sedation, and 2 developed constipation. The results suggest that topiramate may have a role in the treatment of challenging/maladaptive behaviors in intellectually disabled individuals. PMID:14520128

  18. Risk factors and prognostic factors of acute kidney injury in children: A retrospective study between 2003 and 2013.

    PubMed

    Zhou, Yan-mei; Yin, Xiao-ling; Huang, Zhi-bin; He, Yong-hua; Qiu, Li-ru; Zhou, Jian-hua

    2015-12-01

    Recent report on epidemiology of acute kidney injury (AKI) is lacking for Chinese children. We aimed to investigate the risk factors for stage and prognostic factors for renal recovery in hospitalized children. Pediatric patients (≤18 years old) admitted during 2003 to 2013 were enrolled in this study. AKI was defined and staged using Kidney Disease Improving Global Outcomes (KDIGO) criteria. Logistic regression analysis was performed to determine the risk factors and prognostic factors. The morbidity of pediatric AKI was 0.31% (205/65 237). There were 45 (22.0%) cases in stage III, 30 (14.6%) cases in stage II and 130 (63.4%) cases in stage III. The majority of etiologies were intrinsic renal defects (85.4%). Age, weight, vomit, etiology, blood urea nitrogen (BUN) at admission and several blood gas measurements were associated with AKI stage III. Age (OR=0.894; 95% CI, 0.832-0.962; P=0.003), vomit (OR=2.375; 95% CI, 1.058-5.333; P=0.036) and BUN at admission (OR=1.135; 95% CI, 1.085-1.187; P<0.001) were identified as independent risk factors for AKI stage III. After treatment, 172 (83.9%) patients achieved complete or partial recovery. The mortality was 3.9%. Variables were found as prognostic factors for renal recovery, such as age, stage, hospital stay, BUN at discharge, white blood cells, red blood cells, platelets (PLTs), blood pH and urine blood. Among them, AKI stage (stage III vs. stage I; OR, 6.506; 95% CI, 1.640-25.816; P=0.008), BUN at discharge (OR, 0.918; 95% CI, 0.856-0.984; P=0.016) and PLTs (OR, 1.007; 95% CI, 1.001-1.013; P=0.027) were identified as independent prognostic factors. AKI is still common in Chinese hospitalized children. Identified risk factors and prognostic factors provide guiding information for clinical management of AKI. PMID:26670426

  19. Rutherford's war

    NASA Astrophysics Data System (ADS)

    Campbell, John

    2016-02-01

    Seagulls, sea lions and the comic-book hero Professor Radium were all recruited to fight the threat of submarines during the First World War. But as John Campbell explains, it was Ernest Rutherford who led the way a century ago in using acoustics to deter these deadly craft.

  20. Is a black eye a useful sign of facial fractures in patients with minor head injuries? A retrospective analysis in a level I trauma centre over 10 years.

    PubMed

    Büttner, Michael; Schlittler, Fabian Lukas; Michel, Chantal; Exadaktylos, Aris Konstantinos; Iizuka, Tateyuki

    2014-07-01

    Orbital blunt trauma is common, and the diagnosis of a fracture should be made by computed tomographic (CT) scan. However, this will expose patients to ionising radiation. Our objective was to identify clinical predictors of orbital fracture, in particular the presence of a black eye, to minimise unnecessary exposure to radiation. A 10-year retrospective study was made of the medical records of all patients with minor head trauma who presented with one or two black eyes to our emergency department between May 2000 and April 2010. Each of the patients had a CT scan, was over 16 years old, and had a Glasgow Coma Score (GCS) of 13-15. The primary outcome was whether the black eye was a valuable predictor of a fracture. Accompanying clinical signs were considered as a secondary outcome. A total of 1676 patients (mean (SD) age 51 (22) years) and minor head trauma with either one or two black eyes were included. In 1144 the CT scan showed a fracture of the maxillofacial skeleton, which gave an incidence of 68.3% in whom a black eye was the obvious symptom. Specificity for facial fractures was particularly high for other clinical signs, such as diminished skin sensation (specificity 96.4%), diplopia or occulomotility disorders (89.3%), fracture steps (99.8%), epistaxis (95.5%), subconjunctival haemorrhage (90.4%), and emphysema (99.6%). Sensitivity for the same signs ranged from 10.8% to 22.2%. The most striking fact was that 68.3% of all patients with a black eye had an underlying fracture. We therefore conclude that a CT scan should be recommended for every patient with minor head injury who presents with a black eye. PMID:24793410

  1. Unruly Bodies: The Rhetorical Domestication of Twenty-First-Century Veterans of War

    ERIC Educational Resources Information Center

    Achter, Paul

    2010-01-01

    Veterans of wars in Afghanistan and Iraq with visually identifiable injuries possess "unruly" bodies that render the story of war in efficient, emotional terms. The injured veteran's explicit connection of war with injury motivates state and mainstream news discourse that domesticates veterans' bodies, managing representations of injured veterans…

  2. Water Wars

    Energy Science and Technology Software Center (ESTSC)

    2012-09-11

    Sandia National Laboratories and Intel Corporation are cooperating on a project aimed at developing serious games to assist in resource planners in conducting open and participatory projects. Water Wars serves as a prototype game focused on water issues. Water Wars is a multi-player, online role-playing "serious game" combining large-scale simulation (e.g. SimCity), with strategy and interpersonal interaction (e.g. Diplomacy). The game is about water use set in present-day New Mexico. Players enact various stakeholder rolesmore » and compete for water while simultaneously cooperating to prevent environmental collapse. The gamespace utilizes immersive 3D graphics to bring the problem alive. The game integrates Intel's OpenSim visualization engine with Sandia developed agent-based and system dynamics models.« less

  3. Water Wars

    SciTech Connect

    Clark-Casey, Justin

    2012-09-11

    Sandia National Laboratories and Intel Corporation are cooperating on a project aimed at developing serious games to assist in resource planners in conducting open and participatory projects. Water Wars serves as a prototype game focused on water issues. Water Wars is a multi-player, online role-playing "serious game" combining large-scale simulation (e.g. SimCity), with strategy and interpersonal interaction (e.g. Diplomacy). The game is about water use set in present-day New Mexico. Players enact various stakeholder roles and compete for water while simultaneously cooperating to prevent environmental collapse. The gamespace utilizes immersive 3D graphics to bring the problem alive. The game integrates Intel's OpenSim visualization engine with Sandia developed agent-based and system dynamics models.

  4. [Endovascular surgery in the war].

    PubMed

    Reva, V A; Samokhvalov, I M

    2015-01-01

    Rapid growth of medical technologies has led to implementation of endovascular methods of diagnosis and treatment into rapidly developing battlefield surgery. This work based on analysing all available current publications generalizes the data on using endovascular surgery in combat vascular injury. During the Korean war (1950-1953) American surgeons for the first time performed endovascular balloon occlusion of the aorta - the first intravascular intervention carried out in a zone of combat operations. Half a century thereafter, with the beginning of the war in Afghanistan (2001) and in Iraq (2003) surgeons of central hospitals of the USA Armed Forces began performing delayed endovascular operations to the wounded. The development of technologies, advent of mobile angiographs made it possible to later on implement high-tech endovascular interventions in a zone of combat operations. At first, more often they performed implantation of cava filters, somewhat afterward - angioembolization of damaged accessory vessels, stenting and endovascular repair of major arteries. The first in the theatre of war endovascular prosthetic repair of the thoracic aorta for severe closed injury was performed in 2008. Russian experience of using endovascular surgery in combat injuries is limited to diagnostic angiography and regional intraarterial perfusion. Despite the advent of stationary angiographs in large hospitals of the RF Ministry of Defence in the early 1990s, endovascular operations for combat vascular injury are casuistic. Foreign experience in active implementation of endovascular technologies to treatment of war-time injuries has substantiated feasibility of using intravascular interventions in tertiary care military hospitals. Carrying out basic training courses on endovascular surgery should become an organic part of preparing multimodality general battlefield surgeons rendering care on the theatre of combat operations. PMID:26035580

  5. Lower jaw reconstruction and dental rehabilitation after war injuries: The experience of Paul Tessier in Iran in the late 1980s.

    PubMed

    Simon, François; Ketoff, Serge; Guichard, Benjamin; Wolfe, S Anthony; Tulasne, Jean-François; Bertolus, Chloé; Khonsari, Roman Hossein

    2015-06-01

    Iraq-Iran war resulted in more than 400,000 people requiring prolonged medical care in Iran. An international team of prominent reconstructive surgeons led by Paul Tessier, the founder of craniofacial surgery, was invited to Iran during the war by official organizations entitled to support war victims. This team provided up-to-date oral and maxillofacial rehabilitation to patients with severe trauma defects in the lower third of the face. We collected the medical notes of 43 patients operated on by the Tessier team in Iran in the 1980s (files property of AFCF). The parameters we collected were: age of the patient, nature of the trauma (when available), previous procedures, number of implants placed (mandibular and maxillary), associated procedures (bone grafts, soft-tissue procedures, orthognathic surgery). A protocol based on soft-tissue rehabilitation using local flaps, parietal or iliac bone grafts and implant placement 6 months later was used in all patients. Paul Tessier's approach emphasizes the importance of keeping high standards of care in difficult situations and maintaining standard protocols. PMID:25887424

  6. Injuries presenting to a walk-in clinic at a summer dance intensive program: a three-year retrospective data analysis.

    PubMed

    Fulton, Jessica; Burgi, Ciara; Canizares, Rosalinda C; Sheets, Charles; Butler, Robert J

    2014-01-01

    Summer dance intensive programs are an integral part of many serious dancers' training. The risk and rate of injury in this setting have not been well studied. The goal of this data analysis is to detail the epidemiology of dance injuries reported during a summer dance intensive over a consecutive 3 year period. Data collection included information regarding the number of evaluation and treatment sessions conducted at the program's walk-in clinic, body regions injured, whether the injuries were recurrences of pre-existing conditions or newly sustained during the intensive, and at what point in the program they were recorded. Overall, more of the clinic's clientele presented with multiple injuries than with single discrete injuries. The anatomic distribution of injuries appears to be consistent with previously reported data, with the four most commonly injured body regions being ankle, pelvis and hip, knee, and lumbar spine. Injuries sustained during the intensive (IR) occurred at a 2:1 ratio to pre-intensive injuries (PR). Relative to those with PR injuries, dancers with IR injuries were far more likely to present during the first half of the program. This study is a first step toward filling a gap in the literature by describing injury incidence in a specific population within the dance community. PMID:25474178

  7. Occupational outcomes following mild traumatic brain injury in Canadian military personnel deployed in support of the mission in Afghanistan: a retrospective cohort study

    PubMed Central

    Garber, Bryan G; Rusu, Corneliu; Zamorski, Mark A; Boulos, David

    2016-01-01

    Objective Deployment-related mild traumatic brain injury (MTBI) occurs in a significant number of military personnel but its long-term impacts are unclear. This study explores the impact of deployment-related MTBI on continued fitness-for-duty, with the ultimate intent of identifying potential targets for intervention to attenuate its effects. Participants Consisted of 16 193 Canadian Armed Forces (CAF) personnel who deployed in support of the mission in Afghanistan and completed an enhanced postdeployment screening (EPDS) questionnaire over the period January 2009–July 2012. Primary outcome The primary outcome was development of permanent medical unfitness defined as a ‘career-limiting medical condition’ (CL-MC). The secondary outcome was the diagnostic categories recorded for each individual at the time a CL-MC was established. Design This study used a retrospective cohort design. Linked administrative and health data provided the primary outcome and the diagnoses responsible for it. Survival analysis was used to estimate the risk of a CL-MC and Cox regression provided adjusted HRs (aHRs) for the association between a CL-MC and MTBI, accounting for key covariates and confounders. Diagnostic categories associated with CL-MCs were identified. Results Over a median follow-up period of 3.42 years, 6.57% of the study population developed a CL-MC. MTBI was independently associated with CL-MCs (aHR=1.65, 95% CI 1.35 to 2.03). Mental disorders and musculoskeletal conditions were the primary diagnoses associated with CL-MCs (identified as the primary diagnosis in 55.4% and 25.9%, respectively), and a neurological condition was only documented in 5.8% of those with MTBI who developed a CL-MC Conclusions Deployment-related MTBI was associated with adverse occupational outcome but mental disorders and musculoskeletal conditions primarily drove subsequent medical unfitness. These findings support a diagnostic and treatment approach focusing on these comorbidities as

  8. The Forgotten War: Korea.

    ERIC Educational Resources Information Center

    Fleming, Dan B.; Kaufman, Burton I.

    1990-01-01

    Evaluates the coverage of the Korean War in 12 high school history textbooks. Lists the books, and reviews the coverage of each in the areas of: total coverage and illustrations; Korean war background; causes of the War; the Truman response; waging the War; the Truman-MacArthur controversy; and the results of the War. (GG)

  9. Factors influencing injury severity score regarding Thai military personnel injured in mass casualty incident April 10, 2010: lessons learned from armed conflict casualties: a retrospective study

    PubMed Central

    2012-01-01

    Background Political conflicts in Bangkok, Thailand have caused mass casualties, especially the latest event April 10, 2010, in which many military personnel were injured. Most of them were transferred to Phramongkutklao Hospital, the largest military hospital in Thailand. The current study aimed to assess factors influencing Injury Severity Score (ISS) regarding Thai military personnel injured in the mass casualty incident (MCI) April 10, 2010. Methods A total of 728 injured soldiers transferred to Phramongkutklao Hospital were reviewed. Descriptive statistics was used to display characteristics of the injuries, relationship between mechanism of injury and injured body regions. Multiple logistic regressions were used to calculate the adjusted odds ratio (adjusted OR) of ISS comparing injured body region categories. Results In all, 153 subjects defined as major data category were enrolled in this study. Blast injury was the most common mechanism of injury (90.2%). These victims displayed 276 injured body regions. The most common injured body region was the extremities (48.5%). A total of 18 patients (11.7%) had an ISS revealing more than 16 points. Three victims who died were expected to die due to high Trauma and Injury Severity Score (TRISS). However, one with high TRISS survived. Factors influencing ISS were age (p = 0.04), abdomen injury (adjusted OR = 29.9; 95% CI, 5.8-153.5; P < 0.01), head & neck injury (adjusted OR = 13.8; 95% CI, 2.4-80.4; P < 0.01) and chest injury (adjusted OR = 9.9; 95% CI, 2.1-47.3; P < 0.01). Conclusions Blast injury was the most common mechanism of injury among Thai military personnel injured in the MCI April 10, 2010. Age and injured body region such as head & neck, chest and abdomen significantly influenced ISS. These factors should be investigated for effective medical treatment and preparing protective equipment to prevent such injuries in the future. PMID:22214518

  10. Retrospective Evaluation of Canine and Feline Maxillomandibular Trauma Cases; Comparison of Lunar Cycle and Seasonality with Non-maxillomandibular Traumatic Injuries (2003-2012)

    PubMed Central

    Mulherin, Brenda L.; Soukup, Jason W.; Hetzel, Scott

    2014-01-01

    Summary Objectives To determine relationships between seasonality and lunar cycle and the frequency of maxillomandibular (MM) and non-maxillomandibular (non-MM) injury in canine and feline trauma patients. Methods A medical records database was searched to identify all MM trauma patients (67) and a random sample of non-MM trauma patients (129) according to search criteria. Season of injury, moon phase and moon luminosity were calculated for the date of injury. Results MM injury occurred predominately in the spring and decreased through winter while non-MM injury occurred more frequently in the summer and fall. The difference in the frequency of MM and non-MM injuries during different seasons was not significant (p=0.071). When comparing injuries occurring in the quarters following the full moon and leading up to the full moon, a difference (p=0.007) was noted with an increased percentage of moon was illuminated at the time injuries occurred following a full moon as compared to leading up to the full moon. Clinical Significance These results may guide clinicians to closely evaluate trauma patients that are presented on emergency during a particular season or lunar phase. Based on the season at the time of injury, close evaluation for MM versus non-MM trauma may be appropriate. PMID:24569925

  11. A retrospective study evaluating the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures

    PubMed Central

    Su, Yunshan; Ren, Dong; Zou, Yan; Lu, Jian; Wang*, Pengcheng

    2016-01-01

    OBJECTIVE: To evaluate the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures. METHODS: Fifty-six cases of thoracolumbar vertebral fractures treated in our trauma center from October 2012 to October 2013 were included in this study. The fractures were classified by the anteroposterior classification, whereas the severity of intervertebral disc injury was evaluated using magnetic resonance imaging. The Spearman correlation coefficient was used to analyze the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar fractures, whereas a χ2 test was adopted to measure the variability between different fracture types and upper and lower adjacent disc injuries. RESULTS: The Spearman correlation coefficients between fracture types and the severity of the upper and lower adjacent disc injuries were 0.739 (PU<0.001) and 0.368 (PL=0.005), respectively. It means that the more complex Arbeitsgemeinschaft für Osteosynthesefragen (AO) classifications are the disc injury is more severe. There was also a significant difference in the severity of injury between the upper and lower adjacent discs near the fractured vertebrae (p<0.001). CONCLUSIONS: In thoracolumbar spinal fractures, the severity of the adjacent intervertebral disc injury is positively correlated with the anteroposterior fracture type. The injury primarily involves intervertebral discs near the fractured end plate, with more frequent and severe injuries observed in the upper than in the lower discs. The presence of intervertebral disc injury, along with its severity, may provide useful information during the clinical decision-making process. PMID:27438561

  12. The War (on Terror) on Alzheimer's.

    PubMed

    George, Daniel R; Whitehouse, Peter J

    2014-01-01

    In the decade following the tragedies of 9/11, a US-led "War on Terror" has coincided with a US-led "War on Alzheimer's disease". Not only has the rhetoric from these two wars overlapped and produced similar practical and conceptual problems, the campaigns have also become interwoven through the emerging public health issue of war-related head injuries, as well as a shared neglect for environmental contributions to human suffering. This article first explores similarities in the framing and prosecution of both wars, and then considers the long-term consequences of traumatic brain injuries (TBI) and traumatic environmental injuries (TEI) in the context of a society facing the increased prevalence of dementia. Ultimately, it is argued that addressing the challenges of cognitive aging and preventing violent social conflict both require a vernacular of higher ideals and values--as well as new language patterns rising out of the ecological movement--to trump the more expedient war rhetoric that has disproportionately marked public discourse around terrorism and Alzheimer's disease during the past decade. PMID:24381043

  13. Radiation combined injury: overview of NIAID research.

    PubMed

    DiCarlo, Andrea L; Ramakrishnan, Narayani; Hatchett, Richard J

    2010-06-01

    The term "radiation combined injury" (RCI) is used to describe conditions where radiation injury is coupled with other insults such as burns, wounds, infection, or blunt trauma. A retrospective account of injuries sustained following the atomic bombing of Hiroshima estimates that RCI comprised approximately 65% of all injuries observed. Much of the research that has been performed on RCI was carried out during the Cold War and our understanding of the clinical problem RCI presents does not reflect the latest advances in medicine or science. Because concerns have increased that terrorists might employ radiological or nuclear weapons, and because of the likelihood that victims of such terrorism would experience RCI, the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health sponsored a meeting in 2007 to explore the state of the research in this area, identify programmatic gaps, and establish priorities for future research. As a follow-up to that meeting, in 2008 NIAID sponsored an initiative on RCI, leading to the award of several exploratory/developmental grants, the goals of which are to better understand biological synergy involved in RCI-induced damage, develop improved animal models for various type of RCI, and advance identification and testing of potential countermeasures to treat injuries that would be expected following a radiological or nuclear event. This program has already yielded new insight into the nature of combined injuries and has identified a number of novel and existing compounds that may be effective treatments for this condition. PMID:20445395

  14. Gender Differences in Sport Injury Risk and Types of Inju-Ries: A Retrospective Twelve-Month Study on Cross-Country Skiers, Swimmers, Long-Distance Runners and Soccer Players

    PubMed Central

    Ristolainen, Leena; Heinonen, Ari; Waller, Benjamin; Kujala, Urho M.; Kettunen, Jyrki A.

    2009-01-01

    This twelve months survey compared injury risk and injury types by genders (312 females, 262 males) in 15- to 35-year-old cross-country skiers, swimmers, long- distance runners and soccer players. More male than female athletes reported at least one acute injury (44% vs. 35%, p < 0.05), and more male than female runners reported at least one overuse injury (69% vs. 51%, p < 0.05). When the incidence of acute and overuse injuries both separately and combined was calculated per 1000 training hours, per 1000 competition hours and all exposure hours combined we found no gender differences in either of these comparisons. After adjustment for sport event males were at increased risk for posterior thigh overuse injuries compared to females (relative risk (RR) 5.8, 95% confidence interval (CI) 1.3 to 26.4, p < 0.05) while females were at increased risk for overuse injuries in the ankle compared to males (RR 3.1, 95% CI 1.0 to 9.3, p < 0.05). After adjustment for exposure time (injuries/1000 exposure hours) significance of the difference between the sexes in overuse injury to the ankle persisted (female 0.11 vs. male 0.02 injuries/1000 exposure hours, p < 0.05). Six athletes had an anterior cruciate ligament (ACL) injury, of whom four were female soccer players. After combining all reported acute and overuse ankle and knee injuries, the proportion of athletes with such injury was higher in the female compared to male soccer players (75% and 54% respectively; p < 0.05), but no difference was found in such injuries when calculated per 1000 exposure hours. In conclusion, we found some gender differences in sport-related injuries, but most of these differences seemed to be explained at least in part by differences in the amount of training. Key points Only a few sport injury studies have compared in-jury rates between the sexes Overall gender-related risk for acute and overuse injuries in top-level athletes between the sexes was small Some gender differences in the specific

  15. Adverse health consequences of the Vietnam War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2015-01-01

    The 40th anniversary of the end of the Vietnam War is a useful time to review the adverse health consequences of that war and to identify and address serious problems related to armed conflict, such as the protection of noncombatant civilians. More than 58,000 U.S. servicemembers died during the war and more than 150,000 were wounded. Many suffered from posttraumatic stress disorders and other mental disorders and from the long-term consequences of physical injuries. However, morbidity and mortality, although difficult to determine precisely, was substantially higher among the Vietnamese people, with at least two million of them dying during the course of the war. In addition, more than one million Vietnamese were forced to migrate during the war and its aftermath, including many "boat people" who died at sea during attempts to flee. Wars continue to kill and injure large numbers of noncombatant civilians and continue to damage the health-supporting infrastructure of society, expose civilians to toxic chemicals, forcibly displace many people, and divert resources away from services to benefit noncombatant civilians. Health professionals can play important roles in promoting the protection of noncombatant civilians during war and helping to prevent war and create a culture of peace. PMID:26754766

  16. Vietnam: Historians at War

    ERIC Educational Resources Information Center

    Moyar, Mark

    2008-01-01

    Although the Vietnam War ended more than thirty years ago, historians remain as divided on what happened as the American people were during the war. Mark Moyar maps the ongoing battle between "orthodox" and "revisionist" Vietnam War historians: the first group, those who depict Vietnam as a bad war that the United States should not have fought,…

  17. War and Children's Mortality.

    ERIC Educational Resources Information Center

    Carlton-Ford, Steve; Houston, Paula; Hamill, Ann

    2000-01-01

    Examines impact of war on young children's mortality in 137 countries. Finds that years recently at war (1990-5) interact with years previously at war (1946-89) to elevate mortality rates. Religious composition interacts with years recently at war to reduce effect. Controlling for women's literacy and access to safe water eliminates effect for…

  18. Returning from the War Zone: A Guide for Military Personnel

    MedlinePlus

    Hed Returning from the War Zone AGuide for Military Personnel Welcome home! Thank you for your service to ... the death or injury of friends or other military personnel, civilians, or enemy combatants. You may have survived ...

  19. The War of Jenkins’ Ear

    PubMed Central

    Graboyes, Evan M.; Hullar, Timothy E.

    2012-01-01

    Objective In 1731, Spanish sailors boarded the British brig Rebecca off the coast of Cuba and sliced off the left ear of its captain, Robert Jenkins. This traumatic auriculectomy was used as a pretext by the British to declare war on Spain in 1739, a conflict that is now known as the War of Jenkins’ Ear. Here, we examine the techniques available for auricular repair at the time of Jenkins’ injury and relate them to the historical events surrounding the incident. Methods Review of relevant original published manuscripts and monographs. Results Surgeons in the mid-18th century did not have experience with repair of traumatic total auriculectomies. Some contemporary surgeons favored auricular prostheses over surgical treatment. Methods for the reconstruction of partial defects were available, and most authors advocated a local post-auricular flap instead of a free tissue transfer. Techniques for repair of defects of the auricle lagged behind those for repair of the nose. Conclusion Limitations in care of traumatic auricular defects may have intensified the significance of Jenkins’ injury and helped lead to the War of Jenkins’ Ear, but conflict between Britain and Spain was probably unavoidable due to their conflicting commercial interests in the Caribbean. PMID:23444484

  20. Injuries in combat from 1982-2005 with particular reference to those to the head and neck: A review.

    PubMed

    Rustemeyer, Jan; Kranz, Volker; Bremerich, Andreas

    2007-10-01

    The aim of this review was to examine the range of combat injuries with particular reference to those of the head and neck. We evaluated 10 retrospective studies selected from the period 1982-2005 that covered war injuries from Vietnam, Lebanon, Slovenia, Croatia, Iraq, Somalia, and Afghanistan. We found differences in the causes of injuries. Injuries from fragments were more common during the 90s than during the Vietnam War, where shooting injuries predominated. Injuries to the trunk were reduced in conflicts from 1991 onwards as military personal armour systems including protective vests were used. However, the mortality of wounded soldiers in all conflicts was consistently between 10% and 14%. There was a high incidence of injuries to the head and neck (up to 40%) though they affected only 12% of the body surface area. Though the data from the different military conflicts are not totally comparable, there are trends in the type of injuries and mortality, which may lead to changes in existing systems of medical care. PMID:17316932

  1. Non-suicidal self-injury as a predictor of active and passive suicidal ideation among Iraq/Afghanistan war veterans.

    PubMed

    Kimbrel, Nathan A; Gratz, Kim L; Tull, Matthew T; Morissette, Sandra B; Meyer, Eric C; DeBeer, Bryann B; Silvia, Paul J; Calhoun, Patrick C; Beckham, Jean C

    2015-06-30

    The present study examined the association between lifetime non-suicidal self-injury (NSSI) and current suicidal ideation among Iraq/Afghanistan veterans. NSSI was positively associated with passive, active, and concurrent active-passive suicidal ideation at the bivariate level. NSSI remained a predictor of active, OR=5.15, and concurrent active-passive suicidal ideation, OR=7.01, when other risk factors were considered. These findings suggest that NSSI may be a particularly useful marker of active suicidal ideation among veterans. PMID:25858799

  2. Non-suicidal self-injury as a predictor of active and passive suicidal ideation among Iraq/Afghanistan war veterans

    PubMed Central

    Kimbrel, Nathan A.; Gratz, Kim L.; Tull, Matthew T.; Morissette, Sandra B.; Meyer, Eric C.; DeBeer, Bryann B.; Silvia, Paul J.; Calhoun, Patrick C.; Beckham, Jean C.

    2015-01-01

    The present study examined the association between lifetime non-suicidal self-injury (NSSI) and current suicidal ideation among Iraq/Afghanistan veterans. NSSI was positively associated with passive, active, and concurrent active-passive suicidal ideation at the bivariate level. NSSI remained a predictor of active, OR = 5.15, and concurrent active-passive suicidal ideation, OR = 7.01, when other risk factors were considered. These findings suggest that NSSI may be a particularly useful marker of active suicidal ideation among veterans. PMID:25858799

  3. Medical responsibility and thermonuclear war

    SciTech Connect

    Cassel, C.; Jameton, A.

    1982-09-01

    The attention of physicians is being drawn to the issue of nuclear weapons and nuclear war, creating controversy about whether a political concern is appropriate for health care professionals. The use of nuclear weapons would incur human death and injury on a scale both unprecedented and unimaginable, and possibly damage the ecosphere far beyond the weapons' immediate effects. Medical supplies and facilities would be nonexistent; no meaningful medical response would be possible. A physician's responsibility to prevent nuclear war is based on the imperative to prevent a devastating incurable disease that cannot be treated. Such an imperative is consistent with the historic tradition of the social responsibility of health professionals, and can be justified by philosophical argument.

  4. 48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...' compensation and war-hazard insurance. 628.305 Section 628.305 Federal Acquisition Regulations System...' compensation and war-hazard insurance. (b)(1) Acquisitions for services, including construction but excluding... employees and their beneficiaries for war-hazard injury, death, capture, or detention as prescribed by...

  5. Early opioid prescription and risk of long-term opioid use among US workers with back and shoulder injuries: a retrospective cohort study.

    PubMed

    Heins, Sara E; Feldman, Dorianne R; Bodycombe, David; Wegener, Stephen T; Castillo, Renan C

    2016-06-01

    The number of prescription opioid overdose deaths has increased dramatically in recent years and many prescribers are unsure how to balance treatment of pain with secondary prevention. Guidelines recommend low-severity injury patients not receive opioids early in the course of their care, but evidence supporting this guideline is limited. Data from 123 096 workers' compensation claims with back and shoulder injuries were analysed to evaluate this guideline. Back and shoulder injury claimants with early opioid use (≤1 month after injury) had 33% lower (95% CI 24% to 41% lower) odds and 29% higher (95% CI 6% to 58% higher) odds, respectively, of long-term opioid use (>3 months) than claimants with late opioid use, after adjusting for key covariates. Stratified analyses indicate that early opioid use does not appear to increase the risk of long-term use except in cases where no diagnosis or only the diagnosis of unspecified shoulder pain is given prior to prescription. PMID:26136461

  6. The unfought chemical war

    SciTech Connect

    Freeman, K. )

    1991-12-01

    In December 1943, in the middle of the scorching northern Australia summer, a young Australian commando, Tom Mitchell, sweated in his respirator and gas-protective clothing as he got ready to take part in a mustard-gas experiment. He grimly watched six US aircraft, B-24 Liberators, drop bombs filled with mustard gas on Brook Island, near Innisfail in the state of Queensland. Ten minutes later, Mitchell was rushing around the island to tend sampling equipment. But a few hours later, he and another Australian soldier were ordered back onto the island - this time, stripped of their respirators and protective clothing. They were forced to camp on the island from dusk to dawn in ordinary clothing without any safety equipment. Mitchell now suffers from lung and heart disease. Last year, nearly 47 years after he was burned, Mitchell settled with the Australian government for $25,000 (Australian). Publicity over his lawsuit, filed in 1981, along with revelations made in a documentary film broadcast in Australia in 1989, has prompted thousands of other Australian survivors of chemical-warfare tests to ask the Australian Department of Veterans Affairs for disability benefits. Veterans of chemical-warfare tests are also breaking their silence in the United States and Canada, stepping forward to seek compensation for their injuries. The impetus behind the US revelations came from a campaign begun in 1989 by Cong. Porter Goss, a Florida Republican, to win benefits for four participants in US Navy mustard-gas tests. During a flurry of publicity in mid-June 1991, the Department of Veterans Affairs announced that it was relaxing its rules to make it easier for World War 2 mustard-gas victims to collect benefits. In Canada, an information hot line run by the Department of National Defense in 1988 and a 1989 book by John Bryden, Deadly Allies: Canada's Secret War 1937-1947, brought the tests to national attention.

  7. Nuclear war: Opposing viewpoints

    SciTech Connect

    Szumski, B.

    1985-01-01

    This book presents opposing viewpoints on nuclear war. Topics discussed include: how nuclear would begin; would humanity survive; would civil defense work; will an arms agreement work; and can space weapons reduce the risk of nuclear war.

  8. Early Korean War Coverage.

    ERIC Educational Resources Information Center

    Lee, Raymond S. H.

    1978-01-01

    Examines the themes of the war front news reported in certain South Korean and United States newspapers during the first 16 days of the Korean War; attempts to determine significant differences in the themes of war front news between the Korean and United States papers. (Author/GT)

  9. Science and War.

    ERIC Educational Resources Information Center

    Roland, Alex

    1985-01-01

    Provides a wide-ranging survey of relations between war, science, and technology from the days of the American colonies to the Vietnam War, indicating that the overall impact of science and technology on war has been overstated by historians in many fields. Includes military histories that science/technology historians have not used. (JN)

  10. Bohler’s angle’s role in assessing the injury severity and functional outcome of internal fixation for displaced intra-articular calcaneal fractures: a retrospective study

    PubMed Central

    2013-01-01

    Background Controversy exits over the role of Böhler’s angle in assessing the injury severity of displaced intra-articular calcaneal fractures and predicting the functional outcome following internal fixation. This study aims to investigate whether a correlation exists between Böhler’s angle and the injury severity of displaced calcaneal fractures, and between surgical improvement of Böhler’s angle and functional outcome. Methods Patients treated operatively for unilateral closed displaced intra-articular calcaneal fractures from January 1, 2004 to March 31, 2008 were identified. The Böhler’s angles of both calcaneus were measured, and the measurement of the uninjured foot was used as its normal control. The difference in the value of Böhler’s angle measured preoperatively or postoperatively between the angle of the injured foot and that of the contralateral calcaneus were calculated, respectively. The change in Böhler’s angle by ratio was calculated by dividing the difference value of Böhler’s angle between bilateral calcaneus by its normal control. The injury severity was assessed according to Sanders classification. The functional outcomes were assessed using American Orthopaedic Foot & Ankle Society hindfoot scores. Results 274 patients were included into the study with a mean follow-up duration of 71 months. According to Sanders classification, the fracture pattern included 105 type II, 121 type III and 48 type IV fractures. According to American Orthopaedic Foot & Ankle Society hindfoot scoring system, the excellent, good, fair and poor results were achieved in 104, 132, 27, and 11 patients, respectively. The preoperative Böhler’s angle, difference value of Böhler’s angle between bilateral calcaneus, and change in Böhler’s angle by ratio each has a significant correlation with Sanders classification (rs=−0.178, P=0.003; rs=−0.174, P=0.004; rs=−0.172, P=0.005, respectively), however, is not correlated with functional outcome

  11. [Progress in surgery of limb's wounds during the Great War].

    PubMed

    Chauvin, Frédéric; Fischer, Louis-Paul; Ferrandis, Jean-Jacques; Chauvin, Edouard; Gunepin, François-Xavier

    2002-01-01

    The prominent tenets of limb's wound surgery have been improved during the Great War. Before 1914, traditional treatment of war injuries was usually applied on the ground because injuries caused by firearms were supposedly trivial while the threatening infection refrained surgeons from acting. From the very start of 1914, gangrene and septicaemia were the terrible consequences of new types of injuries provoked by shrapnel, all the more dangerous that the wounded men were numerous and the injuries were nursed after a too important delay. New surgical facilities have been organised by the French Military Health Service which created the "Ambulances Chirurgicales Automobiles", improved the selection procedures and the mobilization of many surgeons. New surgical treatments such as lancing, continuous use irrigation, delayed suture of wounds allowed improvement of results and saved more than one soldier. Finally, the excision of dead and contaminated tissues is still nowadays the most important progress in war surgery. PMID:12387254

  12. War zone paediatrics in Rwanda.

    PubMed

    Pearn, J

    1996-08-01

    Children are particularly vulnerable to injury and death in two types of 20th century conflicts; terrorist attack and civil war. This account describes some first-hand experiences of the aftermath of the Rwandan Civil War of 1994. Events leading to the conflict are described, eye witness accounts of child trauma during the war are recorded and the medical problems (currently ongoing) affecting children are described. Over a period of 3 months from April to June 1994, between half and one million Rwandese, a significant proportion of them women and children, were murdered in brutal hand-to-hand killing, dying from close-quarter gunshot and machete slaughter. Nearly half of the population became refugees in neighbouring countries or displaced persons in their own land. UNAMIR II, the United Nations Emergency Humanitarian Response, grew to some 7000 persons by May 1995. Medical aid was provided by emergency medical contingents from the United Kingdom, Canada and Australia, the latter through its Australian Medical Support Force, providing the definitive emergency medical infrastructure from August 1994. In the consequent post-war civil and social disruption, children suffered from burns, cholera and from motor vehicle trauma. Ongoing landmine blasts continue to affect children and adolescents especially. A new International humanitarian code to build a time-expiry device into landmines and other similar ordinance is urgently required as the post-conflict ongoing disasters in Rwanda, Afghanistan and Cambodia illustrate. Current problems affecting children include an increasing risk of HIV infection, trauma and the special humanitarian needs of thousands of orphans. PMID:8844531

  13. German Emergency Care in Neurosurgery and Military Neurology during World War II, 1939-1945.

    PubMed

    Stahnisch, Frank W

    2016-01-01

    A critical analysis of the historical involvement of neurology and neurosurgery in military emergency care services enables us to better contextualize and appreciate the development of modern neurology at large. Wartime neurosurgery and civil brain science during the German Nazi period tightly coalesced in examining the specific injury types, which military neurosurgeons such as Wilhelm Toennis, Klaus Joachim Zuelch, and Georg Merrem encountered and treated based on their neurophysiological understanding gained from earlier peacetime research. Collaborative associations with Dr. Toennis in particular proved to be highly beneficial to other military neurologists and neurosurgeons during World War II and beyond. This article also discusses the prewar developments and considers the fate of German neurosurgeons and military neurologists after the war. The envisaged dynamic concepts of fast action, reaction, and recycling, which contemporary physicians had intensively studied in the preceding scientific experiments in their neurophysiological laboratories, had already been introduced into neurological surgery during the interwar period. In retrospect, World War II emergency rescue units greatly strengthened military operations through an active process of 'recycling' indispensable army personnel. Neurosurgical emergency chains thereby introduced another decisive step in the modernization of warfare, in that they increased the momentum of military mobility in the field. Notwithstanding the violence of warfare and the often inhumane ways in which such knowledge in the field of emergency neurology was gained, the protagonists among the group of experts in military neurology and neurosurgery strongly contributed to the postwar clinical neuroscience community in Germany. In differing political pretexts, this became visible in both East Germany and West Germany after the war, while the specific military and political conditions under which this knowledge of emergency medicine

  14. Retrospective analysis of fatal falls.

    PubMed

    Thierauf, Annette; Preuss, Johanna; Lignitz, Eberhard; Madea, Burkhard

    2010-05-20

    Fatal falls are frequent and inhomogeneous events and affect every age. The criminalistic classification can often only be done on the basis of extensive investigations and the autopsy results. We retrospectively surveyed 291 cases of fatal falls on which a post-mortem examination had been carried out in the institutes of Forensic Medicine in Bonn and Greifswald. In large part, these cases are falls from height (n=123) and ground-level falls (n=122). These are compared to fatal falls down a stairs (n=46); the analysis is confined to injuries to the cranium. In ground-level falls the injury pattern in falls under the influence of alcohol differs from that of falls with no alcohol in the case history: all injuries are seen in higher relative frequency in casualties after the consumption of alcohol. In falls from height, the previous consumption of alcohol did not influence the injury pattern; the intracranial traumas are seen in decreasing frequency with increasing heights. The aim of this retrospective analysis is to present injury patterns and influencing factors like fall heights and alcohol for the different kinds of falls on the basis of our collective and to demonstrate similarities and differences between the subgroups. PMID:20176452

  15. The Effects of World War II on Economic and Health Outcomes across Europe

    PubMed Central

    Kesternich, Iris; Siflinger, Bettina; Smith, James P.; Winter, Joachim K.

    2013-01-01

    We investigate long-run effects of World War II on socio-economic status and health of older individuals in Europe. We analyze data from SHARELIFE, a retrospective survey conducted as part of SHARE in Europe in 2009. SHARELIFE provides detailed data on events in childhood during and after the war for over 20,000 individuals in 13 European countries. We construct several measures of war exposure—experience of dispossession, persecution, combat in local areas, and hunger periods. Exposure to war and more importantly to individual-level shocks caused by the war significantly predicts economic and health outcomes at older ages. PMID:24850973

  16. To Win a Nuclear War: The Pentagon's secret war plans

    SciTech Connect

    Kaku, M.; Axelrod, D.

    1986-01-01

    Kaku and Axelrod trace the evolution of the strategies and technologies of nuclear war planning, and the personalities of the planners, through post-war foreign policy from the Berlin Crisis to Star Wars. To Win a Nuclear War takes readers beyond the details of the costs of nuclear attack into the attitudes of war planners and Presidents from Eisenhower to Reagan.

  17. Retrospective studies.

    PubMed

    Silveira, Patrícia Pelufo; Manfro, Gisele Gus

    2015-01-01

    Large retrospective, epidemiological studies accumulated in the late 1980s, providing increasing evidence to the deeply rooted thought that perinatal events could persistently affect the individual's functioning and health/disease patterns throughout the lifetime. Evidences of such associations can be found in the literature since the beginning of the twentieth century, but studies from Barker, Hales, and colleagues serve as an important hallmark. They proposed the "thrifty phenotype" hypothesis, stating that poor nutrition in fetal and early infant life is detrimental to the development and function of the individuals' organism, predisposing them to the later development of adult chronic diseases. At first used to explain the increased risk for type 2 diabetes in low birth weight individuals, the hypothesis was soon adapted to other systems, becoming one of the core assumptions of the Developmental Origins of Adult Health and Disease (DOHaD) model. The central nervous system is also vulnerable to the effects of environmental variation during fetal or neonatal life. Many researchers have explored the effects of perinatal programming on the human neurodevelopment, and some aspects of the brain structure and/or functioning (such as cognitive function, physiological reactivity to stress, and the risk for behavioral disorders or psychopathology) were shown to be modifiable by the exposure to certain adverse events early in life such as neonatal infections, exposure to gestational psychosocial stress, nutrition during gestation, exposure to drugs, or tobacco smoking during pregnancy. Until recently, most studies focused on birth weight as a strong surrogate of the intrauterine environment, investigating the effects of low birth weight (as a marker of suboptimal fetal environment) on a variety of neurodevelopmental outcomes. Despite the fact that literature reviews on this topic are as old as 1940, the more recent retrospective studies are summarized in this chapter

  18. Healthcare utilization and mortality among veterans of the Gulf War

    PubMed Central

    Gray, Gregory C; Kang, Han K

    2006-01-01

    The authors conducted an extensive search for published works concerning healthcare utilization and mortality among Gulf War veterans of the Coalition forces who served during the1990–1991 Gulf War. Reports concerning the health experience of US, UK, Canadian, Saudi and Australian veterans were reviewed. This report summarizes 15 years of observations and research in four categories: Gulf War veteran healthcare registry studies, hospitalization studies, outpatient studies and mortality studies. A total of 149 728 (19.8%) of 756 373 US, UK, Canadian and Australian Gulf War veterans received health registry evaluations revealing a vast number of symptoms and clinical conditions but no suggestion that a new unique illness was associated with service during the Gulf War. Additionally, no Gulf War exposure was uniquely implicated as a cause for post-war morbidity. Numerous large, controlled studies of US Gulf War veterans' hospitalizations, often involving more than a million veterans, have been conducted. They revealed an increased post-war risk for mental health diagnoses, multi-symptom conditions and musculoskeletal disorders. Again, these data failed to demonstrate that Gulf War veterans suffered from a unique Gulf War-related illness. The sparsely available ambulatory care reports documented that respiratory and gastrointestinal complaints were quite common during deployment. Using perhaps the most reliable data, controlled mortality studies have revealed that Gulf War veterans were at increased risk of injuries, especially those due to vehicular accidents. In general, healthcare utilization data are now exhausted. These findings have now been incorporated into preventive measures in support of current military forces. With a few diagnostic exceptions such as amyotrophic lateral sclerosis, mental disorders and cancer, it now seems time to cease examining Gulf War veteran morbidity and to direct future research efforts to preventing illness among current and

  19. Adverse health consequences of the Iraq War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2013-03-16

    The adverse health consequences of the Iraq War (2003-11) were profound. We conclude that at least 116,903 Iraqi non-combatants and more than 4800 coalition military personnel died over the 8-year course. Many Iraqi civilians were injured or became ill because of damage to the health-supporting infrastructure of the country, and about 5 million were displaced. More than 31,000 US military personnel were injured and a substantial percentage of those deployed suffered post-traumatic stress disorder, traumatic brain injury, and other neuropsychological disorders and their concomitant psychosocial problems. Many family members of military personnel had psychological problems. Further review of the adverse health consequences of this war could help to minimise the adverse health consequences of, and help to prevent, future wars. PMID:23499043

  20. A two-year retrospective review of the determinants of pre-hospital analgesia administration by alpine helicopter emergency medical physicians to patients with isolated limb injury.

    PubMed

    Eidenbenz, D; Taffé, P; Hugli, O; Albrecht, E; Pasquier, M

    2016-07-01

    Up to 75% of pre-hospital trauma patients experience moderate to severe pain but this is often poorly recognised and treated with insufficient analgesia. Using multi-level logistic regression analysis, we aimed to identify the determinants of pre-hospital analgesia administration and choice of analgesic agent in a single helicopter-based emergency medical service, where available analgesic drugs were fentanyl and ketamine. Of the 1156 patients rescued for isolated limb injury, 657 (57%) received analgesia. Mean (SD) initial pain scores (as measured by a numeric rating scale) were 2.8 (1.8), 3.3 (1.6) and 7.4 (2.0) for patients who did not receive, declined, and received analgesia, respectively (p < 0.001). Fentanyl as a single agent, ketamine in combination with fentanyl and ketamine as a single agent were used in 533 (84%), 94 (14%) and 10 (2%) patients, respectively. A high initial on-scene pain score and a presumptive diagnosis of fracture were the main determinants of analgesia administration. Fentanyl was preferred for paediatric patients and ketamine was preferentially administered for severe pain by physicians who had more medical experience or had trained in anaesthesia. PMID:27091515

  1. Comparison of contemporary preoperative risk models at predicting acute kidney injury after isolated coronary artery bypass grafting: a retrospective cohort study

    PubMed Central

    Chen, Shao-Wei; Chang, Chih-Hsiang; Fan, Pei-Chun; Chen, Yung-Chang; Chu, Pao-Hsien; Chen, Tien-Hsing; Wu, Victor Chien-Chia; Chang, Su-Wei; Lin, Pyng-Jing; Tsai, Feng-Chun

    2016-01-01

    Objectives Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with short-term and long-term adverse outcomes. The European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, the Society of Thoracic Surgeons (STS) score and Age, Creatinine and Ejection Fraction (ACEF) score, have been widely used for predicting the operative risk of cardiac surgery. The aim of this study is to investigate the discriminant ability among current available models in predicting postoperative AKI. Methods From January 2010 to December 2012, 353 patients who underwent isolated CABG were enrolled. The clinical characteristics, outcomes and scores of prognostic models were collected. The primary outcome was postoperative AKI, defined based on the Kidney Disease Improving Global Outcome (KDIGO) Clinical Practice Guideline for AKI, in 2012. Results 102 patients (28.9%) developed postoperative AKI. For AKI prediction, EuroSCORE II, STS score and ACEF score were all good tools for stage-3 AKI. The ACEF score was shown to have satisfied discriminant ability to predict postoperative AKI with area under a receiver operating characteristic curve: 0.781±0.027, (95% CI 0.729 to 0.834, p value <0.001). Multivariate logistic analysis identified that lower ejection fraction and higher serum creatinine were independent risk factors for AKI. Conclusions The simple and extremely user-friendly ACEF score can accurately identify the risk of postoperative AKI and has shown satisfactory discriminant ability when compared with other systems. The ACEF score might be the easiest tool for predicting postoperative AKI. PMID:27354068

  2. Relevance of New Definitions to Incidence and Prognosis of Acute Kidney Injury in Hospitalized Patients with Cirrhosis: A Retrospective Population-Based Cohort Study

    PubMed Central

    Tandon, Puneeta; James, Matthew T.; Abraldes, Juan G.; Karvellas, Constantine J.; Ye, Feng; Pannu, Neesh

    2016-01-01

    Background The implementation of new serum creatinine (SCr)-based criteria for acute kidney injury (AKI) has brought to light several areas of uncertainty in patients with cirrhosis. Study Design Population-based cohort study. Setting & Participants Adults with cirrhosis hospitalized between 2002–2012. Predictor We aimed to address the prognostic implications of the new AKI criteria in cirrhosis. Outcomes Baseline kidney function was defined from all outpatient SCr within 3 months before hospitalization. Cox proportional hazards models were fit to examine associations between AKI, renal recovery and all-cause mortality. Results 4,733 patients were studied. The 30-day mortality was higher for participants with AKI (43.9% vs 8.5%; p-value<0.001), and increased with AKI severity. The highest incidence of AKI occurred when the lowest SCr within the three months prior to admission was used to define baseline. The hazard ratio for mortality using the lowest SCr within 3 months and the closest pre-admission SCr (definition suggested by the recent consensus guideline) were similar, validating the use of the latter measure. As compared to patients without AKI, stage 1 AKI with maximum SCr ≤132 mmol/L remained associated with a 3.5-fold increased hazard of death at 30 days (95% CI 2.6 to 4.7). Limitations As an observational study, the results were vulnerable to residual confounding and ascertainment bias in the use of laboratory data to identify AKI. We did not have access to liver function or disease etiology variables and were unable to adjust for these in our analyses. Conclusions These results confirm the graded relationship between AKI severity, renal recovery, and mortality and further clarify previously discordant reports about the prognostic relevance of new AKI criteria in patients with cirrhosis. PMID:27504876

  3. Early demographic and clinical predictors of developing acute kidney injury in snake bite patients: A retrospective controlled study from an Indian tertiary care hospital in North Eastern Uttar Pradesh India

    PubMed Central

    Singh, R. R.; Uraiya, Dharmendra; Kumar, Anoop; Tripathi, Neeraj

    2016-01-01

    Aims: This study was conducted retrospectively to define early demographic and clinical predictors for acute kidney injury (AKI) among snake bite patients at the time of hospital admission. Materials and Methods: We analyzed 138 cases with a poisonous snake bite. Patients were classified into two groups according to the presence and absence of AKI. The data regarding clinical features and demographic profile of these patients were collected from the hospital records in a prestructured pro forma and statistically compared. Results: Of the 138 patients of venomous snake bite, 62 developed AKI (44.92%). Patients who developed AKI were older in age. Moreover, prolonged bite to anti-snake venom (ASV) time had a significant relationship in developing AKI (P < 0.05). Among the clinical features, there was an independent positive association of AKI with abdomen pain, tenderness and vomiting, cellulitis, bleeding tendencies, myalgia, and black or brown urine (P < 0.05). Neurological features were inversely associated with renal involvement. Conclusion: We found that marked abdominal pain, tenderness and vomiting, myalgia, black or brown urine, bite site cellulitis, bleeding tendencies, and prolonged (>2 h) bite to ASV time were significantly associated with the development of AKI in snake bite patients. PMID:27555694

  4. When Kids Lose Parents in Our War in Iraq

    ERIC Educational Resources Information Center

    Hardy, Lawrence

    2006-01-01

    As of July, more than 1,200 children had lost parents in the war in Iraq, and thousands more had parents with serious injuries, according to the Center for the Study of Traumatic Stress at the Uniform Services University in Bethesda, Maryland. The war, which began three and a half years ago, has resulted in the deaths of more than 2,600 U.S.…

  5. Workbook to End War.

    ERIC Educational Resources Information Center

    American Friends Service Committee, Philadelphia, PA. Peace Literature Service.

    A workbook, written for use in local churches and synagogues, suggests projects and programs for concerned individuals who wish to contribute to an effort to end war. An introduction presents the rationale of the workbook, the creation of a network to end war, and ways in which groups and individuals can become involved in this endeavor. A chapter…

  6. Economics of War

    ERIC Educational Resources Information Center

    Solman, Paul

    2008-01-01

    The author describes and elaborates on how to use his public-television reports on the costs of the war in Iraq to teach economics. He shows how the Iraq war can provide economics instructors with an example for discussing cost-benefit analysis and opportunity costs in class. (Contains 4 notes.)

  7. In Time of War.

    ERIC Educational Resources Information Center

    Becker, Patti Clayton

    2003-01-01

    Examines the role of libraries, particularly public libraries, in times of war. Discusses similarities between responses after World War Two and the September 11, 2001 attacks; government restrictions on information; American Library Association responses, including propaganda and libraries; and the library and the community. (LRW)

  8. World War II Homefront.

    ERIC Educational Resources Information Center

    Garcia, Rachel

    2002-01-01

    Presents an annotated bibliography that provides Web sites focusing on the U.S. homefront during World War II. Covers various topics such as the homefront, Japanese Americans, women during World War II, posters, and African Americans. Includes lesson plan sources and a list of additional resources. (CMK)

  9. War Literature. [Lesson Plan].

    ERIC Educational Resources Information Center

    Soderquist, Alisa

    Based on Stephen Crane's poems about war and his novel "The Red Badge of Courage," this lesson plan presents activities designed to help students understand that Crane examined war-related themes in prose and poetry; that close study of a poem for oral presentation helps readers see meaning or techniques not noted earlier; and that not all readers…

  10. Horsemen of the Apocalypse: lessons from the Gulf War.

    PubMed

    Boyle, J S; Bunting, S M

    1998-12-01

    War is a major global threat to human health, not only in the immediate effects of death and injury to the people, but also in the damage to infrastructures such as food, water, and power supplies and to social structures that support families, economies, and governments. Iraq's devastating aftershocks from the Gulf War include the physical and psychologic effects of displacement, poverty, famine, disease, and environmental destruction. Early nursing leaders vocally opposed World War I, and contemporary nurses should consider becoming activists in the primary and secondary prevention of this major global health problem. PMID:9845484

  11. Follow-up studies of World War II and Korean war prisoners. II. Morbidity, disability, and maladjustments.

    PubMed

    Beebe, G W

    1975-05-01

    US Army veterans taken prisoner (POW's) in World War II and in the Korean War are compared with controls as to hospital admissions from 1946 to 1965 (1954-1965 for Korean War POW's), and as to symptoms, disability, and maladjustments in 1966-1967. Sequelae of the POW experience are both somatic and psychiatric, and are of greatest extent and severity among Pacific World War II POW's. Among European World War II POW's only psychiatric sequelae are apparent. Somatic sequelae were most prevalent in the early years after liberation, but for Pacific World War II POW's they persist in the form of higher hospital admission rates for many specific causes in the most recent period. Nevertheless, persistent psychiatric sequelae (especially psychoneurosis but also schizophrenia) are the more notable and pervasive for both Pacific World War II POW's and Korean War POW's as seen not only in elevated hospital admission rates but also in VA disability awards and in symptoms reported on the cornell Medical Index Health Questionnaire. The excess morbidity appears to correlate well with retrospective accounts of weight-loss and nutritional deficiency diseases and symptoms during the POW period. PMID:124131

  12. The Leukocyte Antibody Prevalence Study-II (LAPS-II): a retrospective cohort study of transfusion-related acute lung injury in recipients of high-plasma-volume human leukocyte antigen antibody–positive or –negative components

    PubMed Central

    Kleinman, Steven H.; Triulzi, Darrell J.; Murphy, Edward L.; Carey, Patricia M.; Gottschall, Jerome L.; Roback, John D.; Carrick, Danielle; Mathew, Sunitha; Wright, David J.; Cable, Ritchard; Ness, Paul; Gajic, Ognjen; Hubmayr, Rolf D.; Looney, Mark R.; Kakaiya, Ram M.

    2013-01-01

    BACKGROUND We used a multicenter retrospective cohort study design to evaluate whether human leukocyte antigen (HLA) antibody donor screening would reduce the risk of transfusion-related acute lung injury (TRALI) or possible TRALI. STUDY DESIGN AND METHODS In the Leukocyte Antibody Prevalence Study-II (LAPS-II), we evaluated pulmonary outcomes in recipients of 2596 plasma-rich blood components (transfusable plasma and plateletpheresis) sent to participating hospitals; half of the components were collected from anti-HLA–positive donors (study arm) and half from anti-HLA–negative donors (control arm) matched by sex, parity, and blood center. A staged medical record review process was used. Final recipient diagnosis was based on case review by a blinded expert panel of pulmonary or critical care physicians. RESULTS TRALI incidence was 0.59% (seven cases) in study arm recipients versus 0.16% (two cases) in control arm recipients for an odds ratio (OR) of 3.6 (95% confidence interval [CI], 0.7–17.4; p = 0.10). For possible TRALI cases (nine study arm, eight control arm), the OR was 1.2 (95% CI, 0.4–3.0; p = 0.81), and for TRALI and possible TRALI aggregated together, it was 1.7 (95% CI, 0.7–3.7; p = 0.24). Transfusion-associated circulatory overload incidence was identical in the two arms (1.17 and 1.22%, respectively; OR, 1.0; p = 1.0). CONCLUSIONS TRALI incidence in recipients of anti-HLA–positive components was relatively low for a look-back study (1 in 170) and was higher than in the control arm, but did not reach significance. Based on this trend, the data are consistent with the likelihood that TRALI risk is decreased by selecting high-volume plasma components for transfusion from donors at low risk of having HLA antibodies. PMID:21446938

  13. Revealing latent value of clinically acquired CTs of traumatic brain injury through multi-atlas segmentation in a retrospective study of 1,003 with external cross-validation

    NASA Astrophysics Data System (ADS)

    Plassard, Andrew J.; Kelly, Patrick D.; Asman, Andrew J.; Kang, Hakmook; Patel, Mayur B.; Landman, Bennett A.

    2015-03-01

    Medical imaging plays a key role in guiding treatment of traumatic brain injury (TBI) and for diagnosing intracranial hemorrhage; most commonly rapid computed tomography (CT) imaging is performed. Outcomes for patients with TBI are variable and difficult to predict upon hospital admission. Quantitative outcome scales (e.g., the Marshall classification) have been proposed to grade TBI severity on CT, but such measures have had relatively low value in staging patients by prognosis. Herein, we examine a cohort of 1,003 subjects admitted for TBI and imaged clinically to identify potential prognostic metrics using a "big data" paradigm. For all patients, a brain scan was segmented with multi-atlas labeling, and intensity/volume/texture features were computed in a localized manner. In a 10-fold crossvalidation approach, the explanatory value of the image-derived features is assessed for length of hospital stay (days), discharge disposition (five point scale from death to return home), and the Rancho Los Amigos functional outcome score (Rancho Score). Image-derived features increased the predictive R2 to 0.38 (from 0.18) for length of stay, to 0.51 (from 0.4) for discharge disposition, and to 0.31 (from 0.16) for Rancho Score (over models consisting only of non-imaging admission metrics, but including positive/negative radiological CT findings). This study demonstrates that high volume retrospective analysis of clinical imaging data can reveal imaging signatures with prognostic value. These targets are suited for follow-up validation and represent targets for future feature selection efforts. Moreover, the increase in prognostic value would improve staging for intervention assessment and provide more reliable guidance for patients.

  14. Thinking About Preventing Nuclear War.

    ERIC Educational Resources Information Center

    Ground Zero, Washington, DC.

    Potential paths to nuclear war and the available means of prevention of nuclear war are discussed. Presented is a detailed description of six nuclear war scenarios, and brief examples of types of potential deterrents to nuclear war (firebreaks) which are relevant for each. To be effective, the right combination of firebreaks must be used, the…

  15. Returning from the War Zone: A Guide for Families of Military Members

    MedlinePlus

    ... witnessed the death or injury of friends, other military personnel, civilians, or enemy combatants. Your loved one may ... Returning from the War Zone: A Guide for Military Personnel ( PDF) ”. It contains useful resources for service members ...

  16. Americans as Warriors: "Doughboys" in Battle during the First World War.

    ERIC Educational Resources Information Center

    Keene, Jennifer D.

    2002-01-01

    Focuses on the experience of U.S. soldiers during World War I. Addresses topics, such as the difficulties and horrors the soldiers dealt with in the trenches, the problems with untrained soldiers, the sickness and injuries that affected soldiers, and heroes of the war. (CMK)

  17. Hand injuries as an indicator of other associated severe injuries.

    PubMed

    Vossoughi, Faranak; Krantz, Brent; Fann, Stephen

    2007-07-01

    The purpose of this study was to investigate the incidence of disabling or life-threatening injuries in patients with hand injuries. Retrospective data were collected from a level 1 trauma center registry. A total of 472 patients with hand injuries were admitted to the trauma unit between January 2000 and March 2004. Forty-four per cent of patients with hand injuries had life-threatening injuries. Fifty-one per cent of them had motor vehicle crash-related injuries. Motorcycle crashes were the next most common cause followed by explosions, falls, gunshots, machinery, stabs, bites, crushes, and so on. Frequency of associated injuries was as follows: head injuries, 31 per cent, including skull fractures, 22 per cent; spine injuries, 18 per cent, including spine fractures 18 per cent; chest injuries, 36 per cent, including rib fractures, 15 per cent; and abdominal injuries, 13 per cent. The authors focused on the incidence of disabling or life-threatening injuries in patients with hand injuries. Motor vehicle crashes were most common cause of hand injuries. The most common organs to be injured were chest and head. The most common head injury was skull fracture. Other injuries in decreasing order were spine and rib fractures. These data may be helpful in assessing ambulatory patients in the emergency room, in those hand injuries maybe indicative of other simultaneous life-threatening or disabling injuries. PMID:17674946

  18. Neuropsychiatric Disturbances, Self-Mutilation and Malingering in the French Armies during World War I: War Strain or Cowardice?

    PubMed

    Tatu, Laurent; Bogousslavsky, Julien

    2016-01-01

    Between 1914 and 1918, war strain appeared under a number of guises and affected, to varying extents, the majority of French soldiers. The most frequent form of war strain was war psychoneurosis, but war strain also induced more paroxystic disorders, such as acute episodes of terror, self-mutilation, induced illnesses and even suicide. Fear was the constant companion of soldiers of the Great War: soldiers were either able to tame it or overwhelmed by an uncontrollable fear. Nonetheless, over the course of the war, some aspects of fear were recognised as syndromes. The French health service poorly anticipated the major consequences of war strain, as with many other types of injuries. After the establishment of wartime neuropsychiatric centres, two main medical stances emerged: listening to soldiers empathetically on the one hand and applying more repressive management on the other. For many physicians, the psychological consequences of this first modern war were synonymous with malingering or cowardice in the face of duty. The stance of French military physicians in relation to their command was not unequivocal and remained ambivalent, swaying between medico-military collusion and empathy towards soldiers experiencing psychological distress. The ubiquity of suspected malingering modified the already porous borders between neuropsychiatric disorders and disobedience. Several war psychoneurotic soldiers were sentenced by councils of war for deserting their posts in the face of the enemy and were shot. Many soldiers suspected of self-mutilation or suffering from induced illnesses were also sentenced and executed without an expert assessment of their wound or their psychological state. PMID:27035133

  19. An epidemiological investigation of training and injury patterns in triathletes.

    PubMed

    Zwingenberger, Stefan; Valladares, Roberto D; Walther, Achim; Beck, Heidrun; Stiehler, Maik; Kirschner, Stephan; Engelhardt, Martin; Kasten, Philip

    2014-01-01

    Associated with the trend towards increased health consciousness and fitness, triathlon has established itself as a sport for masses. The goals of this study were to evaluate injury risk factors of non-professional triathletes and to compare prospective and retrospective evaluation methods. Using an online survey, 212 triathletes retrospectively answered a questionnaire about their training habits and injuries during the past 12 months. Forty-nine of these triathletes participated in a 12-month prospective trial. Injuries were classified with regard to the anatomical location, type of injury, incidence and associated risk factors. Most injuries occurred during running (50%) followed by cycling (43%) and swimming (7%). Fifty-four per cent (retrospective) and 22% (prospective) of the injuries were contusions and abrasions, 38% (retrospective) and 46% (prospective) were ligament and capsular injuries, 7% (retrospective) and 32% (prospective) were muscle and tendon injuries and 1% (retrospective) and 0% (prospective) were fractures. The incidence of an injury per 1000 training hours was 0.69 (retrospective) and 1.39 (prospective) during training and 9.24 (retrospective) and 18.45 (prospective) during competition. The main risk factor for injury in non-professional triathlon is participation in a competitive triathlon event. A retrospective design may underestimate the rate of overuse injuries. PMID:24102132

  20. Early postoperative albumin level following total knee arthroplasty is associated with acute kidney injury: A retrospective analysis of 1309 consecutive patients based on kidney disease improving global outcomes criteria.

    PubMed

    Kim, Ha-Jung; Koh, Won-Uk; Kim, Sae-Gyeol; Park, Hyeok-Seong; Song, Jun-Gol; Ro, Young-Jin; Yang, Hong-Seuk

    2016-08-01

    Hypoalbuminemia has been reported to be an independent risk factor for acute kidney injury (AKI). However, little is known about the relationship between the albumin level and the incidence of AKI in patients undergoing total knee arthroplasty (TKA). The aim of our study was to assess incidence and risk factors for AKI and to evaluate the relationship between albumin level and AKI following TKA.The study included a retrospective review of medical records of 1309 consecutive patients who underwent TKA between January 2008 and December 2014. The patients were divided into 2 groups according to the lowest serum albumin level within 2 postoperative days (POD2_alb level < 3.0 g/dL vs ≥3.0 g/dL). Multivariate logistic regression analysis was used to assess risk factors for AKI. A comparison of incidence of AKI, hospital stay, and overall mortality in the 2 groups was performed using propensity score analysis.Of 1309 patients, 57 (4.4%) developed AKI based on Kidney Disease Improving Global Outcomes criteria. Factors associated with AKI included age (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.01-1.09; P = 0.030), diabetes (OR 3.12; 95% CI 1.65-5.89; P < 0.001), uric acid (OR 1.51; 95% CI 1.26-1.82; P < 0.001), beta blocker use (OR 2.65; 95% CI 1.48-4.73; P = 0.001), diuretics (OR 16.42; 95% CI 3.08-87.68; P = 0.001), and POD2_alb level < 3.0 g/dL (OR 1.92; 95% CI 1.09-3.37; P = 0.023). After propensity score analysis, POD2_alb level<3.0 g/dL was associated with AKI occurrence (OR 1.82; 95% CI 1.03-3.24, P = 0.041) and longer hospital stay (P = 0.001).In this study, we demonstrated that POD2_alb level<3.0 g/dL was an independent risk factor for AKI and lengthened hospital stay in patients undergoing TKA. PMID:27495094

  1. Life without war.

    PubMed

    Fry, Douglas P

    2012-05-18

    An emerging evolutionary perspective suggests that nature and human nature are less "red in tooth and claw" than generally acknowledged by a competition-based view of the biological world. War is not always present in human societies. Peace systems, defined as groups of neighboring societies that do not make war on each other, exist on different continents. A comparison of three peace systems--the Upper Xingu River basin tribes of Brazil, the Iroquois Confederacy of upper New York State, and the European Union--highlight six features hypothesized to be important in the creation and maintenance of intersocietal peace: (i) an overarching social identity, (ii) interconnections among subgroups, (iii) interdependence, (iv) nonwarring values, (v) symbolism and ceremonies that reinforce peace, and (vi) superordinate institutions for conflict management. The existence of peace systems demonstrates that it is possible to create social systems free of war. PMID:22605769

  2. Preventing nuclear war

    SciTech Connect

    Fisher, R.

    1981-03-01

    By focusing on military hardware, we ignore the human side of the nuclear war problem and how we think about nuclear weapons. Three sets of assumptions are examined: our goals, the means of pursuing these goals, and how to allocate responsibility. The quest for power and peace, for example, will not be attained by a war of mutual destruction. The assumption that every problem has a military solution forecloses diplomacy and negotiation, approaches that require understanding and reconciling different interests. With no military solution, a new security system should be one of shared responsibility in which each person will seize opportunities that help to educate the public, lead to wiser decisions, and reduce the risk of war. (DCK)

  3. War Damage Assessment

    NASA Technical Reports Server (NTRS)

    1994-01-01

    During and after the Persian Gulf war, hundreds of "oil lakes" were created in Kuwait by oil released from damaged wells. The lakes are a hazard to the Kuwait atmosphere, soil and ground water and must be carefully monitored. Boston University Center for Remote Sensing, assisted by other organizations, has accurately mapped the lakes using Landsat and Spot imagery. The war damage included the formation of over 300 oil lakes, oil pollution and sand dune movement. Total damage area is over 5,400 square kilometers - 30 percent of Kuwait's total surface area.

  4. United Campuses to Prevent Nuclear War: Nuclear War Course Summaries.

    ERIC Educational Resources Information Center

    Journal of College Science Teaching, 1983

    1983-01-01

    Briefly describes 46 courses on nuclear war available from United Campuses to Prevent Nuclear War (UCAM). These courses are currently being or have been taught at colleges/universities, addressing effects of nuclear war, arms race history, new weapons, and past arms control efforts. Syllabi (with assignments/reading lists) are available from UCAM.…

  5. Radiological Effects of Nuclear War.

    ERIC Educational Resources Information Center

    Shapiro, Charles S.

    1988-01-01

    Described are the global effects of nuclear war. Discussed are radiation dosages, limited nuclear attacks, strategic arms reductions, and other results reported at the workshop on nuclear war issues in Moscow in March 1988. (CW)

  6. U.S. War Costs: Two Parts Temporary, One Part Permanent

    PubMed Central

    Edwards, Ryan D.

    2014-01-01

    Military spending, fatalities, and the destruction of capital, all of which are immediately felt and are often large, are the most overt costs of war. They are also relatively short-lived. But the costs of war borne by combatants and their caretakers, which includes families, communities, and the modern welfare state, tend instead to be lifelong. In this paper I show that a significant component of the budgetary costs associated with U.S. wars is long-lived. One third to one half of the total present value of historical war costs are benefits distributed over the remaining life spans of veterans and their dependents. Even thirty years after the end of hostilities, typically half of all benefits remain to be paid. Estimates of the costs of injuries and deaths suggest that the private burden of war borne by survivors, namely the uncompensated costs of service-related injuries, are also large and long-lived. PMID:25221367

  7. The Math Wars

    ERIC Educational Resources Information Center

    Schoenfeld, Alan H.

    2004-01-01

    During the 1990s, the teaching of mathematics became the subject of heated controversies known as the math wars. The immediate origins of the conflicts can be traced to the "reform" stimulated by the National Council of Teachers of Mathematics' "Curriculum and Evaluation Standards for School Mathematics." Traditionalists fear that reform-oriented,…

  8. Waging War on Violence.

    ERIC Educational Resources Information Center

    Closing the Gap, 1995

    1995-01-01

    Focusing on the theme of violence, this newsletter issue includes information about resources for violence information, a list of funding and grant agencies, conference information, and the following brief articles: (1) Waging War on Violence; (2) Minority Health Perspective (Clay Simpson); (3) Inmates Learn Alternatives to Violence; (4) National…

  9. Grading the War Story

    ERIC Educational Resources Information Center

    Burdick, Melanie

    2009-01-01

    This article considers the emotional and psychological complexities of responding to personal narratives when the focus is war. The author teaches at a community college and she always begins her semester with a narrative assignment for the usual reasons: students write better when they write what they know; teachers should scaffold writing…

  10. Recent Cold War Studies

    ERIC Educational Resources Information Center

    Pineo, Ronn

    2003-01-01

    Cold War historiography has undergone major changes since the 1991 collapse of the Soviet Union. For two years (1992-1993) the principal Soviet archives fell open to scholars, and although some of the richest holdings are now once again closed, new information continues to find its way out. Moreover, critical documentary information has become…

  11. War, Terrorism, and Children

    ERIC Educational Resources Information Center

    DeRanieri, Joseph T.; Clements, Paul T.; Clark, Kathleen; Kuhn, Douglas Wolcik; Manno, Martin S.

    2004-01-01

    Many caregivers are encountering the issue of communicating with children and adolescents about current world events, specifically war and terrorism. As health care providers, it is important to raise awareness of how children may understand, interpret, and respond to related fears and concerns. Although honesty and reassurance are clearly the…

  12. Education and War

    ERIC Educational Resources Information Center

    Blair, Elizabeth E., Ed.; Miller, Rebecca B., Ed.; Tieken, Mara Casey, Ed.

    2009-01-01

    This book examines the complex and varied relations between educational institutions and societies at war. Drawn from the pages of the "Harvard Educational Review," the essays provide multiple perspectives on how educational institutions support and oppose wartime efforts. As the editors of the volume note, the book reveals how people swept up in…

  13. Stabilizing Star Wars

    SciTech Connect

    Weinberg, A.M.; Barkenbus, J.N.

    1984-01-01

    An orderly replacement of offensive with defensive nuclear weapons is part of the defense-protected build-down (DPB) strategy described by Weinberg and Barkenbus. Differing from the administration's Star Wars approach by relying on interceptor missiles rather than costly and unproven lasers and particle beams, the plan also calls for a simultaneous freeze on offensive weapons. (DCK)

  14. The War Against Pests

    ERIC Educational Resources Information Center

    Smith, Ray F.

    1973-01-01

    Insecticides should not be the only weapons of war used against pests; in addition to them, a strategy aimed at winning the millenial warfare should combine the tactical use of natural plant enemies, reinforced plant genetic qualities, and the application of adequate ecological techniques. (BL)

  15. Cold War Propaganda.

    ERIC Educational Resources Information Center

    Bennett, Paul W.

    1988-01-01

    Briefly discusses the development of Cold War propaganda in the United States, Canada, and the USSR after 1947. Presents two movie reviews and a Canadian magazine advertisement of the period which illustrate the harshness of propaganda used by both sides in the immediate postwar years. (GEA)

  16. End the Math Wars

    ERIC Educational Resources Information Center

    Kuhn, Matt; Dempsey, Kathleen

    2011-01-01

    In 1999, Richard Lee Colvin published an article in "The School Administrator" titled "Math Wars: Tradition vs. Real-World Applications" that described the pendulum swing of mathematics education reform. On one side are those who advocate for computational fluency, with a step-by-step emphasis on numbers and skills and the…

  17. Nuclear War and Science Teaching.

    ERIC Educational Resources Information Center

    Hobson, Art

    1983-01-01

    Suggests that science-related material on nuclear war be included in introductory courses. Lists nuclear war topics for physics, psychology, sociology, biology/ecology, chemistry, geography, geology/meteorology, mathematics, and medical science. Also lists 11 lectures on nuclear physics which include nuclear war topics. (JN)

  18. Iowa and World War I.

    ERIC Educational Resources Information Center

    Hardesty, Carolyn, Ed.

    1989-01-01

    This issue of the children's quarterly magazine, "The Goldfinch," focuses on World War I. A brief discussion of how the United States came to enter the War is followed by a discussion of propaganda. An article on the use of posters to encourage citizens to participate in the war effort is illustrated with reproductions of several of these posters.…

  19. The Technological Culture of War

    ERIC Educational Resources Information Center

    Pretorius, Joelien

    2008-01-01

    The article proceeds from the argument that war is a social institution and not a historical inevitability of human interaction, that is, war can be "unlearned." This process involves deconstructing/dismantling war as an institution in society. An important step in this process is to understand the philosophical and cultural bases on which…

  20. Alternatives to War in History.

    ERIC Educational Resources Information Center

    Kimball, Jeffrey

    1994-01-01

    Asserts that human history is a story of paradoxes: cooperation and conflict, war and peace. States that, throughout history, various individuals and groups have sought alternatives to war. Describes attempts to keep the peace, to manage conflict, and to initiate social reforms that eliminate the causes of war. (CFR)

  1. The Great War: Online Resources.

    ERIC Educational Resources Information Center

    Duncanson, Bruce

    2002-01-01

    Presents an annotated bibliography of Web sites about World War I. Includes: (1) general Web sites; (2) Web sites with information during the war; (3) Web sites with information about post-World War I; (4) Web sites that provide photos, sound files of speeches, and propaganda posters; and (5) Web sites with lesson plans. (CMK)

  2. Traumatic war stressors and psychiatric symptoms among World War II, Korean, and Vietnam War veterans.

    PubMed

    Fontana, A; Rosenheck, R

    1994-03-01

    Three hypotheses regarding symptoms of war-related posttraumatic stress disorder and general psychiatric distress were tested: that symptoms are more severe the more severe the traumatic exposure, regardless of the war in question; that symptoms are less severe the older the veterans' age; and that symptom levels differ across sociocultural cohorts. A total of 5,138 war zone veterans who were seeking treatment from specialized Veterans Affairs outpatient clinical teams made up the sample: 320 World War II, 199 Korean War, and 4,619 Vietnam War veterans. All hypotheses were supported significantly. The similarity of relationships between traumatic exposure and symptoms across wars testifies to the generality of these experiences. Furthermore, the results suggest the operation of significant effects due both to aging and to cohort differences in sociocultural attitudes toward the stigma of mental illness and the popularity of the wars. PMID:8185865

  3. War Finance: Economic and Historic Lessons

    ERIC Educational Resources Information Center

    Boldt, David J.; Kassis, Mary Mathewes

    2004-01-01

    In this article, the authors provide a historical review of how the U.S. government has funded its participation in major wars during the past 150 years. They focus attention on five conflicts--the Civil War, World War I, World War II, the Korean War and the Vietnam War. Those conflicts were funded in different ways, with each funding method…

  4. Broken faces: reconstructive surgery during and after the Great War.

    PubMed

    Pichel, Beatriz

    2010-03-01

    Amongst the most terrifying injuries experienced by the soldiers during the First World War (1914-1918) were facial wounds. The French Medical Corps took photographic portraits of these wounded men, the so-called gueules cassées, with a view to conducting reconstructive surgery. However, other groups were quick to use the images they produced for their own political, social or artistic purposes. These photographs then, with their many meanings, capture the diversity of attitudes towards the Great War in its aftermath. PMID:20106529

  5. WAR & Military Mental Health

    PubMed Central

    Pols, Hans; Oak, Stephanie

    2007-01-01

    Involvement in warfare can have dramatic consequences for the mental health and well-being of military personnel. During the 20th century, US military psychiatrists tried to deal with these consequences while contributing to the military goal of preserving manpower and reducing the debilitating impact of psychiatric syndromes by implementing screening programs to detect factors that predispose individuals to mental disorders, providing early intervention strategies for acute war-related syndromes, and treating long-term psychiatric disability after deployment. The success of screening has proven disappointing, the effects of treatment near the front lines are unclear, and the results of treatment for chronic postwar syndromes are mixed. After the Persian Gulf War, a number of military physicians made innovative proposals for a population-based approach, anchored in primary care instead of specialty-based care. This approach appears to hold the most promise for the future. PMID:17971561

  6. Penile injuries: A 10-year experience

    PubMed Central

    Krishna Reddy, S.V.; Shaik, Ahammad Basha; Sreenivas, K.

    2014-01-01

    We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating injuries; and Group 4 (n = 7) with patients with penile soft tissue injuries. Grading of injury was done using the American Association for the Surgery of Trauma (AAST)-Organ injury scale of penile injury. Penile injuries without urethral injuries are urological emergencies which require immediate attention. PMID:25295134

  7. War on fear

    PubMed Central

    Burney, Ian

    2012-01-01

    This article examines the processes through which civilian fear was turned into a practicable investigative object in the inter-war period and the opening stages of the Second World War, and how it was invested with significance at the level of science and of public policy. Its focus is on a single historical actor, Solly Zuckerman, and on his early war work for the Ministry of Home Security-funded Extra Mural Unit based in Oxford’s Department of Anatomy (OEMU). It examines the process by which Zuckerman forged a working relationship with fear in the 1930s, and how he translated this work to questions of home front anxiety in his role as an operational research officer. In doing so it demonstrates the persistent work applied to the problem: by highlighting it as an ongoing research project, and suggesting links between seemingly disparate research objects (e.g. the phenomenon of ‘blast’ exposure as physical and physiological trauma), the article aims to show how civilian ‘nerve’ emerged from within a highly specific analytical and operational matrix which itself had complex foundations. PMID:23626409

  8. A brief history of war amputation.

    PubMed

    Kinch, K J; Clasper, J C

    2011-12-01

    Throughout the history of warfare, changes in weaponry have produced changes in the nature of war injury. The 16th century saw the introduction of firearms in conventional warfare, bringing the destructive power of weaponry to new and unseen heights with a dramatic increase in the severity and complexity of battle injuries. Destructive gunshot wounding associated with embedded foreign material often led to sepsis and demanded the more radical treatment of amputation. Over the past 500 years innumerable developments have taken place in anaesthesia, asepsis, transfusion therapy and resuscitation, antibiotic therapy, vascular surgery and wound management. Medical services have had to adapt in order to cope with the changing volume and changing nature of battle casualties resulting from modern weaponry. Despite the progress made, amputation is still a commonly performed operation following traumatic limb injury. In those cases where the decision to amputate is not so clearly and distinctly defined, history has shown that prevention of infection requires aggressive primary surgery and removal of all devitalised tissue. This paper examines the history of amputation in the management of the battlefield casualty suffering limb injury, beginning in the 16th century and continuing into present day. PMID:22319981

  9. In Flanders fields: the Great War, Antoine Depage, and the resurgence of débridement.

    PubMed Central

    Helling, T S; Daon, E

    1998-01-01

    OBJECTIVE: The care of traumatic wounds has evolved over hundreds of years, largely as a result of armed conflicts. The lessons learned during World War I in the treatment of extensive soft-tissue injuries proved invaluable in reducing infection and preventing loss of limb and life. Foremost among these was the use of debridement. This report reviews the development of debridement as standard treatment of war wounds and highlights the surgeon largely responsible for its resurgence during one of this century's saddest chapters. SUMMARY BACKGROUND DATA: Before World War I, the care of wounds consisted of minimal exploration and liberal use of then-new antiseptics. For limited injuries, this approach appeared adequate. World War I saw the introduction of devastating weapons that produced injuries that caused extensive devitalization of tissue. Standard treatment of these patients proved woefully inadequate to prevent life-threatening infections. METHODS: This is a historical review of the conditions that occurred during World War I that prompted a change in wound management. One of those responsible for this change was the Belgian surgeon Antoine Depage. His life and contributions to the care of war wounds are profiled. Depage reintroduced the discarded French practice of wound incision and exploration (debridement) and combined it with excision of devitalized tissue. RESULTS: Through the use of debridement, excision, and delayed wound closure based on bacteriologic survey, Depage was able to reduce the incidence of infectious complications of soft-tissue injuries, particularly those involving fractures. CONCLUSIONS: Through his experiences in the Great War, Antoine Depage was able to formulate a treatment plan for wounds of war. All such injuries were assumed to be contaminated and, as such, they required early and careful debridement. Depage thought that wound closure should often be delayed and based his decision to close on the bacteriologic status of the wound

  10. Urethral Injuries

    MedlinePlus

    ... Injuries Ureteral Injuries Urethral Injuries Injuries to the Penis and Scrotum Most urethral injuries occur in men. ... leakage of urine into the tissues of the penis, scrotum, abdominal wall, or perineum (the area between ...

  11. Imaging of Physeal Injury

    PubMed Central

    Jawetz, Shari T.; Shah, Parina H.; Potter, Hollis G.

    2015-01-01

    Context: As the intensity of youth participation in athletic activities continues to rise, the number of overuse injuries has also increased. A subset of overuse injuries involves the physis, which is extremely susceptible to injury. This paper aims to review the utility of the various imaging modalities in the diagnosis and management of physeal injuries in the skeletally immature population. Evidence Acquisition: A search for the keywords pediatric, physis, growth plate, x-ray, computed tomography, magnetic resonance imaging, and overuse injury was performed using the PubMed database. No limits were set for the years of publication. Articles were reviewed for relevance with an emphasis on the imaging of growth plate injuries. Study Design: Retrospective literature review. Level of Evidence: Level 4. Results: Three major imaging modalities (radiographs, computed tomography, and magnetic resonance imaging) complement each other in the evaluation of pediatric patients with overuse injuries. However, magnetic resonance imaging is the only modality that offers direct visualization of the physis, and it also offers the best soft tissue contrast for evaluating the other periarticular structures for concomitant injury. Conclusion: Imaging has an important role in the diagnosis of physeal injuries, and the information it provides has a tremendous impact on the subsequent management of these patients. PMID:25984260

  12. [Surgical treatment of iatrogenic bile duct injuries following laparoscopic cholecystectomy: analysis of long-term results. Retrospective clinical study in 51 patients operated in the Campania region from 1991 to 2003].

    PubMed

    Conzo, Giovanni; Amato, Giuseppe; Angrisani, Luigi; Bardi, Ugo; Barone, Giovanni; Belli, Giulio; Brancaccio, Umberto; Calise, Fulvio; Caliendo, Angelo; Celsi, Salvatore; Corcione, Francesco; Cuccurullo, Diego; De Falco, Giuseppe; Delrio, Paolo; De Werra, Carlo; De Sena, Guido; Docimo, Giovanni; Esposito, Maria Grazia; Fantini, Corrado; Giardiello, Cristiano; Musella, Mario; Molino, Carlo; Muto, Crescenzo; Pennetti, Lucio; Puziello, Alessandro; Porcelli, Alberto; Rea, Roberto; Rendano, Franco; Palazzo, Antonietta; Santangelo, Michele; Santaniello, Walter; Santini, Luigi; Sperlongano, Pasquale; Stanzione, Francesco; Tartaglia, Alberto; Tricarico, Annunziato; Vincenti, Rodolfo; Lorenzo, Michele

    2005-01-01

    An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and the outcome of biliary complications during and following laparoscopic cholecystectomy. A questionnaire was mailed to all surgeons with experience in laparoscopic cholecystectomy in the Campania region. Data were collected from January 1991 to December 2003. Each patient was requested to indicate age, gender, associated diseases, site and type of lesion, surgical experience, diagnosis, treatment and complications. Twenty-six surgeons answered the questionnaire. Fifty-one patients (36 F/15 M; mean age: 42.5 +/- 11.9, range 13-91 years) with bile duct injuries following laparoscopic cholecystectomy were reported. The most frequent lesions were main bile duct partial or total transection. The intraoperative mortality rate was 1/51 (1.9%) due to a complex biliary and vascular injury. The postoperative mortality rate of revision surgery was 5/50 (10%). T-tube positioning (n = 20) and Roux-en-Y hepato-jejunostomy (n = 20) were the procedures most frequently performed. The complication rate in patients treated with the T-tube was significantly higher than in those treated with hepatico-jejunostomy. Surgical treatment of biliary injuries following laparoscopic cholecystectomy was characterized by unusually high mortality and morbidity for a non-neoplastic disease. Roux-en-Y hepato-jejunostomy remains the procedure of choice for these injuries. PMID:16060179

  13. Suicide among War Veterans

    PubMed Central

    Rozanov, Vsevolod; Carli, Vladimir

    2012-01-01

    Studies aiming to identify if war veterans are at higher risk of suicide have often produced inconsistent results; this could be due to the complexity of comparisons and different methodological approaches. It should be noted that this contingent has many risk factors, such as stressful exposures, wounds, brain trauma and pain syndrome. Most recent observations confirm that veterans are really more likely to die of suicide as compared to the general population; they are also more likely to experience suicidal ideation and suffer from mental health problems. Suicides are more frequent in those who develop PTSD, depression and comorbid states due to war exposure. Combat stress and its’ frequency may be an important factor leading to suicide within the frame of the stress-vulnerability model. According to this model, the effects of stress may interact with social factors, interpersonal relations and psychological variables producing suicidal tendencies. Modern understanding of stress-vulnerability mechanisms based on genetic predispositions, early life development, level of exposure to stress and stress-reactivity together with interpersonal aspects may help to build more effective suicide prevention programs based on universal/selective/indicated prevention principles. PMID:22851956

  14. [Two famous female nurses during the Crimean War].

    PubMed

    Zhao, Xiao-Yun

    2013-11-01

    During the Crimean War outbroken in 1854, there were massive death tolls due to delayed treatment of the injuries and shortage of battlefield medical workers. Nightingale, assigned by the government, and Mary Seacole, voluntarily went to the battlefield, to join the rescuing of the injured soldiers. These two nurses, with different family background and race, saved the lives of many injuries and patients. They were highly praised after the relevation by the media. The name of Nightingale was remembered by the later generations. Contrarily, that of the latter was forgotten. Historically, the deeds and contributions to nursing by Mary Seacole must be also respected similarly. PMID:24524640

  15. Ultrasonography in the evaluation of hemoperitoneum in war casualties.

    PubMed

    Miletić, D; Fuckar, Z; Mraović, B; Dimec, D; Mozetic, V

    1999-08-01

    The aim of this study was to evaluate the sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the detection of hemoperitoneum among war casualties, and to compare the results of this method in a specific war situation and civil conditions. Ninety-four wounded individuals with suspected blunt or penetrating abdominal trauma were treated at a level I war hospital (group W), and 242 civilians with multiple injuries with suspected blunt abdominal trauma were evaluated at the emergency center of a university hospital (group C). All examinations were performed in less than 5 minutes with a portable ultrasonographic scanner, and typical points were scanned (Morison's pouch, Douglas and perisplenic spaces, paracolic gutter). In group W, hemoperitoneum was identified correctly in 19 patients, with three false-negative and no false-positive findings, whereas group C presented 98 true-positive results, 13 false-negative results, and again no false-positive results. We observed that ultrasonography in specific war conditions showed sensitivity of 86%, specificity of 100%, accuracy as high as 97%, positive predictive value of 100%, and negative predictive value of 96%, whereas in civil conditions the corresponding values were 88%, 100%, 95%, 100%, and 91%, respectively. The sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the diagnosis of hemoperitoneum are approximately equal in war and civil conditions. PMID:10459274

  16. [The Great War 1914-1918 and oral and maxillofacial surgery].

    PubMed

    Koole, R

    2014-11-01

    One hundred years ago the Great War, also known as the first world war, started. Historians consider the attack on the Austrian Archduke Franz Ferdinand on June 18, 1914 as the cause of the catastrophe. The initial war of movement turned into a 'Sitz Krieg', trench warfare. Many hundreds of thousands of military casualties were treated for a wide variety of facial wounds that resulted from the conflict. The origin of the specialisation oralmaxillofacial surgery is considered to be a consequence of these treatments. Several treatments dating from the first world war are still in use, such as the application of the 'dental splint' in fracture treatment, intra-oral transposition flaps for sealing small injuries and bone transplants from the iliac crest to restore defects of the jaw. In the Netherlands, which was neutral, experiences from the Great War were retained by the appointment in 1919 of a Lecturer in Oral Diagnosis and Oral Surgery at the University of Utrecht. PMID:26188477

  17. War wounds management--early reconstruction of soft tissue defects.

    PubMed

    Stanec, Z; Skrbić, S; Dzepina, I; Hulina, D; Ivrlac, R

    1994-01-01

    The authors emphasize that the knowledge of terminal ballistics is important for understanding the pathophysiology of war wounds. They present their own experiences in the treatment of war wounds in 504 casualties treated at the Institute of Plastic and Reconstructive Surgery, Department of Surgery, Clinical Hospital Center in Zagreb. The locations of soft-tissue defects were: head and neck, 103; trunk, 90; and extremities, 903. War wounds were divided into four main categories with regard to the type of the injury and the extension of soft-tissue defect, thus showing the differences in primary excision and reconstruction of the wounds. About 30% of head and neck injuries were treated by primary or delayed primary reconstruction. All thoraco-abdominal wounds were type I or II, and most of them (53.3%) were reconstructed with split-thickness skin grafts. The greatest number of sophisticated reconstructions were performed on extremity injuries (63 wounds were reconstructed by local flaps, while free flaps were used in 40 cases). The authors emphasize the importance of proper primary treatment, which is the condition for early reconstruction. This results in significantly shorter hospitalization, so that 62% of the patients were cured in 20 days and then discharged to early rehabilitation. PMID:7532048

  18. Getting the Civil War Right

    ERIC Educational Resources Information Center

    Loewen, James W.

    2011-01-01

    William Faulkner famously wrote, "The past is never dead. It's not even past." He would not be surprised to learn that Americans, 150 years after the Civil War began, are still getting it wrong. Did America's most divisive war start over slavery or states' rights? The author says that too many people--including educators--get it wrong. The author…

  19. War, Peace, and the Media.

    ERIC Educational Resources Information Center

    Zwicker, Barrie, Ed.

    Written for editors, reporters, and researchers, this publication contains background information on war and peace. Included are newspaper articles, essays, and excerpts from radio commentaries. The information is intended to help journalists provide more accurate coverage of war-and-peace issues, in particular more accurate coverage of the Soviet…

  20. Behavior, society, and nuclear war

    SciTech Connect

    Tetlock, P.E.; Husbands, J.L.; Jervis, R.; Stern, P.C.; Tilly, C.

    1989-01-01

    This book contains chapters on the following topics related to nuclear arms and nuclear war: crisis decision making; behavioral aspects of negotiations on mutual security; democracy, public opinion, and nuclear weapons; the case of wars; A review of theories; methodological themes and variations.

  1. Teaching War Literature, Teaching Peace

    ERIC Educational Resources Information Center

    Powers, Janet M.

    2007-01-01

    This article explores literature taught in three different courses and the peace education approaches used for each, including epics in literature courses, Vietnam War literature, and literature of anger and hope. The author recommends the teaching of war literature as an essential part of a peace education curriculum. Devastating events such as…

  2. Primary Sources Enliven Civil War

    ERIC Educational Resources Information Center

    Robelen, Erik W.

    2011-01-01

    Today, a growing number of teachers are moving beyond the textbook in teaching about the war, and U.S. history more broadly. Teachers are digging directly into primary sources and harnessing technology, all in an attempt to help students better understand the past and bring it to life. Doing so may be especially important with the Civil War,…

  3. Empirically derived injury prevention rules.

    PubMed Central

    Peterson, L; Schick, B

    1993-01-01

    This study describes a set of empirically derived safety rules that if followed, would have prevented the occurrence of minor injuries. Epidemiologists have criticized behavioral interventions as increasing "safe" behavior but failing to demonstrate a decrease in injury. The present study documents retrospectively the link between safe behavior and injury. It demonstrates that these empirically derived rules are very similar to rules for the prevention of serious injury. The study also shows that these rules are not widely accepted and implemented by parents. Suggestions for future research in this area are advanced. PMID:8307829

  4. Iraq War mortality estimates: A systematic review

    PubMed Central

    Tapp, Christine; Burkle, Frederick M; Wilson, Kumanan; Takaro, Tim; Guyatt, Gordon H; Amad, Hani; Mills, Edward J

    2008-01-01

    Background In March 2003, the United States invaded Iraq. The subsequent number, rates, and causes of mortality in Iraq resulting from the war remain unclear, despite intense international attention. Understanding mortality estimates from modern warfare, where the majority of casualties are civilian, is of critical importance for public health and protection afforded under international humanitarian law. We aimed to review the studies, reports and counts on Iraqi deaths since the start of the war and assessed their methodological quality and results. Methods We performed a systematic search of 15 electronic databases from inception to January 2008. In addition, we conducted a non-structured search of 3 other databases, reviewed study reference lists and contacted subject matter experts. We included studies that provided estimates of Iraqi deaths based on primary research over a reported period of time since the invasion. We excluded studies that summarized mortality estimates and combined non-fatal injuries and also studies of specific sub-populations, e.g. under-5 mortality. We calculated crude and cause-specific mortality rates attributable to violence and average deaths per day for each study, where not already provided. Results Thirteen studies met the eligibility criteria. The studies used a wide range of methodologies, varying from sentinel-data collection to population-based surveys. Studies assessed as the highest quality, those using population-based methods, yielded the highest estimates. Average deaths per day ranged from 48 to 759. The cause-specific mortality rates attributable to violence ranged from 0.64 to 10.25 per 1,000 per year. Conclusion Our review indicates that, despite varying estimates, the mortality burden of the war and its sequelae on Iraq is large. The use of established epidemiological methods is rare. This review illustrates the pressing need to promote sound epidemiologic approaches to determining mortality estimates and to establish

  5. Kepler's "War on Mars"

    NASA Astrophysics Data System (ADS)

    Dorsey, William; Orchiston, W.; Stephenson, F. R.

    2011-01-01

    This paper presents an interpretation of how Johannes Kepler changed the study of astronomy. We propose that in his metaphorical "War on Mars,” the Astronomia Nova, Kepler used a revolutionary rhetoric to bring about the usurpation of seventeenth-century astronomy. We discuss how Kepler approached the well-established conceptual framework within which the hypotheses of Ptolemy, Copernicus and Tycho Brahe functioned, and how he sought comprehensive physical principles that could determine the true cause and form of the known Universe. We examine Kepler's need to redefine reality and his use of rhetoric in shaping his astronomical argument for a new astronomy, and we show that his new `laws’ represent a fusion of physics and geometry based upon astronomical observations. We suggest that although Kepler may have believed in and defended some Copernican ideas, his innovative Astronomia Nova opened up a whole new vista for international astronomy.

  6. Water and wars

    NASA Astrophysics Data System (ADS)

    Gleick, Peter H.

    In “Challenging the Rhetoric of Water Wars” (Eos, In Brief, September 5, 2000, p. 410) Randy Showstack reported on the speech given by Minister Kader Asmal upon receiving the 2000 Stockholm Water Prize. This prize was well deserved for the tremendous progress South Africa has made under Minister Asmal's leadership in addressing basic water needs after apartheid. Indeed, I was one of his nominators for this prize and am an ardent fan of his bold programs. But his remarks about water-related conflicts need to be qualified. In his speech, Minister Asmal noted that water scarcity is a “crisis of biblical proportion,” but also suggested “there is not a shred of evidence” to back up arguments that there are water “wars.”

  7. War and domestic violence.

    PubMed

    Colson, E

    1995-01-01

    A longterm study (begun in 1956) of the people of four villages in Gwembe District in Zambia provides information on deaths due to Rhodesian action or to Zimbabwean freedom fighters and on deaths due to domestic violence (which is likely to have been underreported because it is considered shameful). During the decade of the 1970s, one woman and three men died from Rhodesian action and 5 women were killed by kinsmen (two husbands, two sons, and one brother). The police left the kin to settle the case of the sister killed by the brother. One man who killed his mother persuaded a younger, unmarried kinsman to be charged and punished in his stead; another left the community. One of the men who killed his wife was released because of his age (he paid damages to his children in accordance with matrilineal tradition); the other was released for lack of evidence. Battered women usually do not press charges against their husbands but may leave them and, if young, marry again. In some cases, battered women seeking divorce have also won compensation for broken bones. Domestic violence may have been especially prevalent in this period because the economic situation deteriorated, men could not find work, and the Rhodesian war added stress and disrupted the local transportation system. In response, men began to drink more heavily and male violence directed against women and men brewed along with locally-produced alcohol. Domestic violence may be exacerbated when men use women as an outlet for their anger and frustration in stressful times of war. PMID:12295013

  8. Labor Day and the war on workers.

    PubMed Central

    Rosner, D; Markowitz, G

    1999-01-01

    We celebrate Labor Day every year with barbecues and picnics, rarely remembering that the holiday was born in the midst of tremendous labor struggles to improve working conditions. In the last century, 16-hour workdays and 6- and 7-day workweeks led to terribly high injury rates in the nation's mines and mills. Thousands upon thousands of workers died, caught in the grinding machinery of our growing industries. Today, despite improvements, thousands of workers still die in what has been described as a form of war on the American workforce. This commentary reminds us of the historical toll in lives and limbs that workers have paid to provide us with our modern prosperity. It also reminds us that the continuing toll is far too high and that workers who died and continue to die in order to produce our wealth deserve to be remembered and honored on this national holiday. PMID:10474546

  9. Head Injuries

    MedlinePlus

    ... before. Often, the injury is minor because your skull is hard and it protects your brain. But ... injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury. Head injuries ...

  10. Head Injuries

    MedlinePlus

    ... before. Usually, the injury is minor because your skull is hard and it protects your brain. But ... injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury. Head injuries ...

  11. Back Injuries

    MedlinePlus

    ... extending from your neck to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, ... back is the most common site of back injuries and back pain. Common back injuries include Sprains ...

  12. Head Injuries

    MedlinePlus

    ... of head injuries include bicycle or motorcycle wrecks, sports injuries, falls from windows (especially among children who live ... to watch for? When can I start playing sports again after a head injury? How can brain damage from a head injury ...

  13. The Impact of War on Vaccine Preventable Diseases

    PubMed Central

    Obradovic, Zarema; Balta, Snjezana; Obradovic, Amina; Mesic, Salih

    2014-01-01

    Introduction: During the war in Bosnia and Herzegovina, which lasted from 1992-1995, the functioning of all sectors was disturbed, including the health sector. The priority of the heath sector was treatment and less attention was paid to prevention, and this applies also to the Program of implementation of obligatory immunization, as one of the most important prevention measures. This program was conducted with difficulty and sometimes was completely interrupted because of the lack of necessary vaccines and the inability of adequate maintenance of the cold chain. It was difficult and sometimes completely impossible to bring children to vaccination. Because of these problems, a great number of children stayed unvaccinated so they suffered from vaccine-preventable diseases several years after the war. Materials and methods: This is a retrospective epidemiological study. We analyzed data from January 1994 to July 2014 in Canton Sarajevo, and data about measles outbreak in 2014. Results: In the period from January 1994 to July 2014, 3897 vaccine-preventable diseases were registered in Canton Sarajevo. Among them measles, rubella and mumps were the most frequent. In March 2014, measles outbreak was registered. Almost all cases are unvaccinated (99%) and 43% of all cases are connected with failure of vaccination during the war. Conclusion: During the war, routine immunization program was disrupted in Bosnia and Herzegovina (also in Canton Sarajevo). The consequences are presented as vaccine preventable diseases cases. PMID:25685082

  14. Mine blast injuries: ocular and social aspects

    PubMed Central

    Muzaffar, W.; Khan, M. D.; Akbar, M; Khan, M. D.; Malik, A. M.; Durrani, O.

    2000-01-01

    BACKGROUND/AIMS—Landmines have long been used in conventional warfare. These are antipersonnel mines which continue to injure people long after a ceasefire without differentiating between friend or foe, soldier or civilian, women or children. This study focuses on Afghan non-combatants engaged in mine clearing operations in Afghanistan in the aftermath of the Russo-Afghan war. The patterns and types of injuries seen are described and experiences in their management, ways, and means to prevent them, and recommendations for the rehabilitation of the affected individuals are given.
METHODS—It is a retrospective and analytical study of 84 patients aged 19-56 years who sustained mine blast injuries during mine clearing operations in Afghanistan from November 1992 to January 1996. The study was carried out at a military hospital with tertiary care facilities. The patients were divided into three groups on the basis of their injuries. Group 1 required only general surgical attention, group 2 sustained only ocular injuries, while group 3 had combined ocular and general injuries. Patients in groups 2 and 3 were treated in two phases. The first phase aimed at immediate restoration of the anatomy, while restoration of function wherever possible was done in subsequent surgical procedures in the second phase.
RESULTS—It was observed that 51 out of 84 patients (60.7%) had sustained ocular trauma of a variable degree as a result of the blasts. The mean age of the victims was 29 years and they were all male. A total of 91 eyes of 51 patients (89.2%) had been damaged. Bilaterality of damage was seen in 40 (78.4%) patients. Most, 34 (37.3%), eyes became totally blind (NPL). Only a few escaped with injury mild enough not to impair vision. Foreign bodies, small and multiple, were found in the majority of eyes; most, however, were found in the anterior segment, and posterior segment injuries were proportionally less.
CONCLUSIONS—The prevalence of blindness

  15. War and Peace: Toys, Teachers, and Tots.

    ERIC Educational Resources Information Center

    Dodd, Arleen; And Others

    War play is play with a toy that initiates violence or play that involves the imitation of war. War play can involve: (1) the use of toys based on television cartoon shows to imitate the action in the cartoons; (2) play with replicas of war paraphernalia or manipulatives shaped into guns; and (3) dramatic play. The negative effects on children…

  16. The Lessons of the Vietnam War.

    ERIC Educational Resources Information Center

    Starr, Jerold M., Ed.

    This text book on the Vietnam War is to be used in teaching high students. Each of the volume's 12 chapters is a self-contained unit on an aspect of the War. The chapters are: (1) Introduction to Vietnam: land, history, and culture; (2) America at war in Vietnam: decisions and consequences; (3) Was the Vietnam War legal? (4) who fought for the…

  17. Lessons on the Cold War. Lesson Plan.

    ERIC Educational Resources Information Center

    Cunningham, Susan J.

    1994-01-01

    Contends that the end of the Cold War requires teachers to change their teaching methods and content. Presents six lessons, most with three individual student activities, that trace the Cold War from the pre-World War I era through the end of the Vietnam War. (CFR)

  18. American Women and the Great War.

    ERIC Educational Resources Information Center

    Dumenil, Lynn

    2002-01-01

    Provides information on the idealized images of women during World War I. Features the use of posters and propaganda during the war. Focuses on voluntary activities in which women participated, the fight for women's suffrage during the war, and the effect of the war on women working. Includes poster reproductions. (CMK)

  19. Contributions of Psychology to War and Peace

    ERIC Educational Resources Information Center

    Christie, Daniel J.; Montiel, Cristina J.

    2013-01-01

    The contributions of American psychologists to war have been substantial and responsive to changes in U.S. national security threats and interests for nearly 100 years. These contributions are identified and discussed for four periods of armed conflict: World Wars I and II, the Cold War, and the Global War on Terror. In contrast, about 50 years…

  20. Epidemiology of traumatic spinal cord injury in Asia: A systematic review

    PubMed Central

    Ning, Guang-Zhi; Wu, Qiang; Li, Yu-Lin; Feng, Shi-Qing

    2012-01-01

    Study design A systematic review. Background The number of traumatic spinal cord injury (TSCI) reports grows annually, especially in China and Korea. The epidemiological characteristics of TSCI in Asia differ from those in other countries. Thus, we compiled epidemiological factors from Asia to compare with those from other countries. Method We searched articles published in any language between January 1980 to December 2011 using the terms “spinal cord injury”, “traumatic spinal cord injury”, “epidemiology”, and “Asia”. The articles were reviewed for information regarding TSCI incidence, total cases, case criteria, case source, causes of injury, male/female ratio, mean age, prospective or retrospective, neurological level of injury, extent of injury, and America Spinal Injury Association Impairment Scale (AIS)/grade. Results Epidemiological data were extracted from 39 reports in the published literature that met the inclusion criteria. Only two studies reported prevalence rates. Incidence rates ranged from 12.06 to 61.6 per million. The average age ranged from 26.8 to 56.6 years old. Men were at higher risk than women. Motor vehicle collisions (MVCs) and falls were the main causes of TSCI. However, several countries reported war wounds as the major cause. The neurological level and extent of injury were mixed, and most patients were categorized as AIS/Frankel grade A. Conclusion TSCI is an important public health problem and a major cause of paralysis. We must understand the epidemiology to implement appropriate preventative measures. Asian epidemiology is different from that in other regions, so intervention measures must be established according to population-specific characteristics. PMID:22925749

  1. Penetrating cardiac injuries.

    PubMed

    Mittal, V; McAleese, P; Young, S; Cohen, M

    1999-05-01

    Our objective was to determine the influence of several clinical factors on the survival of patients with penetrating wounds to the heart. A retrospective review of 80 consecutive penetrating cardiac injuries treated in a Level II urban trauma center from 1980 through 1994 were examined. Thirty-six patients (45%) had gunshot wounds (including 1 shotgun wound), and 44 (55%) had stab wounds. Intervention consisted of emergency room (ER) or operating room thoracotomy. We measured the effect of several clinical factors on morbidity and patient survival. Survival rate was 17 of 36 (47%) in gunshot injuries and 35 of 44 (80%) in stab injuries, with an overall survival rate of 52 of 80 patients (65%). The average age was 24 years (range, 9-53), and there were 3 female patients. Twelve patients (15%) had multiple cardiac injuries, and 63 (79%) had other associated injuries. Fourteen patients (17%) presented with no blood pressure, and 55 (69%) were hypotensive on admission. ER thoracotomy was performed on 7 of 52 survivors (13%) and 24 of 28 nonsurvivors (86%). Survival after ER thoracotomy was 7 of 31 patients (22%). A selective approach is recommended, because ER thoracotomy has a limited role in penetrating cardiac injury. A high index of suspicion, prompt resuscitation, and immediate definitive surgical management resulted in a high survival rate for these frequently lethal injuries. PMID:10231214

  2. Environmental consequences of nuclear war

    SciTech Connect

    Toon, Owen B.; Robock, Alan; Turco, Richard P.

    2014-05-09

    A regional war involving 100 Hiroshima-sized weapons would pose a worldwide threat due to ozone destruction and climate change. A superpower confrontation with a few thousand weapons would be catastrophic.

  3. Rockets in World War I

    NASA Technical Reports Server (NTRS)

    2004-01-01

    World War I enlisted rockets once again for military purposes. French pilots rigged rockets to the wing struts of their airplanes and aimed them at enemy observation balloons filled with highly inflammable hydrogen.

  4. Environmental consequences of nuclear war

    NASA Astrophysics Data System (ADS)

    Toon, Owen B.; Robock, Alan; Turco, Richard P.

    2014-05-01

    A regional war involving 100 Hiroshima-sized weapons would pose a worldwide threat due to ozone destruction and climate change. A superpower confrontation with a few thousand weapons would be catastrophic.

  5. How Much War Should Be Included in a Course on World War II?

    ERIC Educational Resources Information Center

    Schilling, Donald G.

    1993-01-01

    Contends that end of Cold War increases need for students to understand causes and aftermath of World War II. Recommends spending less time on military aspects of the war and more time on the economic, social, and cultural impact of total war. Provides a selected list of resources to be used in a college level course on the war. (CFR)

  6. Prevention of nuclear war

    SciTech Connect

    Lifton, R.J.

    1980-10-01

    Physicians are exercising their responsibility as healers in their efforts to prevent nuclear war. Death for Hiroshima survivors was experienced in four stages: the immediate impact of destruction, the acute impact of radiation, delayed radiation effects, and later identification as an atomic bomb survivor. Each phase had its physical and psychological impacts and negates Hiroshima as a model for rational behavior despite those who claim survival is possible for those who are prepared. The psychic effects of modern nuclear, chemical, and germ warfare need to be challenged with a symbolization of life and immortality. Studies of psychological reactions to the terror children felt during practice air-raid drills indicate that the fears can be surpressed and re-emerge in adult life as a linking of death with collective annihilation. Other themes which emerge are feelings of impermanence, craziness, identification with the bomb, and a double existence. Psychic numbing and the religion of nuclearism cause dangerous conflicts with the anxieties caused by increasing awareness of death. (DCK)

  7. Star Wars software debate

    SciTech Connect

    Myers, W.

    1986-02-01

    David L. Parnas, Landsdowne Professor of Computer Science at the University of Victoria resigned from the SDI Organization's Panel on Computing in Support of Battle Management on June 28, 1985. Parnas, with 20 years of research on software engineering plus 8 years of work on military aircraft real-time software, says the software portion of SDI cannot be built error-free and he doesn't expect the next 20 years of research to change that fact. Since Parnas resigned, there have been several public debates on Star Wars software questions. In November 1985 the SDIO panel from which Parnas resigned released a draft of its report, reflecting its effort to critics of the project. While one might think that errors could be entirely eliminated with enough care and checking, most software professionals believe there will always be some residue of errors in a system of this size and complexity. The general line of the critics' argument is that the larger the amount of software in a single, unified system, the higher the percentage of errors it will contain. Proponents counter that the one very large system can be divided into a number of smaller, relatively independent pieces, thus reducing the proportionate number of errors in each separate piece. This approach is in turn countered by those who point to the intricate relations between these pieces, which themselves contribute to error.

  8. A TODAY VICTIM OF SECOND WORLD WAR.

    PubMed

    Hăisan, Anca; Dumea, Mihaela; Ursaru, Manuela; Bulat, C; Cimpoeşu, Diana Carmen

    2015-01-01

    Emergency medicine as a medical specialty has to deal with all kind of emergency situations, from medical to post traumatic acute eyents and from new born to the elderly persons, but also with particular situations like explosions. In Romania nowadays these are accidental explosions and rare like frequency, but may be dramatic due to numbers of victims and multisystem injury that may occur. We present a case of a single victim of accidental detonated bomb, a projectile from the Second World War, which unfortunately still may be found in some areas. The management of the case from first call to 112 until the victim is discharge-involves high professional team work. We use these opportunity to make a brief review of the mechanism through the lesions may appear and also to renew the fact that the most impressive lesion may not be the most severe, and we have to examine carefully in order to find the real life threatening injury of the patient. PMID:26204649

  9. Henry's Law: A Retrospective

    ERIC Educational Resources Information Center

    Rosenberg, Robert M.; Peticolas, Warner L.

    2004-01-01

    A retrospective view of Henry's law and its applicability in any specific system at a finite concentration is tested. It can be concluded that Henry's law is only a limiting law and is adequate at low mole fractions but is useful for practical purposes where high precision is not required.

  10. World War I: an air war of consequence.

    PubMed

    Hallion, Richard P

    2014-06-01

    On December 17, 1903, the brothers Wilbur and Orville Wright flew the world's first successful airplane, following this with the first military airplane in 1908. (The 1908 Flyer was built by the brothers in response to a 1907 requirements specification for a 2-place aircraft capable of flying at 40 mph and able to be broken down and transported in a horse-drawn wagon. Technically, since it crashed during its demonstration program and was not formally delivered to the Army, it never became Army property. But the trials had been so impressive that the Army ordered a second, delivered in 1909.) Just six years later, Europe erupted in a general war. Often portrayed as a sideshow to the war on land and sea, the air war heralded the advent of mechanized warfare, the airplane being one of four great technological advances--the submarine, the tank, and radio communication--that, together, revolutionized military affairs. Aircraft reconnaissance influenced the conduct of military operations from the war's earliest days, and airborne observers routinely governed the fall of artillery barrages, crucially important in an artillery-dominant war. PMID:24961713

  11. Injuries in Competitive Dragon Boating

    PubMed Central

    Mukherjee, Swarup; Leong, Hin Fong; Chen, Simin; Foo, Yong Xiang Wayne; Pek, Hong Kiat

    2014-01-01

    Background: Dragon boating is a fast-growing team water sport and involves forceful repetitive motions that predispose athletes to overuse injuries. Despite the rising popularity of the sport, there is a lack of studies on injury epidemiology in dragon boating. Purpose: To investigate the injury epidemiology in competitive dragon boating athletes. Study Design: Descriptive epidemiological study. Methods: A total of 95 dragon boaters (49 males, 46 females) representing their respective universities took part in this study. Data were collected retrospectively using a reliable and valid self-report questionnaire. The study period was from August 2012 to July 2013. Results: A total of 104 musculoskeletal injuries were reported (3.82 injuries/1000 athlete-exposures), 99% of which occurred during training. The most commonly injured regions were the lower back (22.1%), shoulder (21.1%), and wrist (17.3%). The majority of injuries were due to overuse (56.3%), and incomplete muscle-tendon strain was the most prevalent type of injury (50.5%). The time loss from injuries varied. In addition, a significant majority of the dragon boating athletes incurred nonmusculoskeletal injuries, with abrasions (90.5%), blisters (78.9%), and sunburns (72.6%) being the most common. Conclusion: Competitive dragon boating has a moderately high injury incidence, and there seems to be a direct relationship between exposure time and injury rate. A majority of the injuries are overuse in nature, and the body parts most actively involved in paddling movement are at higher risk of injuries. The high incidence of nonmusculoskeletal injuries in dragon boaters suggested that these injuries are likely outcomes of participation in the sport. PMID:26535280

  12. Epidemiology of violence and war.

    PubMed

    Cvjetanović, B

    2000-06-01

    The magnitude of the threat that violence and war pose to the health, the quality of life, and the very survival of humanity is obvious. A number of scientific disciplines have provided, each through its own methodology, insights into the causation, genesis, and dynamics of violence and war. Although epidemiological and psychological methodologies received priority, the multidisciplinary approach to this problem seems to be the most appropriate. This essay attempts to approach holistically the study of epidemiology of violence and war and the ways of preventing these severe problems of the contemporary society. Conceptual models of the causative mechanisms and dynamics of violence and war, mapping the various psychic, social, and environmental factors, are presented. These models, besides advancing abstract ideas, also provide a concrete framework for determining and exploring the interactions and dynamics of the factors and processes which lead to violence and war. The types of interventions outlined for control and prevention are intended to make an impact upon "critical points" within the dynamics of the process which produces violence and war, and are conceived to be implemented on both the national and international level. The importance of family, community, and school influences is considered, but the role of international organizations, including the United Nations, and other governmental and non-governmental organizations is also stressed. Discussion is focused on the factors which favour peace and hamper aggression, on "internationalization" and global society versus xenophobia and nationalism. The conclusions state that there is sufficient knowhow to devise and implement a reasonable and effective international programme for the control and prevention of violence and war, provided there is adequate public and political willingness and support. PMID:10895528

  13. Surgical advances during the First World War: the birth of modern orthopaedics.

    PubMed

    Ramasamy, Arul; Eardley, W G P; Edwards, D S; Clasper, J C; Stewart, M P M

    2016-02-01

    The First World War (1914-1918) was the first truly industrial conflict in human history. Never before had rifle fire and artillery barrage been employed on a global scale. It was a conflict that over 4 years would leave over 750,000 British troops dead with a further 1.6 million injured, the majority with orthopaedic injuries. Against this backdrop, the skills of the orthopaedic surgeon were brought to the fore. Many of those techniques and systems form the foundation of modern orthopaedic trauma management. On the centenary of 'the War to end all Wars', we review the significant advances in wound management, fracture treatment, nerve injury and rehabilitation that were developed during that conflict. PMID:25512441

  14. Astronomers in the Chemist's War

    NASA Astrophysics Data System (ADS)

    Trimble, Virginia L.

    2012-01-01

    World War II, with radar, rockets, and "atomic" bombs was the physicists' war. And many of us know, or think we know, what our more senior colleagues did during it, with Hubble and Hoffleit at Aberdeen; M. Schwarzschild on active duty in Italy; Bondi, Gold, and Hoyle hunkered down in Dunsfeld, Surrey, talking about radar, and perhaps steady state; Greenstein and Henyey designing all-sky cameras; and many astronomers teaching navigation. World War I was The Chemists' War, featuring poison gases, the need to produce liquid fuels from coal on one side of the English Channel and to replace previously-imported dyesstuffs on the other. The talke will focus on what astronomers did and had done to them between 1914 and 1919, from Freundlich (taken prisoner on an eclipse expedition days after the outbreak of hostilities) to Edwin Hubble, returning from France without ever having quite reached the front lines. Other events bore richer fruit (Hale and the National Research Council), but very few of the stories are happy ones. Most of us have neither first nor second hand memories of The Chemists' War, but I had the pleasure of dining with a former Freundlich student a couple of weeks ago.

  15. Eye Injuries

    MedlinePlus

    The structure of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or ...

  16. Head Injuries

    MedlinePlus

    ... injuries internal head injuries, which may involve the skull, the blood vessels within the skull, or the brain Fortunately, most childhood falls or ... knock the brain into the side of the skull or tear blood vessels. Some internal head injuries ...

  17. Back Injuries

    MedlinePlus

    ... the most common site of back injuries and back pain. Common back injuries include Sprains and strains Herniated disks Fractured vertebrae These injuries can cause pain and limit your movement. Treatments vary but might ...

  18. Eye Injuries

    MedlinePlus

    ... of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or work ...

  19. Blast Injuries

    MedlinePlus

    ... Service Members & Veterans Family & Caregivers Medical Providers Blast Injuries U.S. Army photo by Sgt. Gustavo Olgiati How ... tertiary injury Does a blast cause different brain injuries than blunt trauma? There currently is no evidence ...

  20. Ocular Injury

    MedlinePlus

    ... usually occur from blunt trauma, such as a sports injury or a fall with injury to the nose ... of protective goggles at all times. Even in sports like baseball, eye injuries can be prevented by using batting helmets that ...

  1. Sports Injuries

    MedlinePlus

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper ... can also lead to injuries. The most common sports injuries are Sprains and strains Knee injuries Swollen ...

  2. Injuries in competitive boxing. A prospective study.

    PubMed

    Siewe, J; Rudat, J; Zarghooni, K; Sobottke, R; Eysel, P; Herren, C; Knöll, P; Illgner, U; Michael, J

    2015-03-01

    Boxing remains a subject of controversy and is often classified as dangerous. But the discussion is based mostly on retrospective studies. This survey was conducted as a prospective study. From October 2012 to September 2013, 44 competitive boxers were asked to report their injuries once a month. The questionnaire collected general information (training, competition) and recorded the number of bouts fought, injuries and resulting lost days. A total of 192 injuries were recorded, 133 of which resulted in interruption of training or competition. Each boxer sustained 3 injuries per year on average. The injury rate was 12.8 injuries per 1 000 h of training. Boxers fighting more than 3 bouts per year sustain more injuries (p=0.0075). The injury rate does is not a function of age (age≤19 vs. > 19a, p=0.53). Injuries to the head and the upper limbs occur most frequently. The most common injuries are soft tissue lacerations and contusions. Head injuries with neurological symptoms rarely occur (4.2%). Boxing has a high injury rate that is comparable with other contact sports, but most injuries are minor. Injury frequency is not a function of whether the boxer competes in the junior or adult category. Athletes fighting many bouts per year have a greater risk of injury. PMID:25376728

  3. Repatriation and Identification of Finnish World War II Soldiers

    PubMed Central

    Palo, Jukka U.; Hedman, Minttu; Söderholm, Niklas; Sajantila, Antti

    2007-01-01

    Aim To present a summary of the organization, field search, repatriation, forensic anthropological examination, and DNA analysis for the purpose of identification of Finnish soldiers with unresolved fate in World War II. Methods Field searches were organized, executed, and financed by the Ministry of Education and the Association for Cherishing the Memory of the Dead of the War. Anthropological examination conducted on human remains retrieved in the field searches was used to establish the minimum number of individuals and description of the skeletal diseases, treatment, anomalies, or injuries. DNA tests were performed by extracting DNA from powdered bones and blood samples from relatives. Mitochondrial DNA (mtDNA) sequence comparisons, together with circumstantial evidence, were used to connect the remains to the putative family members. Results At present, the skeletal remains of about a thousand soldiers have been found and repatriated. In forensic anthropological examination, several injuries related to death were documented. For the total of 181 bone samples, mtDNA HVR-1 and HVR-2 sequences were successfully obtained for 167 (92.3%) and 148 (81.8%) of the samples, respectively. Five samples yielded no reliable sequence data. Our data suggests that mtDNA preserves at least for 60 years in the boreal acidic soil. The quality of the obtained mtDNA sequence data varied depending on the sample bone type, with long compact bones (femur, tibia and humerus) having significantly better (90.0%) success rate than other bones (51.2%). Conclusion Although more than 60 years have passed since the World War II, our experience is that resolving the fate of soldiers missing in action is still of uttermost importance for people having lost their relatives in the war. Although cultural and individual differences may exist, our experience presented here gives a good perspective on the importance of individual identification performed by forensic professionals. PMID:17696308

  4. Critical concerns in Iraq/Afghanistan war veteran-forensic interface: combat-related postdeployment criminal violence.

    PubMed

    Sreenivasan, Shoba; Garrick, Thomas; McGuire, James; Smee, Daniel E; Dow, Daniel; Woehl, Daniel

    2013-01-01

    Identifying whether there is a nexus between Iraq and Afghanistan combat injuries and civilian violence on return from deployment is complicated by differences in reactions of individuals to combat exposure, the overlapping effects of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD), and the low base rate of civilian violence after combat exposure. Moreover, the overall prevalence of violence among returning Iraq and Afghanistan combat war veterans has not been well documented. Malingered symptoms and either exaggeration or outright fabrication of war zone exposure are challenges to rendering forensic opinions, with the risk reduced by accessing military documents that corroborate war zone duties and exposure. This article serves as a first step toward understanding what may potentiate violence among returning Iraq and Afghanistan veterans. We offer a systematic approach toward the purpose of forensic case formulation that addresses whether combat duty/war zone exposure and associated clinical conditions are linked to criminal violence on return to civilian life. PMID:23771940

  5. Stress and coping in male and female health care providers during the Persian Gulf War: the USNS Comfort hospital ship.

    PubMed

    Slusarcick, A L; Ursano, R J; Fullerton, C S; Dinneen, M P

    1999-03-01

    The development of the USNS Comfort hospital ship during the Persian Gulf War provided an opportunity to examine the relationship of gender to stress and coping in health care providers exposed to wartime stressors. Just before the outbreak of Operation Desert Storm, medical personnel (N = 250) rated the stressfulness of current wartime experiences and the helpfulness of stress-reducing resources onboard ship in a combat theater. The responses of men and women were compared; to identify the dimensions of these responses, a principal factor analysis (orthogonal rotation) was performed. Generally, men and women ranked stressors and stress reducers similarly; women scored higher on the stress ratings. Two factors, similar for men and women, were identified in the stress ratings: fear of injury and trauma-related work demands. The dimensions of the stress reducers, however, were different for men and women. The findings support retrospective studies and suggest that different mechanisms of stress reduction may be operative even though men and women are performing the same activity. PMID:10091488

  6. [The Red Cross System for War Relief during the Second World War and Actual Conditions of Its Efforts in Burma].

    PubMed

    Kawahara, Yukari

    2015-12-01

    This paper aims to show the system for relief provided by the Japanese Red Cross relief units during the Second World War, as well as the actual activities of sixteen of its relief units dispatched to Burma. The Red Cross wartime relief efforts involved using personnel and funding prepared beforehand to provide aid to those injured in war, regardless of their status as ally or enemy. Thus they were able to receive support from the army in order to ensure safety and provide supplies. Nurses dispatched to Burma took care of many patients who suffered from malnutrition and physical injuries amidst the outbreak of infectious diseases typical of tropical areas, without sufficient replacement members. Base hospitals not meant for the front lines also came under attack, and the nurses' lives were thus in mortal danger. Of the 374 original members, 29 died or went missing in action. PMID:27089733

  7. War rape, natality and genocide.

    PubMed

    Schott, Robin May

    2011-01-01

    Feminist philosophy can make an important contribution to the field of genocide studies, and issues relating to gender and war are gaining new attention. In this article I trace legal and philosophical analyses of sexual violence against women in war. I analyze the strengths and limitations of the concept of social death—introduced into this field by Claudia Card—for understanding the genocidal features of war rape, and draw on the work of Hannah Arendt to understand the central harm of genocide as an assault on natality. The threat to natality posed by the harms of rape, forced pregnancy and forced maternity lie in the potential expulsion from the public world of certain groups—including women who are victims, members of the 'enemy' group, and children born of forced birth. PMID:21941691

  8. Nuclear War. The moral dimension

    SciTech Connect

    Child, J.W.

    1985-01-01

    U.S. nuclear policy has become the target of increasing criticism during the past decade. Critics often argue that the use of nuclear weapons would be irrational, would destroy humankind, and thus could not serve any rational policy goal. Other critics point to the immortality of the use of nuclear weapons. Both groups condemn U.S. military policy. In Nuclear War, James Child considers and rejects both these lines of criticism. He argues that a policy of deterrence can be both rational and moral; that U.S. nuclear policy is, on balance, based on rational and moral foundations. Child examines near-term consequences of a nuclear war and finds them ghastly but not unthinkable or incomparable to the havoc produced by previous wars. He also analyzes long-term consequences, such as those proposed by the ''nuclear winter'' theory, and finds the fear of total annihilation of humankind to be unfounded.

  9. War and the demographic trap.

    PubMed

    Last, J M

    1993-08-28

    Advice is offered on alleviating environmental damage and the suffering of women and children from the effects of war. It is postured that the demographic trap, which was described by King and Elliott, is responsible for environmental stress and many wars. The surface cause may be identified as ideology, politics, or ethnicity, but as in the case of Bosnia, the "ethnic cleansing" makes farmland available to sustain expanding Serbian or Croatian populations. If the land is environmentally damaged by war, then there is little hope of sustainable development. Conflicts in many countries have driven people to urban areas or periurban slums because of displacement and the failure of subsistence economics. Mortality from wars has reached more than a 100 million since the early 1990s. A comparable number have died indirectly from famine and disease associated with the disruption of agriculture and infrastructure from wars. Since 1945, 66-75% of mortality victims have been civilians, of whom 15 million have been women and children. In 1993, there were at least 30 conflicts ongoing throughout the world. Not all of these conflicts are as "ferocious" as the Bosnian conflict, but these "so called low intensity wars" nonetheless disrupt and kill. The manifestations of the demographic trap can be alleviated through interventions that focus on multisectoral aid and conflict resolution. There must be a cooperative effort on the part of health workers, agricultural scientists, mediators, and development personnel. Unfortunately, the amount of development assistance from Europe and America has been reduced in recent years. The recession has affected the provision of international aid. African nations, in particular, have been affected, yet these countries remain the neediest in the world. It would appear that aid agencies have given up hope that the demographic trap can be closed. Population growth must be limited, as the only hope for relieving environmental stress, ecological

  10. Knee injuries in female athletes.

    PubMed

    Hutchinson, M R; Ireland, M L

    1995-04-01

    Female athletes are at increased risk for certain sports-related injuries, particularly those involving the knee. Factors that contribute to this increased risk are the differences in sports undertaken and in gender anatomy and structure. Gender differences include baseline level of conditioning, lower extremity alignment, physiological laxity, pelvis width, tibial rotation and foot alignment. Sports like gymnastics and cheerleading create a noncontact environment, but can result in significant knee injuries. In quick stopping and cutting sports, females have an increased incidence of anterior cruciate ligament (ACL) injury by noncontact mechanisms. Patellofemoral (PF) disorders are also very common in female athletes. Awareness of these facts helps the sports medicine professional make an accurate diagnosis and institute earlier treatment-focused rehabilitation with or without surgery. Further prospective and retrospective research is needed in areas of epidemiology, mechanisms, severity and types of knee injuries. The goal is to lessen the severity of certain knee injuries and to prevent others. PMID:7604201

  11. Ankle injuries in basketball players.

    PubMed

    Leanderson, J; Nemeth, G; Eriksson, E

    1993-01-01

    We carried out a retrospective study of the frequency of ankle sprains in basketball players. A questionnaire about previous ankle injuries, time off after such injuries, current ankle problems, personal data, number of practice hours and the use of prophylactic measures was sent out to 102 basketball players in a second division league in Sweden. Ninety-six players answered. 92% of them had suffered an ankle sprain while playing basketball, and of these 83% reported repeated sprains of one ankle. In the last two seasons, 78% of the players had injured at least one ankle. The injury frequency in the investigation was 5.5 ankle injuries per 1000 activity hours. 22% of the players used some kind of prophylactic support of their ankle joints. Because of the great number of ankle sprains and the disability in terms of time away from sports that they cause, prevention of these injuries is essential. PMID:8536029

  12. Glut, war slow Mideast activity

    SciTech Connect

    Not Available

    1984-07-20

    Oilpatch activity in the Middle East has been on the slow side recently, and with a heated-up war between Iran and Iraq throwing off violent sparks around the Arabian Gulf, it's difficult to keep one's mind on business-as-usual. The article deals with the rising cost of insurance for shipping because of the war and the effects on drilling, production and the environment (oil spills). The development and production of offshore oil and gas in Egypt, Saudi Arabia, and the United Arab Emirates is also discussed.

  13. [Explosion injuries - prehospital care and management].

    PubMed

    Holsträter, Thorsten; Holsträter, Susanne; Rein, Daniela; Helm, Matthias; Hossfeld, Björn

    2013-11-01

    Explosion injuries are not restricted to war-like military conflicts or terrorist attacks. The emergency physician may also encounter such injuries in the private or industrial fields, injuries caused by fireworks or gas explosions. In such cases the injury patterns are especially complex and may consist of blunt and penetrating injuries as well as thermal damage. Emergency medical personnel must be prepared to cope with explosion trauma not only in individual cases but also in major casualty incidents (MCI). This necessitates a sound knowledge about the mechanisms and processes of an explosion as well as the particular pathophysiological relationships of explosion injuries in order to be able to initiate the best possible, guideline-conform trauma therapy. PMID:24343140

  14. Neurology and War: From Antiquity to Modern Times.

    PubMed

    Paciaroni, Maurizio; Arnao, Valentina

    2016-01-01

    Here, we chronicle the evolution of warfare from antiquity to modern times (18th century) and its impact on the later-to-be-defined field of neurology, especially with regard to brain, spinal cord and peripheral nerve injuries and neurological disorders caused by biological weapons and psychological trauma. We describe how individuals courageously and intelligently dealt with the horrors of war, from the Egyptians to the Greeks and onward to the Romans, up until the physicians of modern times. In doing so, they responded to the call of duty by inventing solutions that benefitted not only soldiers but also civilian medicine. PMID:27035675

  15. An injury profile of elite ironman competitors.

    PubMed

    Pen, L J; Barrett, R S; Neal, R J; Steele, J R

    1996-03-01

    An injury questionnaire was administered to the 30 elite ironman competitors (mean age = 25.7 +/- 4.6 yrs) participating in a commercially sponsored seven race national series. Responses provided retrospective data from the preceding three years indicating the type, location, frequency, cause and severity of injuries sustained by ironmen, and associated these injuries with particular race components (run, swim, board, ski). Twenty self-reported questionnaires were returned for analysis that described a total of 67 injuries incurred by 19 subjects. Results indicated the following: (i) the most frequently injured body parts were the knee (n = 18) and shoulder (n = 14) with the lower extremity accounting for 55% of all injuries reported; (ii) knee, shin and calf injuries had a significant association with the run component and upper extremity injuries had a significant association with the swim component; (iii) running was perceived to be the most injurious race component in terms of the frequency and severity of injury; (iv) overtraining was perceived to be the main cause of injury; (v) tendinitis was perceived to be the main type of injury; (vi) athletes adjusted their training mode to accommodate injury so that total training volume could be maintained; and (vii) injury did not result in withdrawal from competition. Further research investigating the techniques used in the ironman event and their relationship to injury is recommended. PMID:8742860

  16. War, peace, and international politics. Fourth edition

    SciTech Connect

    Ziegler, D.W. )

    1987-01-01

    We must conclude that war remains a major problem in the last quarter of the twentieth century. My intention in this book is to introduce you to international relations by focusing on this problem. War is not the only problem of international relations, and so this book does not exhaust the field. But war is a central problem, and the possibility of resort to war affects other aspects of international relations. Whatever else we may look at, we cannot avoid looking at war. In fact, in looking at war, we will touch on most of the other subjects important in international relations. War is conflict among states carried on by their armed forces. To distinguish war from border skirmishes and other minor incidents we usually say it must reach a certain magnitude (for example, at least 1,000 soldiers killed in battle over a year). It would be ideal if we could systematically study all the wars in the last hundred years, but such an exhaustive study would be out of place here. At the same time we cannot discuss such subjects as the cause of war or proposals for preventing it without some knowledge about actual wars. We must test theories against historical facts. What follows in Part I is a somewhat detailed history of seven wars (or groups of wars) fought in the last hundred years. These include the most destructive of the wars World War I (1914-1918), World War II (1939-1945), and the Korean War (1950-1953). By way of background to World War I, we will look at the wars of German unification (1864-1871), which preceded and in some ways prepared the way for it. To balance our account, we will also look at several recent wars India and Pakistan (1971), Uganda and Tanzania (1978-1979), and Cambodia, Vietnam, and China (1978-1980). After looking at some of the major wars of the last hundred years, we will look at what people have the about the causes of war in general.

  17. Space technologies and the war in Iraq

    NASA Astrophysics Data System (ADS)

    Getsov, Petar

    The paper presents a description of the application of aerospace technologies during the war in Iraq. The specific instrumentation used by the USA and its allies in the field of communication, navigation, and control of weapons and ammunition to schedule war activities is presented. Conclusions are made on the ever growing application of space technologies in modern wars and their impact on the efficiency of decision-making at war times.

  18. Women and War, Children and War: Stretching the Bonds of Caregiving.

    ERIC Educational Resources Information Center

    McNamee, Abigail S.

    Many things stretch the bonds between caregiver and child, such as war, stress, and trauma. This paper reviews the literature on children who are in direct contact with war or indirect contact with war through television or others' conversations. It also describes the effects of war on children and their families, and children's psychological…

  19. 77 FR 43117 - Meeting of the Cold War Advisory Committee for the Cold War Theme Study

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-23

    ... National Park Service Meeting of the Cold War Advisory Committee for the Cold War Theme Study AGENCY... with the Federal Advisory Committee Act, 5 U.S.C. Appendix, that the Cold War Advisory Committee for the Cold War Theme Study will conduct a teleconference meeting on August 3, 2012. Members of...

  20. Ain't Gonna Study War No More? Explorations of War through Picture Books

    ERIC Educational Resources Information Center

    Crawford, Patricia A.; Roberts, Sherron Killingsworth

    2009-01-01

    At the height of the Vietnam War, Down by the Riverside was transformed from a traditional folk song to a popular anti-war anthem. The raucous and repetitive chorus, "I ain't gonna study war no more ...," became a rallying cry for those who wanted nothing to do with the war and the pain and controversy that surrounded it. Although it seems…

  1. Young Children and War Play.

    ERIC Educational Resources Information Center

    Carlsson-Paige, Nancy; Levin, Diane E.

    1988-01-01

    In a recent survey of parents and early childhood professionals the prevalence of war play among children and an increase in the amount of violence in children's play was noted. Outlines how the deregulation of children's television during the Reagan administration has affected children's exposure to violence in children's television programming.…

  2. War Is Not the Answer.

    ERIC Educational Resources Information Center

    Besteman, Karst J.

    1989-01-01

    Concludes that a war on drugs is not the answer to the problem of drug abuse in the United States. Stresses that the hostile atmosphere generated by the overemphasis upon interdiction and enforcement of penalties undermines the healing and restoring efforts needed in reducing the individual's demand for drugs. (KO)

  3. Images of the Cold War.

    ERIC Educational Resources Information Center

    Chomsky, Noam

    1989-01-01

    The conventional U.S. picture traces the Cold War to Soviet violation of wartime agreements, while the U.S.S.R. defends its actions as responses to American violations and foreign adventurism. An understanding of how ideology is shaped by national self-interest will help students see beyond propaganda and myth in interpreting past and current…

  4. Cold War Geopolitics: Embassy Locations.

    ERIC Educational Resources Information Center

    Vogeler, Ingolf

    1995-01-01

    Asserts that the geopolitics of the Cold War can be illustrated by the diplomatic ties among countries, particularly the superpowers and their respective allies. Describes a classroom project in which global patterns of embassy locations are examined and compared. Includes five maps and a chart indicating types of embassy locations. (CFR)

  5. The Revolutionary War. [Lesson Plan].

    ERIC Educational Resources Information Center

    Buchberg, Wendy

    Based on James Lincoln Collier and Christopher Collier's novel "My Brother Sam Is Dead," this lesson plan presents activities designed to help students understand that one way to learn about the past is to read historical novels; and that some people take one side or another in a war or other conflict, and some find themselves caught in the…

  6. The Civil War and Iowa.

    ERIC Educational Resources Information Center

    Gore, Deborah, Ed.

    1987-01-01

    This journal issue explores Iowa's participation in the U.S. Civil War and primarily focuses on what happened to the men, women, and children who remained at home. A number of social, political, and economic changes are examined, including: (1) the increased responsibilities of women and children; (2) the growth of abolitionism; (3) the role of…

  7. The Politics of Star Wars.

    ERIC Educational Resources Information Center

    Wilkins, Lee

    George Lucas's Star Wars trilogy is used as the basis for the creation of a political subtext arising from one of America's most enduring literary myths--the American Adam. That subtext, when translated into a modern political context, pinpoints two central issues to face this democracy in the coming years, as well as a national ambivalence about…

  8. [World War II 50th Anniversary.

    ERIC Educational Resources Information Center

    Johnson, Jeniffer, Ed.

    1991-01-01

    This edition of "Loblolly," a periodical published by Texas high school students, commemorates the 50th anniversary of World War II. The volume features remembrances of the War by veterans of Panola County, Texas. In addition to transcriptions of conversations with veterans, reproductions of photographs--some from the war period, some from more…

  9. Peace-keeping Forces: YA War Books.

    ERIC Educational Resources Information Center

    Crowe Chris

    2000-01-01

    Argues that good young adult books about war can help teenagers appreciate the blessings of peace and the horrors of war, and perhaps may inspire them to do what they can to preserve peace. Describes briefly 71 young adult war books worth reading. (SR)

  10. World War II Homefront: A Historiography.

    ERIC Educational Resources Information Center

    Winkler, Allan M.

    2002-01-01

    Highlights the scholarship that exists on the World War II homefront covering topics such as World War II as a good war, Franklin D. Roosevelt, economic policy, propaganda, status of women and women's employment, the role of African Americans, racial violence, and the Japanese American experience. (CMK)

  11. Fighting the War on Academic Terrorism. Advocacy

    ERIC Educational Resources Information Center

    Kaplan, Sandra N.

    2005-01-01

    While the attention of the country is focused on the global and national war on terrorism, the war on academic terrorism is being waged in classrooms, infiltrating the gifted programs, and altering the outcomes derived for students participating in gifted programs. The war on academic terrorism is related to the broad areas of curriculum and…

  12. 76 FR 21223 - Civil War Sesquicentennial

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ...#0;#0; ] Proclamation 8654 of April 12, 2011 Civil War Sesquicentennial By the President of the... in an attack on Fort Sumter. These were the first shots of a civil war that would stretch across 4..., 2011, as the first day of the Civil War Sesquicentennial. I call upon all Americans to observe...

  13. Association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury after intensity-modulated radiotherapy in lung cancer: a retrospective analysis.

    PubMed

    Chen, Jinmei; Hong, Jinsheng; Zou, Xi; Lv, Wenlong; Guo, Feibao; Hong, Hualan; Zhang, Weijian

    2015-11-01

    The aim of this study was to investigate the association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury (RILI) after intensity-modulated radiotherapy (IMRT) for lung cancer. The normal lung relative volumes receiving greater than 5, 10, 20 and 30 Gy (V5-30) mean lung dose (MLD), and absolute volumes spared from greater than 5, 10, 20 and 30 Gy (AVS5-30) for the bilateral and ipsilateral lungs of 83 patients were recorded. Any association of clinical factors and dose-volume parameters with Grade ≥2 RILI was analyzed. The median follow-up was 12.3 months; 18 (21.7%) cases of Grade 2 RILI, seven (8.4%) of Grade 3 and two (2.4%) of Grade 4 were observed. Univariate analysis revealed the located lobe of the primary tumor. V5, V10, V20, MLD of the ipsilateral lung, V5, V10, V20, V30 and MLD of the bilateral lung, and AVS5 and AVS10 of the ipsilateral lung were associated with Grade ≥2 RILI (P < 0.05). Multivariate analysis indicated AVS5 of the ipsilateral lung was prognostic for Grade ≥2 RILI (P = 0.010, OR = 0.272, 95% CI: 0.102-0.729). Receiver operating characteristic curves indicated Grade ≥2 RILI could be predicted using AVS5 of the ipsilateral lung (area under curve, 0.668; cutoff value, 564.9 cm(3); sensitivity, 60.7%; specificity, 70.4%). The incidence of Grade ≥2 RILI was significantly lower with AVS5 of the ipsilateral lung ≥564.9 cm(3) than with AVS5 < 564.9 cm(3) (P = 0.008). Low-dose irradiation relative volumes and MLD of the bilateral or ipsilateral lung were associated with Grade ≥2 RILI, and AVS5 of the ipsilateral lung was prognostic for Grade ≥2 RILI for lung cancer after IMRT. PMID:26454068

  14. Traumatic Dural Venous Sinus Injury

    PubMed Central

    Kim, You-Sub; Jung, Seung-Hoon; Lim, Dong-Ho; Kim, Tae-Sun; Kim, Jae-Hyoo

    2015-01-01

    Objective The importance of traumatic dural venous sinus injury lies in the probability of massive blood loss at the time of trauma or emergency operation resulting in a high mortality rate during the perioperative period. We considered the appropriate methods of treatment that are most essential in the overall management of traumatic dural venous sinus injuries. Methods We conducted a retrospective review of all cases involving patients with dural venous sinus injury who presented to our hospital between January 1999 and December 2014. Results Between January 1999 and December 2014, 20 patients with a dural venous sinus injury out of the 1,200 patients with severe head injuries who had been operated upon in our clinic were reviewed retrospectively. There were 17 male and 3 female patients. In 11 out of the 13 patients with a linear skull fracture crossing the dural venous sinus, massive blood loss from the injured sinus wall could be controlled by simple digital pressure using Gelfoam. All 5 patients with a linear skull fracture parallel to the sinus over the venous sinus developed massive sinus bleeding that could not be controlled by simple digital pressure. Conclusion When there is a linear skull fracture parallel to the sinus over the dural venous sinus or a depressed skull fracture penetrating the sinus, the surgeon should be prepared for the possibility of potentially fatal venous sinus injury, even in the absence of a hematoma. PMID:27169076

  15. Injury and violence: a public health perspective.

    PubMed

    Rockett, I R

    1998-12-01

    This report examined injury and violence from a public health perspective. The discussion focuses on the magnitude of the problem, age and regional patterns, war mortality, motor vehicle accidents, natural disasters, US injury and violence mortality and morbidity trends by age, the history of injury, the relationship between energy and injury, similarities between disease and injuries, injury and violence prevention, risk factors, and medical care. The US has two Centers for Disease Control surveillance systems for monitoring behavior that increases the risk of injury or disease. A youth surveillance system surveys high school students about high risk behavior, such as use of weapons and nonuse of seat belts. The surveillance system misses the homeless and people without telephones and undersamples minorities, low income people, and males. Youth surveillance misses groups with high dropout rates, such as Blacks and Hispanics. Lower income people have higher disease and injury rates. US Black males are particularly vulnerable. Health professionals that aim to reduce injury risks must address underlying conditions that perpetuate poverty, such as residential segregation, racial discrimination, unemployment, and inferior educational opportunities. Survival of the injured is dependent on the speed with which Emergency Medical Teams can treat the injury. Treatment within the first hour is a critical determining factor. Specialized trauma centers and emerging technologies, such as geographic information systems, improve survival. The global diffusion of beliefs, values, and practices can promote or inhibit injury and violence. PMID:12321948

  16. Infertility among male UK veterans of the 1990-1 Gulf war: reproductive cohort study

    PubMed Central

    Maconochie, Noreen; Doyle, Pat; Carson, Claire

    2004-01-01

    Objectives To examine the hypothesis that, theoretically at least, exposure to toxicants of the type present in the Gulf war could affect spermatogenesis, which might be observed as increased levels of infertility. Design Retrospective reproductive cohort analysis. Setting Male UK Gulf war veterans and matched comparison group of non-deployed servicemen, surveyed by postal questionnaire. Participants 42 818 completed questionnaires were returned, representing response rates of 53% for Gulf veterans and 42% for non-Gulf veterans; 10 465 Gulf veterans and 7376 non-Gulf veterans reported fathering or trying to father pregnancies after the Gulf war. Main outcome measures Failure to achieve conceptions (type I infertility) or live births (type II infertility) after the Gulf war, having tried for at least a year and consulted a doctor; time to conception among pregnancies fathered by men not reporting fertility problems. Results Risk of reported infertility was higher among Gulf war veterans than among non-Gulf veterans (odds ratio for type I infertility 1.41, 95% confidence interval 1.05 to 1.89; type II 1.50, 1.18 to 1.89). This small effect was constant over time since the war and was observed whether or not the men had fathered pregnancies before the war. Results were similar when analyses were restricted to clinically confirmed diagnoses. Pregnancies fathered by Gulf veterans not reporting fertility problems also took longer to conceive (odds ratio for > 1 year 1.18, 1.04 to 1.34). Conclusions We found some evidence of an association between Gulf war service and reported infertility. Pregnancies fathered by Gulf veterans with no fertility problems also reportedly took longer to conceive. PMID:15253919

  17. Sharps injuries in ophthalmic practice

    PubMed Central

    Ghauri, A-J; Amissah-Arthur, K N; Rashid, A; Mushtaq, B; Nessim, M; Elsherbiny, S

    2011-01-01

    Purpose Accidental sharps injuries are a potential route for transmission of blood-borne infection to healthcare workers. Ophthalmic staff in particular are at risk of sustaining such injuries due to the microsurgical nature of the speciality. Forthcoming European Union legislation aimed at reducing sharps injuries requires the development of risk-based sharps policy. The authors believe that this is the first study to assess the risks of sharps injuries and their management specific to ophthalmic practice within the European Union. Methods A retrospective review of all reported sharps injuries across three eye units in the UK over a period of 6 years was undertaken. Data were analysed to determine the circumstances surrounding the injury, occupation of the injured person, and whether appropriate actions were taken following incidents. Results A total of 68 sharps injuries were reported over the 6-year period. Nurses sustained 54.4% (n=37) of needlestick injuries, doctors 39.7% (n=27), and allied healthcare staff 5.9% (n=4). In all 51.5% (n=35) of sharps injuries occurred in the operating theatre, 30.9% (n=21) in the outpatient clinic, 13.2% (n=9) on the ophthalmic ward, and 4.4% (n=3) in unspecified locations. There was a median rate of 1.3 sharps injuries per 1000 surgical procedures per year and a range of 0.4–3.5 per 1000. Conclusions This study demonstrates the need to raise awareness of the unique risks of sharps injuries in ophthalmic practice. This is necessary in order to develop speciality-specific policy that promotes strategies to reduce such injuries, enhances the accuracy of reporting of such events, and provides guidance for appropriate management. PMID:21336251

  18. Lisfranc injuries.

    PubMed

    Welck, M J; Zinchenko, R; Rudge, B

    2015-04-01

    Lisfranc injuries are commonly asked about in FRCS Orthopaedic trauma vivas. The term "Lisfranc injury" strictly refers to an injury where one or more of the metatarsals are displaced from the tarsus. The term is more commonly used to describe an injury to the midfoot centred on the 2nd tarsometatarsal joint. The injury is named after Jacques Lisfranc de St. Martin (1790-1847), a French surgeon and gynaecologist who first described the injury in 1815. 'Lisfranc injury' encompasses a broad spectrum of injuries, which can be purely ligamentous or involve the osseous and articular structures. They are often difficult to diagnose and treat, but if not detected and appropriately managed they can cause long-term disability. This review outlines the anatomy, epidemiology, classification, investigation and current evidence on management of this injury. PMID:25543185

  19. Pancreatic injury.

    PubMed

    Ahmed, Nasim; Vernick, Jerome J

    2009-12-01

    Injury to the pancreas, because of its retroperitoneal location, is a rare occurrence, most commonly seen with penetrating injuries (gun shot or stab wounds). Blunt trauma to the pancreas accounts for only 25% of the cases. Pancreatic injuries are associated with high morbidity and mortality due to accompanying vascular and duodenal injuries. Pancreatic injuries are not always easy to diagnose resulting in life threatening complications. Physical examination as well as serum amylase is not diagnostic following blunt trauma. Computed tomography (CT) scan can delineate the injury or transaction of the pancreas. Endoscopic retrograde pancreaticography (ERCP) is the main diagnostic modality for evaluation of the main pancreatic duct. Unrecognized ductal injury leads to pancreatic pseudocyst, fistula, abscess, and other complications. Management depends upon the severity of the pancreatic injury as well as associated injuries. Damage control surgery in hemodynamic unstable patients reduces morbidity and mortality. PMID:20016434

  20. Contributions of psychology to war and peace.

    PubMed

    Christie, Daniel J; Montiel, Cristina J

    2013-10-01

    The contributions of American psychologists to war have been substantial and responsive to changes in U.S. national security threats and interests for nearly 100 years. These contributions are identified and discussed for four periods of armed conflict: World Wars I and II, the Cold War, and the Global War on Terror. In contrast, about 50 years ago, largely in reaction to the threat of nuclear war, some psychologists in the United States and around the world broke with the tradition of supporting war and began focusing their scholarship and activism on the prevention of war and promotion of peace. Today, peace psychology is a vibrant area of psychology, with theory and practice aimed at understanding, preventing, and mitigating both episodes of organized violence and the pernicious worldwide problem of structural violence. The growth, scope, and content of peace psychology are reviewed along with contributions to policies that promote peace, social justice, and human well-being. PMID:24128314

  1. Complications and risk factors for mortality in penetrating abdominal firearm injuries: analysis of 120 cases.

    PubMed

    Iflazoglu, Nidal; Ureyen, Orhan; Oner, Osman Z; Tusat, Mustafa; Akcal, Mehmet A

    2015-01-01

    Due to the high kinetic energy, of bullets and explosive gun particles, their paths through the abdomen (permanent cavity effect), and the blast effect (temporary cavity effect), firearm injuries (FAI) can produce damage not only in the organ they enter, but in the surrounding tissues as well. Since they change route after entering the body they may cause organ damage in locations other than those at the path of entry. For example, as a result of the crushing onto bone tissues, bullet particles or broken bone fragments may cause further damage outside of the path of travel, For these reasons it is very difficult to predict the possible complications from the size of the actual injury in patients with penetrating abdominal firearm injuries. The factors affecting the mortality and morbidity from firearm injuries have been evaluated in various studies. Insufficient blood transfusion, long duration of time until presenting to a hospital and the presence of colon injuries are common factors that cause the high complication rates and mortality. A total of 120 cases injured in the civil war at Turkey's southern neighbouring countries were admitted to our hospital and evaluated in terms of: development of complications and factors affecting mortality; age, gender, time of presentation to the hospital, number of injured organs, the type of injuring weapon, the entrance site of the bullet, the presence of accompanying chest trauma, the amount of administered blood, the penetrating abdominal trauma index (PATI) and the injury severity score (ISS) scores were determined and evaluated retrospectively. The most significant factors for the development of complications and mortality include: accompanying clinical shock, high number of injured organs, numerous blood transfusions administered and accompanying thoracic trauma. It has also been observed that the PATI and ISS scoring systems can be used in predicting the complication and mortality rates in firearm injuries

  2. Complications and risk factors for mortality in penetrating abdominal firearm injuries: analysis of 120 cases

    PubMed Central

    Iflazoglu, Nidal; Ureyen, Orhan; Oner, Osman Z; Tusat, Mustafa; Akcal, Mehmet A

    2015-01-01

    Due to the high kinetic energy, of bullets and explosive gun particles, their paths through the abdomen (permanent cavity effect), and the blast effect (temporary cavity effect), firearm injuries (FAI) can produce damage not only in the organ they enter, but in the surrounding tissues as well. Since they change route after entering the body they may cause organ damage in locations other than those at the path of entry. For example, as a result of the crushing onto bone tissues, bullet particles or broken bone fragments may cause further damage outside of the path of travel, For these reasons it is very difficult to predict the possible complications from the size of the actual injury in patients with penetrating abdominal firearm injuries. The factors affecting the mortality and morbidity from firearm injuries have been evaluated in various studies. Insufficient blood transfusion, long duration of time until presenting to a hospital and the presence of colon injuries are common factors that cause the high complication rates and mortality. A total of 120 cases injured in the civil war at Turkey’s southern neighbouring countries were admitted to our hospital and evaluated in terms of: development of complications and factors affecting mortality; age, gender, time of presentation to the hospital, number of injured organs, the type of injuring weapon, the entrance site of the bullet, the presence of accompanying chest trauma, the amount of administered blood, the penetrating abdominal trauma index (PATI) and the injury severity score (ISS) scores were determined and evaluated retrospectively. The most significant factors for the development of complications and mortality include: accompanying clinical shock, high number of injured organs, numerous blood transfusions administered and accompanying thoracic trauma. It has also been observed that the PATI and ISS scoring systems can be used in predicting the complication and mortality rates in firearm injuries

  3. Electron Paramagnetic Resonance Retrospective Dosimetry

    SciTech Connect

    Romanyukha, Alex; Trompier, Francois

    2011-05-05

    Necessity for, principles of, and general concepts of the electron paramagnetic resonance (EPR) retrospective dosimetry are presented. Also presented and given in details are examples of EPR retrospective dosimetry applications in tooth enamel, bone, and fingernails with focus on general approaches for solving technical and methodological problems. Advantages, drawbacks, and possible future developments are discussed and an extensive bibliography on EPR retrospective dosimetry is provided.

  4. Basketball injuries.

    PubMed

    Newman, Joel S; Newberg, Arthur H

    2010-11-01

    Basketball injuries are most prevalent in the lower extremity, especially at the ankle and knee. Most basketball injuries are orthopedic in nature and commonly include ligament sprains, musculotendinous strains, and overuse injuries including stress fractures. By virtue of its excellent contrast resolution and depiction of the soft tissues and trabecular bone, magnetic resonance imaging has become the principal modality for evaluating many basketball injuries. In this article, commonly encountered basketball injuries and their imaging appearances are described. The epidemiology of basketball injuries across various age groups and levels of competition and between genders are reviewed. PMID:21094400

  5. The management of war wounds to the extremities.

    PubMed

    Stanec, Z; Skrbić, S; Dzepina, I; Hulina, D; Ivrlac, R; Unusić, J; Montani, D; Prpić, I

    1994-03-01

    We present our experience in the treatment of war wounds in 174 patients treated in the Institute of Plastic and Reconstructive Surgery, Department of Surgery, Clinical Hospital Center in Zagreb. The wounds were divided into four categories depending on the type of injury and the extension of the soft tissue defect which showed the differences in primary excision and reconstruction of wounds. Patients were placed in one of two groups depending on their primary treatment and time of definitive reconstruction. Group A comprised 79 patients who were initially treated by plastic surgeons and whose reconstructive procedure was done within five days. Group B comprised 95 patients who were initially treated in a field hospital and referred later to the plastic surgery unit for definitive reconstruction more than five days after the injury. Sixty-nine (87%) of the patients in group A had only one or two debridements before definitive closure and stayed in hospital 20 days or less. In group B, 59 (62%) of the patients required three or more debridements before definitive closure and remained in hospital more than 21 days (p < 0.001). Proper primary treatment and early reconstruction result in significantly shorter duration of hospital stay and lead to more effective rehabilitation and recovery of the patients. A knowledge in terminal ballistics is important in the understanding of the pathophysiology of war wounds. PMID:8029651

  6. Snowblower injuries to the hand.

    PubMed

    Dietzel, D P; Gorosh, J; Burke, E F; Singer, R M

    1997-12-01

    We retrospectively reviewed the records of 62 patients who sustained serious hand injuries caused by snowblowers between 1981 and 1990. Frequency of injuries to digits tended to correlate with length (i.e., middle, index, ring, or small finger or thumb). Damage to tendons did not seem to follow any particular pattern. The majority of victims sustained multiple digital involvement. Complete versus partial amputation followed the same length distribution as did injured digits. Most of the injuries occurred to the dominant hand. When patients were further questioned regarding the circumstances and events leading to their injury, a recurring pattern was found. Most patients described a wet, heavy snow having recently fallen. The majority of the patients who were injured by placing their hands into the exit chute admitted that they were aware the machine was running, but thought that they had a greater clearance to the rotating impeller blade. PMID:9413590

  7. Pediatric Genital Injury: An Analysis of the National Electronic Injury Surveillance System

    PubMed Central

    Casey, Jessica T.; Bjurlin, Marc A.; Cheng, Earl Y.

    2013-01-01

    Objective To describe the characteristics of pediatric genital injuries presenting to United States emergency departments (EDs). Methods A retrospective cohort study utilizing the U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS) from 1991-2010 to evaluate pediatric genital injuries was performed. Results Pediatric genital injuries represented 0.6% of all pediatric injuries with the incidence of injuries rising through the period studied, 1991-2010. The mean age at injury was 7.1 years old and was distributed 56.6% girls and 43.4% boys. A total of 43.3% had lacerations and 42.2% had contusions/abrasions. The majority of injuries occurred at home (65.9%), and the majority of patients (94.7%) were treated and released from the hospital. The most common consumer products associated with pediatric genital trauma were: bicycles (14.7% of all pediatric genital injuries), bathtubs (5.8%), daywear (5.6%), monkey bars (5.4%), and toilets (4.0%). Conclusion Although pediatric genital injuries represent a small proportion of overall injuries presenting to the ED, genital injuries continue to rise despite public health measures targeted to decrease childhood injury. Our results can be used to guide further prevention strategies for pediatric genital injury. PMID:23953603

  8. Traumatic brain injury

    PubMed Central

    Risdall, Jane E.; Menon, David K.

    2011-01-01

    There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilcian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad. PMID:21149359

  9. Spinal injury

    MedlinePlus

    ... head. Alternative Names Spinal cord injury; SCI Images Skeletal spine Vertebra, cervical (neck) Vertebra, lumbar (low back) Vertebra, thoracic (mid back) Vertebral column Central nervous system Spinal cord injury Spinal anatomy Two person roll - ...

  10. Corneal injury

    MedlinePlus

    ... as sand or dust Ultraviolet injuries: Caused by sunlight, sun lamps, snow or water reflections, or arc- ... a corneal injury if you: Are exposed to sunlight or artificial ultraviolet light for long periods of ...

  11. Inhalation Injuries

    MedlinePlus

    ... you can inhale that can cause acute internal injuries. Particles in the air from fires and toxic ... and lung diseases worse. Symptoms of acute inhalation injuries may include Coughing and phlegm A scratchy throat ...

  12. Injury risk evaluation in sport climbing.

    PubMed

    Neuhof, A; Hennig, F F; Schöffl, I; Schöffl, V

    2011-10-01

    The aim of this study was to quantify and rate acute sport climbing injuries. Acute sport climbing injuries occurring from 2002 to 2006 were retrospectively assessed with a standardized web based questionnaire. A total number of 1962 climbers reported 699 injuries, which is equivalent to 0.2 injuries per 1 000 h of sport participation. Most (74.4%) of the injuries were of minor severity rated NACA I or NACA II. Injury distribution between the upper (42.6%) and lower extremities (41.3%) was similar, with ligament injuries, contusions and fractures being the most common injury types. Years of climbing experience (p<0.01), difficulty level (p<0.01), climbing time per week during summer (p<0.01) and winter (p<0.01) months were correlated with the injury rate. Age (p<0.05 (p=0.034)), years of climbing experience (p<0.01) and average climbing level (p<0.01) were correlated to the injury severity rated through NACA scores. The risk of acute injuries per 1 000 h of sport participation in sport climbing was lower than in previous studies on general rock climbing and higher than in studies on indoor climbing. In order to perform inter-study comparisons of future studies on climbing injuries, the use of a systematic and standardized scoring system (UIAA score) is essential. PMID:21913158

  13. Injury Patterns In Low Intensity Conflict

    PubMed Central

    Saraswat, V

    2009-01-01

    Summary Injury patterns and their outcome has been the subject of interest in all kinds of military conflicts. This retrospective study was conducted in a tertiary care hospital (Level I trauma centre) to find out the trends in injuries in low intensity conflict, adequacy of pre hospital treatment, mortality patterns and adequacy of treatment after reaching tertiary care hospital. 418 patients were treated over a period of two years. All were male and 76% younger than 30 years of age. 61% patients reported directly from the site of incident and 39% were transferred from other trauma centre. Two-third of patients (73.9%) reported with at least one limb injury and 44.9% with extremity injury alone. Multiple injuries were most common injury (29%). Head and neck injuries were seen in 20% patients and Thoracic and abdominal injuries were seen in 2.6% and 3.4% patients only. Most common mode of injury was Gunshot wound (41.4%), followed by splinter injuries (39.2%) and Road traffic accident(RTA) (19.4%). Overall mortality was 3.8% and inpatient mortality of 1.4%. Head and neck injuries were leading cause of death followed by thoracic injuries. PMID:20640095

  14. Retrospective CMORPH Reprocessing Efforts

    NASA Astrophysics Data System (ADS)

    Yarosh, Y.; Joyce, R.; Xie, P.

    2008-05-01

    constellation, there is enough to retrospectively reprocess CMORPH well beyond the current archive start. Also IR based PMW calibrated rainfall estimates will be calculated as part of the retrospective reprocessing. These estimates will be blended for times and locations that the PMW information is too old for relative accuracy. This blended method (CMORPH-IR) combines the CMORPH and IR based estimates via an error model developed by running test CMORPH processing, albeit withholding random high quality PMW estimates, and determining the error/skill of the CMORPH relative to the IR-based rainfall as a function of season, surface type, region, and age of PMW information in half hourly increments from PMW scan time. The retrospective processing will be performed for Year 2002 and proceed backward. Detailed results will be reported at the meeting.

  15. Cycling injuries.

    PubMed Central

    Cohen, G. C.

    1993-01-01

    Bicycle-related injuries have increased as cycling has become more popular. Most injuries to recreational riders are associated with overuse or improper fit of the bicycle. Injuries to racers often result from high speeds, which predispose riders to muscle strains, collisions, and falls. Cyclists contact bicycles at the pedals, seat, and handlebars. Each is associated with particular cycling injuries. Images Figure 1 Figure 3 Figure 4 Figure 5 PMID:8471908

  16. Causal Inference in Retrospective Studies.

    ERIC Educational Resources Information Center

    Holland, Paul W.; Rubin, Donald B.

    1988-01-01

    The problem of drawing causal inferences from retrospective case-controlled studies is considered. A model for causal inference in prospective studies is applied to retrospective studies. Limitations of case-controlled studies are formulated concerning relevant parameters that can be estimated in such studies. A coffee-drinking/myocardial…

  17. Orienteering injuries

    PubMed Central

    Folan, Jean M.

    1982-01-01

    At the Irish National Orienteering Championships in 1981 a survey of the injuries occurring over the two days of competition was carried out. Of 285 individual competitors there was a percentage injury rate of 5.26%. The article discusses the injuries and aspects of safety in orienteering. Imagesp236-ap237-ap237-bp238-ap239-ap240-a PMID:7159815

  18. Head injury.

    PubMed

    Hureibi, K A; McLatchie, G R

    2010-05-01

    Head injury is one of the commonest injuries in sport. Most are mild but some can have serious outcomes. Sports medicine doctors should be able to recognise the clinical features and evaluate athletes with head injury. It is necessary during field assessment to recognise signs and symptoms that help in assessing the severity of injury and making a decision to return-to-play. Prevention of primary head injury should be the aim. This includes protective equipment like helmets and possible rule changes. PMID:20533694

  19. An historical context of modern principles in the management of intracranial injury from projectiles.

    PubMed

    Agarwalla, Pankaj K; Dunn, Gavin P; Laws, Edward R

    2010-05-01

    The contemporary management of projectile head injuries owes much to the lessons neurosurgeons have distilled from their experiences in war. Through early investigation and an increasingly detailed account of wartime clinical experience, neurosurgeons--including the field's early giants--began to gain a greater understanding not only of intracranial missile pathophysiology but also of appropriate management. In this paper, the authors trace the development of the principles of managing intracranial projectile injury from the Crimean War in the 19th century through the Vietnam War to provide a context that frames a summary of today's core management principles. PMID:20568940

  20. Perilunate Injuries, Not Dislocated (PLIND)

    PubMed Central

    Herzberg, Guillaume

    2013-01-01

    Purpose We reviewed a series of equivalents of perilunate dislocations and fracture-dislocations (PLDs–PLFDs) in which there was no dislocation of the capitate from the lunate on the initial radiographs. We propose to include these injuries as a variant of perilunate dislocations that we have termed a perilunate injury, not dislocated (PLIND) lesion in a modified classification of perilunate injuries. Methods A review of the records of all acute perilunate injuries and displaced carpal fractures was done in a single-center university hospital wrist surgery unit over a 5-year period. All cases presenting at the acute stage with displaced fractures of scaphoid, lunate, triquetrum, or capitate along with scapholunate and/or lunotriquetral dissociation but no dislocation of the capitate from the lunate in the sagittal or coronal plane were reviewed and considered as PLIND lesions. Results We identified 11 patients with PLIND lesions. Three cases with clinical and radiological follow-up are presented. Discussion Equivalents of PLDs–PLFDs presenting without dislocation of the capitate from the lunate do exist. These injuries may be overlooked despite their severity. They require both osseous and ligamentous repair. Including them into an existing perilunate injuries classification highlights their recognition and enables a better understanding and treatment of both acute and chronic nondislocated perilunate injuries. Level of Evidence Level IV, retrospective case series. PMID:24436839

  1. Inhalation injury: a decade without progress.

    PubMed

    Sobel, J B; Goldfarb, I W; Slater, H; Hammell, E J

    1992-01-01

    Despite major advances in the management of patients with critical burn injuries, inhalation injury continues to be a major determinant of death resulting from burn injuries. Two cohort groups of victims with burn and inhalation injuries, separated by a decade, were retrospectively reviewed in an effort to determine the impact of newer treatment modalities. Patients were categorized as being at "high" or "low" risk on the basis of primary and secondary diagnostic criteria. Despite a statistically significant decrease in the percent of total body surface injury, no change in mortality rate was noted between the two groups. The advent of sophisticated diagnostic and management techniques does not appear to have decreased the mortality rate associated with inhalation injury. PMID:1452592

  2. To win a nuclear war: The Pentagon's secret strategy

    SciTech Connect

    Kaku, M.; Axelrod, D.

    1986-01-01

    This book provides a survey of U.S. plans concerning nuclear war from 1945 through the present. The authors explain U.S. nuclear war plans and contingencies. They also trace the evolution of the strategies and technologies of nuclear war planning, and the personalities of the planners, through post-war foreign policy from the Berlin Crisis to Star wars.

  3. The Quotidianisation of the War in Everyday Life at German Schools during the First World War

    ERIC Educational Resources Information Center

    Scholz, Joachim; Berdelmann, Kathrin

    2016-01-01

    The outbreak of the First World War had a powerful impact on German schools. Undoubtedly, schools were institutions of socialisation that did offer support to the war. Indeed, research has shown that a specific "war pedagogy" made an aggressive propaganda possible in the classroom. This research usually emphasises the enthusiasm for war…

  4. Winning the War: A Historical Analysis of the FFA during World War II

    ERIC Educational Resources Information Center

    Wolf, Kattlyn J.; Connors, James J.

    2009-01-01

    The United States' participation in World War II affected millions of men, women, and children, both at home and around the world. The war effort also affected the Future Farmers of America (FFA). FFA members, agriculture teachers, and national FFA officers all volunteered to serve their country during the war. Local FFA chapters and individual…

  5. Civil War Preservation Trust Two Week Curriculum for Teaching the Civil War.

    ERIC Educational Resources Information Center

    Civil War Preservation Trust, Washington, DC.

    The Civil War was perhaps the greatest turning point in U.S. history. The dual themes of slavery and power deeply divided the growing nation during the first half of the 19th century. The mission of the Civil War Preservation Trust (CWPT) is to preserve the significant Civil War battlefields by protecting the land and educating the public about…

  6. Basketball injuries in a rural area.

    PubMed

    Prebble, T B; Chyou, P H; Wittman, L; McCormick, J; Collins, K; Zoch, T

    1999-11-01

    This study was conducted to determine the frequency and nature of basketball injuries occurring in a rural setting. More than 6000 patients with sports-related injuries presented to a rural emergency department between June 1, 1988 and June 1, 1994. Of these patients, 1189 (19% of the total) were injured playing basketball. A chart abstraction form was utilized to retrospectively review injuries noting demographics, types and sites of injuries, as well as referral and treatment plans. Approximately two-thirds (66.4%) of those injured were males, with most injuries (53%) occurring during school-related activities. Almost four-fifths (78%) of injuries occurred between the ages of 10 and 19. The ankle (33.1%) was the body site most commonly injured, followed in frequency by finger injuries (19.3%), sprains and strains, which accounted for the majority (55%) of injuries. The most common mechanism of injury was recorded in which no contact with other players occurred (37.4%). The vast majority (99%) of injuries were managed as outpatients. The majority of cases (72%) were expected to recover within 2 weeks. Similarities were noted regarding sites of injury and age of distribution of patients when compared to the previous studies. PMID:10638288

  7. Politics or Economics? International Migration during the Nicaraguan Contra War*

    PubMed Central

    Lundquist, Jennifer H.; Massey, Douglas S.

    2010-01-01

    The issue of whether Central Americans in the United States are ‘political’ or ‘economic’ migrants has been widely debated, yet little empirical research has informed the controversy. Earlier studies have relied primarily on cross-sectional aggregate data. In order to overcome these limitations we draw on recent surveys conducted in five Nicaraguan communities by the Latin American Migration Project. Using retrospective data, we reconstruct a history of a family’s migration to the United States and Costa Rica from the date of household formation to the survey date and link these data to national-level data on GDP and Contra War violence. While out migration to both Costa Rica and the United States is predicted by economic trends, US-bound migration was more strongly linked to the level of Contra War violence independent of economic motivations, especially in an interactive model that allows for a higher wartime effect of social networks. We conclude that elevated rates of Nicaraguan migration to the United States during the late 1980s and early 1990s were a direct result of the US-Contra intervention. The approach deployed here – which relates to the timing of migration decisions to macro-level country trends – enables us to address the issue of political versus economic motivations for migration with more precision than prior work. PMID:20852719

  8. Politics or Economics? International Migration during the Nicaraguan Contra War.

    PubMed

    Lundquist, Jennifer H; Massey, Douglas S

    2005-02-01

    The issue of whether Central Americans in the United States are 'political' or 'economic' migrants has been widely debated, yet little empirical research has informed the controversy. Earlier studies have relied primarily on cross-sectional aggregate data. In order to overcome these limitations we draw on recent surveys conducted in five Nicaraguan communities by the Latin American Migration Project. Using retrospective data, we reconstruct a history of a family's migration to the United States and Costa Rica from the date of household formation to the survey date and link these data to national-level data on GDP and Contra War violence. While out migration to both Costa Rica and the United States is predicted by economic trends, US-bound migration was more strongly linked to the level of Contra War violence independent of economic motivations, especially in an interactive model that allows for a higher wartime effect of social networks. We conclude that elevated rates of Nicaraguan migration to the United States during the late 1980s and early 1990s were a direct result of the US-Contra intervention. The approach deployed here - which relates to the timing of migration decisions to macro-level country trends - enables us to address the issue of political versus economic motivations for migration with more precision than prior work. PMID:20852719

  9. 36 CFR 1229.12 - What are the requirements during a state of war or threatened war?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... during a state of war or threatened war? 1229.12 Section 1229.12 Parks, Forests, and Public Property... § 1229.12 What are the requirements during a state of war or threatened war? (a) Destruction of records... war between the United States and any other nation or when hostile action appears imminent, the...

  10. 36 CFR 1229.12 - What are the requirements during a state of war or threatened war?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... during a state of war or threatened war? 1229.12 Section 1229.12 Parks, Forests, and Public Property... § 1229.12 What are the requirements during a state of war or threatened war? (a) Destruction of records... war between the United States and any other nation or when hostile action appears imminent, the...

  11. 36 CFR 1229.12 - What are the requirements during a state of war or threatened war?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... during a state of war or threatened war? 1229.12 Section 1229.12 Parks, Forests, and Public Property... § 1229.12 What are the requirements during a state of war or threatened war? (a) Destruction of records... war between the United States and any other nation or when hostile action appears imminent, the...

  12. 36 CFR 1229.12 - What are the requirements during a state of war or threatened war?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... during a state of war or threatened war? 1229.12 Section 1229.12 Parks, Forests, and Public Property... § 1229.12 What are the requirements during a state of war or threatened war? (a) Destruction of records... war between the United States and any other nation or when hostile action appears imminent, the...

  13. 36 CFR 1229.12 - What are the requirements during a state of war or threatened war?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... during a state of war or threatened war? 1229.12 Section 1229.12 Parks, Forests, and Public Property... § 1229.12 What are the requirements during a state of war or threatened war? (a) Destruction of records... war between the United States and any other nation or when hostile action appears imminent, the...

  14. Profiteering on the Iran-Iraq war

    SciTech Connect

    Brzoska, M.

    1987-06-01

    The military gear delivered from the US in the Iran-contra affair represents only a minor portion of arms sales to the combatants in the Iraq-Iran war. That war has now lasted more than six years and has deeply influenced the international arms market. Occurring during a period when other demand for arms has been relatively low, the war has nourished new suppliers and has revived both the legal and illegal private arms market. The erratic behavior of the USSR and the US, until recently by far the most important arms suppliers to the Third World, has pushed Iran and Iraq toward more commercially oriented sources, including many in the Third World. Both countries have had ample supplies of weapons during the war, and these weapons have served their purpose. Mainly because of its duration, the war already ranks third among post-World War II wars - after the Vietnam war and the Biafra war - in battlefield victims, with 300,000-500,000 casualties. The economic cost has risen to nearly $500 billion in weapons, destruction, and lost income. While it is hard to see anything but losers on the battlefield, the arms traffickers are profiting. Total Iranian arms imports since August 1980 have been higher than $10 billion, while Iraq has imported more than $30 billion worth. It is difficult to know whether making arms more difficult to obtain would have stopped the war, but judging from other recent wars, such as those between India and Pakistan, between Uganda and Tanzania, and in the Middle East, it seems likely that hostilities could have been stopped long ago. 12 references.

  15. Risk of Early Childhood Injuries in Twins and Singletons

    ERIC Educational Resources Information Center

    Roudsari, Bahman S.; Utter, Garth H.; Kernic, Mary A.; Mueller, Beth A.

    2006-01-01

    The incidence of twin births in the United States (US) has increased more than 65 per cent since 1980. However, the risk of injury to multiple-birth children is unknown. We sought to compare the risk of injury-related hospitalization and death between multiples and singletons. We conducted a retrospective cohort study using linked birth…

  16. The Syrian civil war: The experience of the Surgical Intensive Care Units

    PubMed Central

    Ozdogan, Hatice Kaya; Karateke, Faruk; Ozdogan, Mehmet; Cetinalp, Sibel; Ozyazici, Sefa; Gezercan, Yurdal; Okten, Ali Ihsan; Celik, Muge; Satar, Salim

    2016-01-01

    Objective: Since the civilian war in Syria began, thousands of seriously injured trauma patients from Syria were brought to Turkey for emergency operations and/or postoperative intensive care. The aim of this study was to present the demographics and clinical features of the wounded patients in Syrian civil war admitted to the surgical intensive care units in a tertiary care centre. Methods: The records of 80 trauma patients admitted to the Anaesthesia, General Surgery and Neurosurgery ICUs between June 1, 2012 and July 15, 2014 were included in the study. The data were reviewed regarding the demographics, time of presentation, place of reference, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Injury Severity Score (ISS), surgical procedures, complications, length of stay and mortality. Results: A total of 80 wounded patients (70 males and 10 females) with a mean age of 28.7 years were admitted to surgical ICUs. The most frequent cause of injury was gunshot injury. The mean time interval between the occurrence of injury and time of admission was 2.87 days. Mean ISS score on admission was 21, and mean APACHE II score was 15.7. APACHE II scores of non-survivors were significantly increased compared with those of survivors (P=0.001). No significant differences was found in the age, ISS, time interval before admission, length of stay in ICU, rate of surgery before or after admission. Conclusion: The most important factor affecting mortality in this particular trauma-ICU patient population from Syrian civil war was the physiological condition of patients on admission. Rapid transport and effective initial and on-road resuscitation are critical in decreasing the mortality rate in civil wars and military conflicts. PMID:27375683

  17. Women as prisoners of war.

    PubMed

    Skelton, W P; Skelton, N K

    1995-11-01

    American women are increasingly becoming involved in combat-related roles. Inevitably, our country will have several killed and taken prisoner. No National Academy of Science/National Research Council or VA study has ever been undertaken to examine the chronic sequelae of the experiences undergone by these captured women. This paper examines the after-effects of 3.5 years of incarceration on the 79 American women taken prisoner by the Japanese in the Philippines during World War II. Emphasis is given to their living conditions in a prisoner-of-war camp and their resulting long-term disabilities. Comparison of data reported in this paper with those of several epidemiological studies of male survivors of Philippine camps allows several novel points to be made. Overall, half of the women had a service-connected disability, exactly like the men. Furthermore, although the average degree of service-connected disability, 37%, is the same as that of the men, not one of the women in this study was service-connected for tuberculosis or peptic ulcer disease. This is a major finding, since, compared to age-matched combat controls, the men had a higher post-repatriation death rate for the first 7 years due to tuberculosis; likewise, peptic ulcer disease is so common in the male survivors that it is a presumptive service-connected disability. PMID:8538890

  18. The Life of a Civil War Soldier.

    ERIC Educational Resources Information Center

    Sanders, Barbara J.

    2002-01-01

    Provides a lesson plan that is based on the Gettysburg National Military Park's "Life of a Civil War Soldier" traveling trunk program. Explains that this lesson offers a recipe for using a trunk to present the life of a Civil War soldier in the classroom. Includes activities and learning stations. (CMK)

  19. How Could a Beaver Start a War?

    ERIC Educational Resources Information Center

    Millward, Robert

    2010-01-01

    Students gain a better understanding of war and economics when the variables come alive through stories, artifacts, and paintings. In this article, the author describes a short story about the fur trade which can generate lots of student questions about the fur economics, the Eastern Woodland Indians, trade artifacts, and war. The author also…

  20. Girl's Schooling in War-Torn Somalia

    ERIC Educational Resources Information Center

    Moyi, Peter

    2012-01-01

    A civil war has raged in Somalia since 1991. The civil war was the final blow to an already collapsed education system. Somalia has received little research and policy attention yet children, especially girls, are very vulnerable during times of conflict. The different gender roles, activities, and status in society create gender differentiated…

  1. Telling War Stories: The Things They Carry

    ERIC Educational Resources Information Center

    Paquette, Paige; Warren, Mike

    2010-01-01

    This webtext reveals two modern-day methods for soldiers to share their war stories: 1) soldiers sharing their stories with cadets from West Point through a project linking veterans from the Global War on Terror with composition students; and 2) soldiers learning in online composition classrooms designed specifically for them.

  2. The Origins of the Cold War.

    ERIC Educational Resources Information Center

    Paterson, Thomas G.

    1986-01-01

    Briefly reviews conventional reasoning about the start of the Cold War. Describes contemporary revisionist views of the Cold War and the reasons they arose. Maintains that American leaders exaggerated the Soviet ideological and military threat, spurring an American arms build-up which ultimately led to the present-day arms race. (JDH)

  3. Health and Civil War in Rural Burundi

    ERIC Educational Resources Information Center

    Bundervoet, Tom; Verwimp, Philip; Akresh, Richard

    2009-01-01

    We combine household survey data with event data on the timing and location of armed conflicts to examine the impact of Burundi's civil war on children's health status. The identification strategy exploits exogenous variation in the war's timing across provinces and the exposure of children's birth cohorts to the fighting. After controlling for…

  4. "War of the Worlds" and the Editors.

    ERIC Educational Resources Information Center

    Wolfe, G. Joseph

    1980-01-01

    An analysis of 1938 newspaper editorials about Orson Welles' notorious "War of the Worlds" broadcast reveals that they explained audience reaction on the grounds of gullibility, the ominous threat of war, and the technique of the broadcast, and that they offered radio a rather stern lecture on the relationship between freedom and responsibility.…

  5. Madonnas, Whores, and the Persian Gulf War.

    ERIC Educational Resources Information Center

    Bruno, Maria F.

    1992-01-01

    Discusses reactions and attitudes of students in a women's studies course during the Gulf War. Contends that the imagery of war as a sexual, phallic event was a major topic of class discussion. Presents excerpts from teacher and student conversations. (CFR)

  6. War on Rats, 1972 Progress Report.

    ERIC Educational Resources Information Center

    District of Columbia Dept. of Environmental Services, Washington, DC.

    The City of Washington, D.C., with federal funding, declared war on one of the city's most pressing problems--rats. The War on Rats Program, in conjunction with Operation Clean Sweep, made a city-wide survey of rat infestations and recorded the areas of heavy rat infestation. After the problem areas had been identified, community organizations…

  7. World War II: A Technology Lesson Plan.

    ERIC Educational Resources Information Center

    Hagar, Suzy

    1990-01-01

    Presents a class activity on the history, causes, and consequences of World War II. Focuses on the development and deployment of the atomic bomb. Utilizes a Video Encyclopedia Program for historical background. Divides the class into groups that are responsible for researching and preparing a videotape on a World War II topic. (RW)

  8. Creative Chaos: Learning from the Yugoslavian War

    ERIC Educational Resources Information Center

    Roberson, Donald N., Jr.

    2010-01-01

    The aim of this paper was to understand more about the continued learning process of those who have experienced negative life experiences. This paper focuses on the various issues of learning and living through war, specifically encounters from the war in former Yugoslavia. Therefore, the purpose of the study was to understand lessons learned by…

  9. Native Americans and the Civil War.

    ERIC Educational Resources Information Center

    Gibson, Arrell Morgan

    1985-01-01

    Details combat and conflicts between Native Americans and settlers before, during, and following the Civil War. Shows how the involvement of tribes in the Civil War and Reconstruction diminished their martial power and made them certain marks for conquest and relegation to reservations. (JHZ)

  10. World War Two and the Holocaust.

    ERIC Educational Resources Information Center

    Boas, Jacob

    This resource book presents readings that could be used to teach about the Holocaust. The readings are brief and could be appropriate for middle school and high school students. Several photographs accompany the text. The volume has the following chapters: (1) "From War to War" (history of Germany from late 19th Century through the end of World…

  11. Skiing Injuries

    PubMed Central

    Bartlett, L. H.

    1975-01-01

    In the broad spectrum of orthopedic skiing injuries, ‘second aid’ on the mountain and at the base by the physician is very important. All skiing physicians should carry minimal medical supplies, including narcotic medication. Diagnosis and treatment of injuries at the hospital are outlined. Most ski fractures of the tibia can be treated by conservative methods. A more aggressive approach to diagnosis and treatment of ligamentous injuries of the knee is recommended. PMID:20469236

  12. Gunshot injuries.

    PubMed

    Hinkle, J; Betz, S

    1995-05-01

    If current trends for this nation continue, by the year 2003 the number of people killed by firearms will exceed the number of people killed in motor vehicle accidents. Critical care practitioners must understand the mechanism of injury associated with firearm injuries to provide optimal care. This article reviews internal, exterior, and terminal ballistics, bullet design, wound classification, and initial assessment and treatment of firearm injuries. PMID:7743422

  13. When Service Members with Traumatic Brain Injury Become Students: Methods to Advance Learning

    ERIC Educational Resources Information Center

    Helms, Kimberly Turner; Libertz, Daniel

    2014-01-01

    The purpose of this paper is to explain which evidence-based interventions in study strategies have been successful in helping soldiers and veterans with traumatic brain injury (TBI) return to the classroom. Military leaders have specifically identified TBI as one of the signature injuries of the wars in Afghanistan and Iraq with over a quarter of…

  14. CAN A SINGLE INJURY CAUSE CANCER?

    PubMed Central

    Hedge, Arden R.

    1959-01-01

    In the absence of positive evidence that a single injury can cause cancer, the tendency is growing to award compensation to persons (particularly employees) with cancers alleged to have originated in trauma, even cancers which are generally conceded to be congenital in origin. Experimental attempts to induce cancer through trauma have been unsuccessful or doubtful in result. War-wounded persons, boxers and railroad accident victims have no higher incidence of cancer than other groups. Physicians and others in a position to educate the public should strive to dispel the error that cancer following injury is demonstrably or even probably the cause. PMID:13618747

  15. Long-term sequelae of electrical injury

    PubMed Central

    Wesner, Marni L.; Hickie, John

    2013-01-01

    Abstract Objective To summarize the current evidence-based knowledge about the long-term sequelae of injuries from electrical current. Quality of evidence MEDLINE was searched for English-language articles published in the past 20 years using the following search terms: electrical, injuries, wound, trauma, accident, sequelae, long-term, follow-up, and aftereffects. For obvious reasons, it is unethical to randomly study electrical injury in controlled clinical trials. By necessity, this topic is addressed in less-rigorous observational and retrospective work and case studies. Therefore, the strength of the literature pertaining to the long-term sequelae of electrical injury is impaired by the necessity of retrospective methods and case studies that typically describe small cohorts. Main message There are 2 possible consequences of electrical injury: the person either survives or dies. For those who survive electrical injury, the immediate consequences are usually obvious and often require extensive medical intervention. The long-term sequelae of the electrical injury might be more subtle, pervasive, and less well defined, but can include neurologic, psychological, and physical symptoms. In the field of compensation medicine, determining causation and attributing outcome to an injury that might not result in objective clinical findings becomes a considerable challenge. Conclusion The appearance of these consequences of electrical injury might be substantially delayed, with onset 1 to 5 or more years after the electrical injury. This poses a problem for patients and health care workers, making it hard to ascribe symptoms to a remote injury when they might not arise until well after the incident event. PMID:24029506

  16. Vascular Injury in Orthopedic Trauma.

    PubMed

    Mavrogenis, Andreas F; Panagopoulos, George N; Kokkalis, Zinon T; Koulouvaris, Panayiotis; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios; Mantas, George; Moulakakis, Konstantinos G; Sfyroeras, George S; Lazaris, Andreas; Soucacos, Panayotis N

    2016-07-01

    Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma. Spasm can occur after either blunt or penetrating trauma to an extremity and is more common in young patients. Clinical presentation of vascular injury may not be straightforward. Physical examination can be misleading or initially unimpressive; a normal pulse examination may be present in 5% to 15% of patients with vascular injury. Detection and treatment of vascular injuries should take place within the context of the overall resuscitation of the patient according to the established principles of the Advanced Trauma Life Support (ATLS) protocols. Advances in the field, made mostly during times of war, have made limb salvage the rule rather than the exception. Teamwork, familiarity with the often subtle signs of vascular injuries, a high index of suspicion, effective communication, appropriate use of imaging modalities, sound knowledge of relevant technique, and sequence of surgical repairs are among the essential factors that will lead to a successful outcome. This article provides a comprehensive literature review on a subject that generates significant controversy and confusion among clinicians involved in the care of trauma patients. [Orthopedics. 2016; 39(4):249-259.]. PMID:27322172

  17. Rowing injuries.

    PubMed

    Rumball, Jane S; Lebrun, Constance M; Di Ciacca, Stephen R; Orlando, Karen

    2005-01-01

    Participation in the sport of rowing has been steadily increasing in recent decades, yet few studies address the specific injuries incurred. This article reviews the most common injuries described in the literature, including musculoskeletal problems in the lower back, ribs, shoulder, wrist and knee. A review of basic rowing physiology and equipment is included, along with a description of the mechanics of the rowing stroke. This information is necessary in order to make an accurate diagnosis and treatment protocol for these injuries, which are mainly chronic in nature. The most frequently injured region is the low back, mainly due to excessive hyperflexion and twisting, and can include specific injuries such as spondylolysis, sacroiliac joint dysfunction and disc herniation. Rib stress fractures account for the most time lost from on-water training and competition. Although theories abound for the mechanism of injury, the exact aetiology of rib stress fractures remains unknown. Other injuries discussed within, which are specific to ribs, include costochondritis, costovertebral joint subluxation and intercostal muscle strains. Shoulder pain is quite common in rowers and can be the result of overuse, poor technique, or tension in the upper body. Injuries concerning the forearm and wrist are also common, and can include exertional compartment syndrome, lateral epicondylitis, deQuervain's and intersection syndrome, and tenosynovitis of the wrist extensors. In the lower body, the major injuries reported include generalised patellofemoral pain due to abnormal patellar tracking, and iliotibial band friction syndrome. Lastly, dermatological issues, such as blisters and abrasions, and miscellaneous issues, such as environmental concerns and the female athlete triad, are also included in this article.Pathophysiology, mechanism of injury, assessment and management strategies are outlined in the text for each injury, with special attention given to ways to correct

  18. Years of life lost among Iranian people killed in the Iraq-Iran war: the 25-year perspective.

    PubMed

    Mousavi, Batool; Moradi-Lakeh, Maziar; Karbakhsh, Mojgan; Soroush, Mohammadreza

    2014-01-01

    To estimate the years of life lost (YLL), registered deaths due to Iraq-Iran war (1980-2005) were identified considering ICD10 codes of Y36.0 to Y36.9. Estimated YLL was calculated by taking age-weighting options and discount rates. Population life expectancy in each corresponding year was retrieved from the national health database. During 1980-2005, 178,298 Iranian men and 5325 Iranian women died in war. The mean death age was 22.8 ± 9 years, 96.6% occurred during the years of war (September 1980-August 1988). In the years after the war (1988-2005) 6243 (3.4%) of deaths occurred as the result of complication of the war-related injuries or implanted landmines/unexploded ordnances (ICD10 code: Y36.8). YLL in Iraq-Iran war among Iranian victims were calculated as 10,479,405.0 years considering the age weighting and discount rate equal to 0. Age-adjusted YLL were estimated as 10,169,546.2 years in males. Female cases that comprised 2.9% of total victims lost 309,858.8 years. The mean YLL was calculated as 57.1 years for each Iranian victim killed in Iraq-Iran war. The war-related YLL was estimated more than 10 million years that comprised a majority of young men. This study is the first step in estimation of disability adjusted life year (DALY) of Iraq-Iran war on Iranian side. PMID:24344985

  19. Mortality and morbidity in children caused by falling televisions: a retrospective analysis of 71 cases

    PubMed Central

    2011-01-01

    Objectives To quantify injuries in children that result from toppled televisions. Methods Children presenting directly to emergency department due to injuries caused by falling televisions were identified from our digital patient database, and a retrospective chart review of 71 children was performed. Descriptive statistics were applied. Results 71(1.8%) out of 3856 admissions due to injuries sustained at home were TV-related injuries. There were 50 (70.4%) boys and 21(29.6%) girls. Mean age was 39.79 ± 20.14 SD months. Almost three quarters of the children (49/71) sustained various head and facial injuries. There was traumatic brain injury in 14 patients, extremity injuries in 30 patients, thoracic injuries in 13 patients and abdominal injuries in ten patients. 16 patients were hospitalized. 14 of them required follow-up in intensive care unit. Two patients (one with epidural hematoma and one with subdural hematoma) underwent surgical intervention. Four patients with subarachnoid bleeding died. The mean length of hospital stay was 71.25 hours (range, 48-168) in hospitalised patients. The overall mortality rate was 5.6%. Conclusions Falling TVs may cause significant morbidity and mortality in children particularly those younger than 3 years old. Head and facial injuries are the most common body region involved and traumatic brain injury is the major cause of death.

  20. Nursing and en route care: history in time of war.

    PubMed

    Davis, R Scott; Connelly, Linda K

    2011-01-01

    The mission of the en route caregiver is to provide critical care in military helicopters for wounded Warriors. This care minimizes the effects of the wounds and injuries, and improves morbidity and mortality. This article will focus on the history of Army Nursing en route care. From World War II through Vietnam, and continuing through the War on Terrorism in Iraq and Afghanistan, Army nurses served in providing en route care in military airplanes and helicopters for patients being transported to higher echelons of care. From aid stations on the battlefield to forward surgical teams which provide life, limb, and eyesight saving care, to the next higher level of care in combat support hospitals, these missions require specialized nursing skills to safely care for the high acuity patients. Before the en route care concept existed, there was not a program to train nurses in these critical skills. There was also a void of information about patient outcomes associated with the nursing assessment and care provided during helicopter medical evacuation (MEDEVAC) of such unstable patients, and the consequent impact on the patient's condition after transport. The role of critical care nurses has proven to be essential and irreplaceable in providing full-spectrum care to casualties of war, in particular, the postsurgical patients transferred from one surgical facility to another in theatre. However, we have only recently developed the concepts over the required skill set, training, equipment, functionality, evidenced-based care, and sustainability of nursing in the en route care role. Much of the work to quantify and qualify nursing care has been done by individuals and individual units whose lessons-learned have only recently been captured. PMID:22124872

  1. Compensating for cold war cancers.

    PubMed Central

    Parascandola, Mark J

    2002-01-01

    Although the Cold War has ended, thousands of workers involved in nuclear weapons production are still living with the adverse health effects of working with radioactive materials, beryllium, and silica. After a series of court battles, the U.S. government passed the Energy Employees Occupational Illness Act in October 2000 to financially assist workers whose health has been compromised by these occupational exposures. Now work is underway to set out guidelines for determining which workers will be compensated. The National Institute for Occupational Safety and Health has been assigned the task of developing a model that can scientifically make these determinations, a heavy task considering the controversies that lie in estimating low-level radiation risks and the inadequate worker exposure records kept at many of the plants. PMID:12117658

  2. Crisis stability and nuclear war

    SciTech Connect

    Not Available

    1987-01-01

    The authors summarize their viewpoint on and recommendations for strategic command and forces, and arms control and crisis stability. They pressent a study of the paths which might lead the superpowers from a crisis to nuclear war. This book examines the various arenas in which superpower crises may occur. The authors describe the strategies, command structures, and forces of NATO and the Warsaw Pact, paying particular attention to the ladder of alert postures and operations that their forces might mount as a crisis intensifies. They address the Middle East, with special emphasis on the confrontation between Syria and Israel, and the dangers posed by locally-owned chemical and nuclear weapons. The authors also consider the oceans and space.

  3. Weight Drop Models in Traumatic Brain Injury.

    PubMed

    Kalish, Brian T; Whalen, Michael J

    2016-01-01

    Weight drop models in rodents have been used for several decades to advance our understanding of the pathophysiology of traumatic brain injury. Weight drop models have been used to replicate focal cerebral contusion as well as diffuse brain injury characterized by axonal damage. More recently, closed head injury models with free head rotation have been developed to model sports concussions, which feature functional disturbances in the absence of overt brain damage assessed by conventional imaging techniques. Here, we describe the history of development of closed head injury models in the first part of the chapter. In the second part, we describe the development of our own weight drop closed head injury model that features impact plus rapid downward head rotation, no structural brain injury, and long-term cognitive deficits in the case of multiple injuries. This rodent model was developed to reproduce key aspects of sports concussion so that a mechanistic understanding of how long-term cognitive deficits might develop will eventually follow. Such knowledge is hoped to impact athletes and war fighters and others who suffer concussive head injuries by leading to targeted therapies aimed at preventing cognitive and other neurological sequelae in these high-risk groups. PMID:27604720

  4. The Second Lebanon War Experience at Western Galilee Hospital.

    PubMed

    Lino, Bartholomew; Eisenman, Arie; Schuster, Richard; Giloni, Carlos; Bharoum, Masad; Daniel, Moshe; Dallas, Cham

    2016-02-01

    The summer of 2006 in northern Israel served as the battleground for the second war against Hezbollah based along Israel's border with southern Lebanon. Western Galilee Hospital (WGH), which is located only 6 miles from the Lebanese border, served as a major medical center in the vicinity of the fighting. The hospital was directly impacted by Hezbollah with a Katyusha rocket, which struck the ophthalmology department on the 4th floor. WGH was able to utilize a 450-bed underground facility that maintained full hospital functionality throughout the conflict. In a major feat of rapid evacuation, the entire hospital population was relocated under the cover of darkness to these bunkers in just over 1 hour, thus emptying the building prior to the missile impact. Over half of the patients presenting during the conflict did not incur physical injury but qualified as acute stress disorder patients. The particulars of this evacuation remain unique owing to the extraordinary circumstances, but many of the principles employed in this maneuver may serve as a template for other hospitals requiring emergency evacuation. Hospital functionality drastically changed to accommodate the operational reality of war, and many of these tactics warrant closer investigation for possible implementation in other conflict zones. PMID:26193904

  5. Carnosine Treatment for Gulf War Illness: A Randomized Controlled Trial

    PubMed Central

    Baraniuk, James N.; El-Amin, Suliman; Corey, Rebecca; Rayhan, Rakib U.; Timbol, Christian R.

    2013-01-01

    About 25% of 1990-1991 Persian Gulf War veterans experience disabling fatigue, widespread pain, and cognitive dysfunction termed Gulf War illness (GWI) or Chronic Multisymptom Illness (CMI). A leading theory proposes that wartime exposures initiated prolonged production of reactive oxygen species (ROS) and central nervous system injury. The endogenous antioxidant L-carnosine (β-alanyl-L-histidine) is a potential treatment since it is a free radical scavenger in nervous tissue. To determine if nutritional supplementation with L-carnosine would significantly improve pain, cognition and fatigue in GWI, a randomized double blind placebo controlled 12 week dose escalation study involving 25 GWI subjects was employed. L-carnosine was given as 500, 1000, and 1500 mg increasing at 4 week intervals. Outcomes included subjective fatigue, pain and psychosocial questionnaires, and instantaneous fatigue and activity levels recorded by ActiWatch Score devices. Cognitive function was evaluated by WAIS-R digit symbol substitution test. Carnosine had 2 potentially beneficial effects: WAIS-R scores increased significantly, and there was a decrease in diarrhea associated with irritable bowel syndrome. No other significant incremental changes were found. Therefore, 12 weeks of carnosine (1500 mg) may have beneficial cognitive effects in GWI. Fatigue, pain, hyperalgesia, activity and other outcomes were resistant to treatment. PMID:23618477

  6. Gas: the greatest terror of the Great War.

    PubMed

    Padley, A P

    2016-07-01

    The Great War began just over a century ago and this monumental event changed the world forever. 1915 saw the emergence of gas warfare-the first weapon of mass terror. It is relevant to anaesthetists to reflect on these gases for a number of reasons. Firstly and most importantly we should acknowledge and be aware of the suffering and sacrifice of those soldiers who were injured or killed so that we could enjoy the freedoms we have today. Secondly, it is interesting to consider the overlap between poison gases and anaesthetic gases and vapors, for example that phosgene can be formed by the interaction of chloroform and sunlight. Thirdly the shadow of gas warfare is very long and covers us still. The very agents used in the Great War are still causing death and injury through deployment in conflict areas such as Iraq and Syria. Industrial accidents, train derailments and dumped or buried gas shells are other sources of poison gas hazards. In this age of terrorism, anaesthetists, as front-line resuscitation specialists, may be directly involved in the management of gas casualties or become victims ourselves. PMID:27456288

  7. Carnosine treatment for gulf war illness: a randomized controlled trial.

    PubMed

    Baraniuk, James Nicholas; El-Amin, Suliman; Corey, Rebecca; Rayhan, Rakib; Timbol, Christian

    2013-05-01

    About 25% of 1990-1991 Persian Gulf War veterans experience disabling fatigue, widespread pain, and cognitive dysfunction termed Gulf War illness (GWI) or Chronic Multisymptom Illness (CMI). A leading theory proposes that wartime exposures initiated prolonged production of reactive oxygen species (ROS) and central nervous system injury. The endogenous antioxidant L-carnosine (B-alanyl-L-histidine) is a potential treatment since it is a free radical scavenger in nervous tissue. To determine if nutritional supplementation with L-carnosine would significantly improve pain, cognition and fatigue in GWI, a randomized double blind placebo controlled 12 week dose escalation study involving 25 GWI subjects was employed. L-carnosine was given as 500, 1000, and 1500 mg increasing at 4 week intervals. Outcomes included subjective fatigue, pain and psychosocial questionnaires, and instantaneous fatigue and activity levels recorded by ActiWatch Score devices. Cognitive function was evaluated by WAIS-R digit symbol substitution test. Carnosine had 2 potentially beneficial effects: WAIS-R scores increased significantly, and there was a decrease in diarrhea associated with irritable bowel syndrome. No other significant incremental changes were found. Therefore, 12 weeks of carnosine (1500 mg) may have beneficial cognitive effects in GWI. Fatigue, pain, hyperalgesia, activity and other outcomes were resistant to treatment. PMID:23618477

  8. Sports Injuries

    MedlinePlus

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper gear can cause them. Some people get hurt because they are not in shape. Not warming up or stretching enough can also ... injuries are Sprains and strains Knee injuries Swollen ...

  9. Rowing Injuries

    PubMed Central

    Hosea, Timothy M.; Hannafin, Jo A.

    2012-01-01

    Context: Rowing is one of the original modern Olympic sports and was one of the most popular spectator sports in the United States. Its popularity has been increasing since the enactment of Title IX. The injury patterns in this sport are unique because of the stress applied during the rowing stroke. Evidence Acquisition: This review summarizes the existing literature describing the biomechanics of the rowing stroke and rowing-related injury patterns. Data were obtained from previously published peer-reviewed literature through a search of the entire PubMed database (up to December, 2011) as well as from textbook chapters and rowing coaching manuals. Results: Rowing injuries are primarily overuse related. The knee, lumbar spine, and ribs are most commonly affected. The injury incidence is directly related to the volume of training and technique. Conclusion: Familiarity of the injury patterns and the biomechanical forces affecting the rowing athlete will aid in prompt diagnosis and appropriate management. PMID:23016093

  10. Volleyball injuries.

    PubMed

    Eerkes, Kevin

    2012-01-01

    There has been a significant increase in the numbers of people playing indoor and beach volleyball since the early 1980s and, consequently, an increase in injuries. Most injuries are related to repetitive jumping and hitting the ball overhead. The ankle is the most commonly injured joint, but the knee, shoulder, low back, and fingers also are vulnerable. The shoulder in particular is subject to extreme torque when hitting and jump serving the ball. Some injuries have a predilection for those playing on sand versus those playing in an indoor court. The clinician caring for volleyball players should be aware of the types of injuries these players sustain and how to help them return to play promptly and appropriately. This article reviews the specific injuries that are most common as a result of participating in the sport of volleyball. PMID:22965348

  11. Neurosurgical Work during the Napoleonic Wars: George James Guthrie's Experience.

    PubMed

    Roux, Franck-Emmanuel

    2016-01-01

    Involved in what is still considered, along with the two world wars of the 20th century, as one of the major conflicts in Europe, George James Guthrie (1785-1856) was the most famous English army surgeon of the Napoleonic wars. After treating the injured throughout the Peninsular Campaign (1808-1814), in 1815 and then in 1842 he published two major books dealing with cranial and brain injuries, among other topics. In these books, we can find, for example, an early description of the plantar reflex further described by Joseph Babinsky, accurate descriptions of the clinical signs of intracranial hypertension, and details of the physiopathology of subdural and epidural haematomas. Skull fractures are also discussed intensively, along with the indications for trepanation, a much-debated issue at the turn of the 19th century. The dura was often the limit of the surgical field for Guthrie. Nevertheless, he tried to rationalize the use of trepanation and favoured its use in two main cases: in cases of depressed skull bones, jammed bone fragments or debris irritating the dura or the brain and in cases of life-threatening cerebral compression caused by supposed blood clots. In their works, Guthrie and his contemporaries did not address neurosurgery in the modern sense of the word, but rather 'cranial surgery' in most cases. Guthrie, who saw so many patients with brain injuries and amputations, failed to understand that cerebral functions could be localized to the cortex and neglected to describe the phantom limb phenomenon, as did most of his contemporaries. PMID:27035714

  12. Moral Injury, Soul Repair, and Creating a Place for Grace

    ERIC Educational Resources Information Center

    Antal, Chris J.; Winings, Kathy

    2015-01-01

    Our returning veterans face many challenges from loss of limb and physical disabilities to posttraumatic stress disorder, depression, substance abuse, homelessness, family problems, and unemployment. The greater challenge, though, for returning veterans is the injury to their soul due to the war and violence they have experienced. Our challenge is…

  13. Wars2 is a determinant of angiogenesis.

    PubMed

    Wang, Mao; Sips, Patrick; Khin, Ester; Rotival, Maxime; Sun, Ximing; Ahmed, Rizwan; Widjaja, Anissa Anindya; Schafer, Sebastian; Yusoff, Permeen; Choksi, Pervinder Kaur; Ko, Nicole Shi Jie; Singh, Manvendra K; Epstein, David; Guan, Yuguang; Houštěk, Josef; Mracek, Tomas; Nuskova, Hana; Mikell, Brittney; Tan, Jessie; Pesce, Francesco; Kolar, Frantisek; Bottolo, Leonardo; Mancini, Massimiliano; Hubner, Norbert; Pravenec, Michal; Petretto, Enrico; MacRae, Calum; Cook, Stuart A

    2016-01-01

    Coronary flow (CF) measured ex vivo is largely determined by capillary density that reflects angiogenic vessel formation in the heart in vivo. Here we exploit this relationship and show that CF in the rat is influenced by a locus on rat chromosome 2 that is also associated with cardiac capillary density. Mitochondrial tryptophanyl-tRNA synthetase (Wars2), encoding an L53F protein variant within the ATP-binding motif, is prioritized as the candidate at the locus by integrating genomic data sets. WARS2(L53F) has low enzyme activity and inhibition of WARS2 in endothelial cells reduces angiogenesis. In the zebrafish, inhibition of wars2 results in trunk vessel deficiencies, disordered endocardial-myocardial contact and impaired heart function. Inhibition of Wars2 in the rat causes cardiac angiogenesis defects and diminished cardiac capillary density. Our data demonstrate a pro-angiogenic function for Wars2 both within and outside the heart that may have translational relevance given the association of WARS2 with common human diseases. PMID:27389904

  14. Wars2 is a determinant of angiogenesis

    PubMed Central

    Wang, Mao; Sips, Patrick; Khin, Ester; Rotival, Maxime; Sun, Ximing; Ahmed, Rizwan; Widjaja, Anissa Anindya; Schafer, Sebastian; Yusoff, Permeen; Choksi, Pervinder Kaur; Ko, Nicole Shi Jie; Singh, Manvendra K.; Epstein, David; Guan, Yuguang; Houštěk, Josef; Mracek, Tomas; Nuskova, Hana; Mikell, Brittney; Tan, Jessie; Pesce, Francesco; Kolar, Frantisek; Bottolo, Leonardo; Mancini, Massimiliano; Hubner, Norbert; Pravenec, Michal; Petretto, Enrico; MacRae, Calum; Cook, Stuart A

    2016-01-01

    Coronary flow (CF) measured ex vivo is largely determined by capillary density that reflects angiogenic vessel formation in the heart in vivo. Here we exploit this relationship and show that CF in the rat is influenced by a locus on rat chromosome 2 that is also associated with cardiac capillary density. Mitochondrial tryptophanyl-tRNA synthetase (Wars2), encoding an L53F protein variant within the ATP-binding motif, is prioritized as the candidate at the locus by integrating genomic data sets. WARS2(L53F) has low enzyme activity and inhibition of WARS2 in endothelial cells reduces angiogenesis. In the zebrafish, inhibition of wars2 results in trunk vessel deficiencies, disordered endocardial-myocardial contact and impaired heart function. Inhibition of Wars2 in the rat causes cardiac angiogenesis defects and diminished cardiac capillary density. Our data demonstrate a pro-angiogenic function for Wars2 both within and outside the heart that may have translational relevance given the association of WARS2 with common human diseases. PMID:27389904

  15. Influence of war on quantitative and qualitative changes in drug-induced mortality in Split-Dalmatia County, Croatia

    PubMed Central

    Marasović Šušnjara, Ivana; Definis Gojanović, Marija; Vodopija, Davor; Čapkun, Vesna; Smoljanović, Ankica

    2011-01-01

    Aim To study drug-induced mortality and characteristics of overdose deaths in the war (1991-1995), pre-war (1986-1990), and post-war period (1996-2000) in Split-Dalmatia County. Methods We retrospectively searched through Databases of the Department of Forensic Medicine, University Hospital Split, the national register of death records, the archives of the Split-Dalmatia County Police, and the Register of Treated Drug Addicts of the Croatian National Institute of Public Health, covering the period from 1986 to 2000, according to drug poisoning codes IX and X of the International Classification of Diseases. The indicators were statistically analyzed. Results There were 146 registered drug-induced deaths, with 136 (93%) deceased being men. The median age of all cases was 27 years (interquartile range 8). Most of them were single (70.6%), unemployed (44.6%), and secondary school graduates (69.2%). In the war period, there were 4.8 times more deaths than in the pre-war period (P = 0.014), and in the post-war period there were 5.2 times more deaths than in the pre-war period (P = 0.008). The most common site of death was the deceased person’s home. The toxicological analyses showed that 59 (61%) deaths were heroin related, alcohol use was found in 62 cases (42.5%), and multi-substance use was found in more than a half of the cases. In 133 (91.1%) cases, deaths were classified as unintentional, whereas 13 (8.9%) were classified as suicides. Conclusion The war, along with other risk factors, contributed to unfavorable developments related to drug abuse in Split-Dalmatia County, including the increase in the drug-induced mortality rate. PMID:21990081

  16. Head injury - first aid

    MedlinePlus

    ... is shaken, is the most common type of traumatic brain injury. Scalp wounds. Skull fractures. Head injuries may cause ... of people who suffer head injuries are children. Traumatic brain injury (TBI) accounts for over 1 in 6 injury- ...

  17. War casualties on the home front

    SciTech Connect

    Brenda J. Flinn

    2005-11-01

    On May 12, 1942, at Christopher coal mine No. 3 in Osage, West Virginia, a continent away from the frontlines of World War II, Superintendent Ed O'Neil saw the mine ventilation fan suddenly run backwards, propelled by a strong gust of air that tore the belt off the huge blower. The second shift mantrip of 115 coal miners, traversing the drift mouth for the 3:00 p.m. shift, ground to an uneasy halt. The article recounts the tragic consequences of this incident. It also tells of other events affecting coal miners during World War I and World War II.

  18. The causes and prevention of war

    SciTech Connect

    Brown, S.

    1987-01-01

    This book seeks to answer what has become a species-survival question: how can humankind reduce the role of large-scale violence in society. Based partially on the serious thought of past scholars and statesmen on the determinants of war and the conditions for peace, but mainly on the author's own studies and observations of world politics, a wide-ranging examination of both small-scale and international acts of violence are provided. The author realistically appraises the efforts and means of reducing the role of war in international relations and concludes by offering an integrated strategy to prevent and control war.

  19. Toward understanding the effects of nuclear war

    SciTech Connect

    Grover, H.D.; White, G.F.

    1985-10-01

    The authors discuss the scientific justifications for studying the consequences of nuclear war. The consequences of nuclear war and nuclear winter - biotic impoverishment, climate change, pollution of the air, water, and soil - recapitulate in compressed time the patterns of ecological change humankind is even now imposing on the planet. By studying the biological consequences of nuclear war, important discoveries about the intricate nature of the global ecosystem may be made. Wiser management practices and more thorough appreciation of alterations in the physical and biological environment could results.

  20. Preventing Nuclear War: What Physicians Can Achieve

    PubMed Central

    Bates, Don G.

    1986-01-01

    On its fifth anniversary, the International Physicians for the Prevention of Nuclear War was awarded the Nobel Peace Prize. The organization was conceived by two Boston cardiologists who joined with some Soviet colleagues to create an international forum for considering the medical consequences of and means for preventing nuclear war. This article by the organization's archivist documents its difficult progress yet remarkable growth. Overcoming serious obstacles has added to its strength and credibility: now involving organizations with 145,000 members in 41 countries, IPPNW has become the international voice of medicine's concern about nuclear war. PMID:21274253

  1. Perceptions of nuclear war. Research report

    SciTech Connect

    Alexandrow, N.

    1987-05-01

    Mutual deterrence has been the keystone of U.S. nuclear strategic policy with respect to the Soviet Union. But for mutual deterrence to be viable, the perceptions of nuclear weapons and nuclear war must be shared by both nations. There are currently many misconceptions in the West about Soviet views of nuclear war. These misconceptions have been reinforced over the years by Soviet public pronouncements. Through an examination of the mindset of the Soviet people, Soviet doctrinal literature, and Soviet offensive and defensive systems, this paper provides compelling evidence for the way the Soviet Union really perceives nuclear war.

  2. Air bags and ocular injuries.

    PubMed Central

    Stein, J D; Jaeger, E A; Jeffers, J B

    1999-01-01

    PURPOSE: This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed. METHODS: Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries. RESULTS: Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury. CONCLUSION: Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm. Images FIGURE 1 FIGURE 2A FIGURE 2B FIGURE 2C FIGURE 2D FIGURE 3A FIGURE 3B FIGURE 4 FIGURE 5 FIGURE 7 FIGURE 8 PMID:10703118

  3. Assessment of Vascular Injuries and Reconstruction

    PubMed Central

    Baghi, Iraj; Herfatkar, Mohammad Rasool; Shokrgozar, Leila; Poor-Rasuli, Zahra; Aghajani, Fatemeh

    2015-01-01

    Background: Trauma is the third leading cause of death. In this regard, vascular injury plays a leading role in of morbidity and mortality rates. Objectives: The present study aimed to assess the prevalence of vascular injuries and results of vascular reconstruction at a referral hospital in northern Iran. Patients and Methods: A retrospective observational study assessed 88 consecutive patients with vascular injury admitted to Poursina Hospital, Rasht in northern Iran, from October 2007 to October 2009. All study information was collected retrospectively from hospital charts. Results: Most of the affected patients (87/88) were male with a mean age of 29.12 ± 11.20 years. The mechanism of injury in 39.8% was blunt trauma and penetrating trauma in the rest. Of the 53 injured by penetrating trauma (60.2%), the most common cause was stabbing (94.3%). The most common cause of blunt trauma was road traffic accidents (93.1%). The most common mechanism for vascular injuries in upper extremities was penetrating trauma (86.0%) and in lower extremities was blunt trauma (60.0%). Fasciotomy was performed in 16 patients (18.2%) mostly in the lower extremities. Major amputation was required in 10% of the patients. In upper extremities, the most common type of revascularization was end to end anastomosis, followed by inter-position graft. The most common type of reconstruction in the lower extremity was bypass graft. All patients who underwent major amputation were admitted to the center with a delay of more than 6 hours after injury. Conclusions: Major vascular injuries in our center occurred in young men, frequently because of stab wounds. Popliteal injuries mostly caused by motor vehicle accidents was the second most common arterial injury, followed by combined ulnar and radial injuries. Vascular reconstruction in the first hours after trauma may prevent many unnecessary and preventable amputation procedures. PMID:26839869

  4. Risk factors for injuries during airborne static line operations.

    PubMed

    Knapik, Joseph J; Steelman, Ryan

    2014-01-01

    US Army airborne operations began in World War II. Continuous improvements in parachute technology, aircraft exit procedures, and ground landing techniques have reduced the number of injuries over time from 27 per 1,000 descents to about 6 per 1,000 jumps. Studies have identified a number of factors that put parachutists at higher injury risk, including high wind speeds, night jumps, combat loads, higher temperatures, lower fitness, heavier body weight, and older age. Airborne injuries can be reduced by limiting risker training (higher wind speeds, night jumps, combat load) to the minimum necessary for tactical and operational proficiency. Wearing a parachute ankle brace (PAB) will reduce ankle injuries without increasing other injuries and should be considered by all parachutists, especially those with prior ankle problems. A high level of upper body muscular endurance and aerobic fitness is not only beneficial for general health but also associated with lower injury risk during airborne training. PMID:25344715

  5. "Doomed to go in company with miserable pain": surgical recognition and treatment of amputation-related pain on the Western Front during World War 1.

    PubMed

    Edwards, Dafydd S; Mayhew, Emily R; Rice, Andrew S C

    2014-11-01

    The principal feature of injuries from World War 1 was musculoskeletal trauma and injury to peripheral nerves as a result of damage to the upper and lower limbs caused by gunshot wounds and fragments of artillery munitions. Amputation was used as a treatment in field hospitals to save lives; limb conservation was a secondary consideration. A century later, the principal feature of injuries to soldiers in today's wars in Iraq and Afghanistan is also musculoskeletal trauma and injury to the peripheral nerves caused by improvised explosive devices. Common to both types of injury is postamputation pain. We searched The Lancet's archives in this Series paper to show the efforts of surgeons in World War 1 to understand and treat postamputation pain in its own right both during and immediately after the war. Despite unprecedented patient numbers and levels of civilian medical expertise, little progress was made in providing relief from this type of pain, a grave concern to the surgeons treating these soldiers. Today postamputation pain is understood beyond a surgical context but remains a complex and poorly understood condition with few effective treatments. PMID:25441202

  6. Epidemiological study of suicide in the Republic of Croatia -- comparison of war and post-war periods and areas directly and indirectly affected by war.

    PubMed

    Grubisić-Ilić, Mirjana; Kozarić-Kovacić, Dragica; Grubisić, Frane; Kovacić, Zrnka

    2002-09-01

    We examined the differences in the suicide characteristics between areas directly and indirectly affected by war activities and in war and post-war periods according to the following variables: suicide rate, sex, age and method of suicide. Analysis was done on 5349 suicides committed in the period 1993-1998 (war and post-war years). The suicide rates in the Republic of Croatia oscillated in the pre-war, war and post-war periods (1985-2000) but without significant differences. In the areas directly affected by war, the suicide rate was significantly lower than in other areas during the study period 1993-1998 (chi-square = 10.3245; P = 0.0017). The number of suicides in both sexes declined in the areas directly affected by war-more in men than in women; the difference between sexes was statistically significant (chi-square = 3.6697; P = 0.055). Middle- and old-aged people were the population with high suicide risk in both areas (t = 1.76; P = 0.078). There were significant differences in the methods of suicides between war and non-war areas (chi-square = 108.8473; P = 0.001). Firearms or explosive devices were the methods used more significantly for suicides in the areas directly affected by war than in other areas, whereas hanging was more frequently used in the areas indirectly affected by war. PMID:12381495

  7. The hazard of sharp force injuries: Factors influencing outcome.

    PubMed

    Kristoffersen, Stine; Normann, Stig-André; Morild, Inge; Lilleng, Peer Kåre; Heltne, Jon-Kenneth

    2016-01-01

    The risk of dying from sharp force injury is difficult to ascertain. To the best of our knowledge, no study has been performed in Norway regarding mortality due to sharp force injury or factors that impact survival. Thus, the objective of the present study was to investigate and assess mortality in subjects with sharp force injury. This retrospective study comprises data on 136 subjects (34 female, 102 male) with suspected severe sharp force injury (self-inflicted or inflicted by others) admitted to Haukeland University Hospital between 2001 and 2010. The majority of subjects were intoxicated, and the injury was most often inflicted by a knife. The incidence of sharp force injury in Western Norway is similar to the incidence in other European countries. Almost half of the subjects with self-inflicted injury died. In cases with injury inflicted by another individual, one in five died. Mortality rates were higher in those with penetrating chest injuries than those with penetrating abdominal injuries and higher in cases with cardiac injury compared to pleural or lung injury. Sharp force injury can be fatal, but the overall mortality rate in this study was 29%. Factors influencing mortality rate were the number of injuries, the topographic regions of the body injured, the anatomical organs/structures inflicted, and emergency measures performed. PMID:26599374

  8. [War trauma and PTSD among German war survivors. A comparison of former soldiers and women of World War II].

    PubMed

    Nandi, C; Weierstall, R; Huth, S; Knecht, J; Elbert, T

    2014-03-01

    Stressful war experiences can cause posttraumatic stress disorder (PTSD) in survivors. To what extent were the soldiers and young women of World War II affected by PTSD symptoms over the course of their lives? Do these men and women differ in the traumatic experiences and PTSD symptom severity? To investigate these questions 52 male and 20 female Germans aged 81-95 years were recruited through newspaper advertisements and notices and interviewed regarding war experiences and PTSD symptoms. Of the men 2% and 7% met the criteria for current and lifetime PTSD diagnoses, respectively, as compared to 10% and 30% of the women, respectively. Using multiple linear regression a dose-response relationship between the number of trauma types experienced and PTSD symptom severity could be demonstrated. The slope of the regression curve was steeper for women than for men. When controlling for the number of different traumatic experiences women reported a significantly higher severity of PTSD symptoms than men. It is presumed that this difference in severity of symptoms can be attributed to qualitative differences in the type of traumatic stress factors during the war. The present study provides evidence that even today people continue to be affected by PTSD symptoms due to events which occurred during World War II; therefore, during patient contact with this age group the war experiences specific to each individual need to be considered as potential moderators of symptoms. PMID:23695004

  9. Sternal fractures: retrospective analysis of 100 cases.

    PubMed

    Athanassiadi, Kalliopi; Gerazounis, Michalis; Moustardas, Marios; Metaxas, Efstathios

    2002-10-01

    Isolated sternal fractures are seen with increasing frequency in road accidents, especially since the introduction of seatbelt legislation. The medical records of all our patients who were treated with a diagnosis of sternal fracture (SF) over the past two decades were retrospectively reviewed to determine the incidence, morbidity, and mortality of this entity. Between 1984 and 1998, 100 consecutive patients were admitted to the Department of Surge Surgery, General Hospital of Nikea-Piraeus, Greece, for SF. There were 72 men and 28 women ranging in age between 17 and 84 years. Sixty-seven patients sustained an isolated SF and the remaining 33 had a SF in combination with multiple injuries such as flail chest (n = 19), head injury (n = 18), limb fractures (n = 10), spinal fractures (n = 4), hear contusion (n = 1), hemo-pneumothorax (n = 9), pneumothorax (n = 6), hemomediastinum (n = 5), and pericarditis (n = 2), among others. All patients with a radiological diagnosis were admitted for cardiac monitoring for at least 24 hours. Electrocardiogram (ECG), determinations of cardiac enzyme levels such as lactic dehydrogenase, creatine kinase, and creatine kinase-MB, and evaluation by a cardiologist were routinely performed. An echocardiogram was performed as indicated by the cardiologist. Seven patients underwent operation, two for abdominal bleeding, two for chest wall and sternal stabilization, two for open pneumothorax, and one for massive hemothorax. Eight of our patients needed ventilatory support. Four of them died from respiratory insufficiency, myocardial infarction, and heart and lung contusion. Although an isolated SF carries a good prognosis, careful evaluation and clinical observation are essential. PMID:12181604

  10. Patterns in Blast Injuries to the Hand

    PubMed Central

    Buntic, Rudolf F.; Brooks, Darrell

    2008-01-01

    Blast injuries to the hand are not just a wartime phenomenon but also quite common in rural communities throughout northern California. The purpose of this study is to review our experience with blast injuries in the community and review the most common patterns in an attempt to identify the pathomechanics of the hand injury and the reconstructive procedures that are required. This is a retrospective study of blast injuries to the hand treated between 1978 and 2006. Medical records, X-rays, and photos were reviewed to compile standard patient demographics and characterize the injury pattern. Explosives were classified based on their rate of decomposition. Reconstructive solutions were reviewed and characterized based on whether damaged tissues were repaired or replaced. Sixty-two patients were identified with blast injuries to their hand. Patients were predominantly male (92%) with an average age of 27 years. Firecrackers were the most commonly encountered explosives. Thirty-seven patients were identified as holding a low explosive in their dominant hand and were used for characterization of the injury pattern. The apparent pattern of injury was hyperextension and hyperabduction of the hand and digits. Common injuries were metacarpophalangeal and interphalangeal joint hyperextension with associated soft tissue avulsion, hyperabduction at the web spaces with associated palmar soft tissue tears, and finger disarticulation amputations worse at radial digits. Given the mechanisms of injury with tissue loss, surgical intervention generally involved tissue replacement rather than tissue repair. Blast injuries to the hand represent a broad spectrum of injuries that are associated with the magnitude of explosion and probably, the proximity to the hand. We were able to identify a repetitive pattern of injury and demonstrate the predominant use for delayed tissue replacement rather than microsurgical repair at the acute setting. PMID:18780004

  11. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...= en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  12. 46 CFR 308.107 - War risk hull insurance policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false War risk hull insurance policy. 308.107 Section 308.107 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.107 War risk hull insurance policy. Standard Form...

  13. 46 CFR 308.107 - War risk hull insurance policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false War risk hull insurance policy. 308.107 Section 308.107 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.107 War risk hull insurance policy. Standard Form...

  14. 46 CFR 308.107 - War risk hull insurance policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false War risk hull insurance policy. 308.107 Section 308.107 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.107 War risk hull insurance policy. Standard Form...

  15. 46 CFR 308.107 - War risk hull insurance policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false War risk hull insurance policy. 308.107 Section 308.107 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.107 War risk hull insurance policy. Standard Form...

  16. A REMF's View of Viet Nam War Literature Bibliography.

    ERIC Educational Resources Information Center

    Willson, David A.

    An academic librarian who is a Vietnam War veteran was inspired by the exemplary collection of Vietnam War literature at the Colorado State University Library to begin his own personal collection of mass market paperbacks dealing with the Vietnam War. Although Vietnam War fiction was common on the mass market racks in the mid 1980s, it has been…

  17. 38 CFR 3.2 - Periods of war.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Periods of war. 3.2..., Compensation, and Dependency and Indemnity Compensation General § 3.2 Periods of war. This section sets forth the beginning and ending dates of each war period beginning with the Indian wars. Note that the...

  18. 46 CFR 308.104 - Additional war risk insurance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers...

  19. 46 CFR 308.104 - Additional war risk insurance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers...

  20. 46 CFR 308.104 - Additional war risk insurance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers...

  1. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...= en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  2. 38 CFR 3.2 - Periods of war.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Periods of war. 3.2..., Compensation, and Dependency and Indemnity Compensation General § 3.2 Periods of war. This section sets forth the beginning and ending dates of each war period beginning with the Indian wars. Note that the...

  3. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...=en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  4. 38 CFR 3.2 - Periods of war.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Periods of war. 3.2..., Compensation, and Dependency and Indemnity Compensation General § 3.2 Periods of war. This section sets forth the beginning and ending dates of each war period beginning with the Indian wars. Note that the...

  5. 46 CFR 308.104 - Additional war risk insurance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers...

  6. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...=en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  7. 46 CFR 308.107 - War risk hull insurance policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false War risk hull insurance policy. 308.107 Section 308.107 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.107 War risk hull insurance policy. Standard Form...

  8. 46 CFR 308.104 - Additional war risk insurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Additional war risk insurance. 308.104 Section 308.104 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Hull and Disbursements Insurance § 308.104 Additional war risk insurance. Owners or charterers...

  9. 38 CFR 3.2 - Periods of war.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Periods of war. 3.2..., Compensation, and Dependency and Indemnity Compensation General § 3.2 Periods of war. This section sets forth the beginning and ending dates of each war period beginning with the Indian wars. Note that the...

  10. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...= en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  11. Middle School Students, Science Textbooks, Television and Nuclear War Issues.

    ERIC Educational Resources Information Center

    Hamm, Mary

    The extent to which the issue of nuclear war technology is treated in middle-school science texts, and how students learn about nuclear war and war technology were studied. Five raters compared the most widely used textbooks for grades 6 and 7 to determine the amount of content on: (1) population growth; (2) world hunger; (3) war technology; (4)…

  12. Photojournalism: A Record of War. Learning Page Lesson Plan.

    ERIC Educational Resources Information Center

    Fricke, Chris; Ritz, Glenda

    Photography has been used to record war since the Crimean War in 1855. This lesson plan explores how and why war has been photographed and also gives students an opportunity to see the bias within the recording/reporting of war. The lesson plan: cites educational objectives; gives time required; recommends a grade level; notes curriculum fit; and…

  13. The anthropology of war and peace

    SciTech Connect

    Turner, P.R.; Pitt, D.

    1989-01-01

    Drawing parallels between tribal behavior and international relations to demonstrate that societies are not inherently aggressive but are led into conflict when pride or in-group pressures push people to fight, this profound look at the chilling reality of cold war and its arsenal of nuclear destruction offers valuable new insights into how prejudices and stereotypes contribute to what may seem like an inexorable drift to war. Yet the authors conclude that war is not inevitable, as they offer suggestions for an end to the arms race in, the nuclear age. Based on original research, this is a long overdue contribution to the study of war and peace in our time and a text for newly emerging courses on the subject.

  14. The Portable War Room Research Project

    NASA Technical Reports Server (NTRS)

    Govers, Francis X., III; Fry, Mark

    1997-01-01

    The Portable War Room is an internal TASC project to research and develop a visualization and simulation environment to provide for decision makers the power to review the past, understand the present, and peer into the future.

  15. The Cold War: A Yearbook Perspective.

    ERIC Educational Resources Information Center

    Graebner, William

    1986-01-01

    Shows how the photographs, valedictorian addresses, nicknames, cartoons and other material contained in high school yearbook can yield information regarding the world views of Americans at the start of the Cold War. (JDH)

  16. Climatic and biological consequences of nuclear war

    SciTech Connect

    Grover, H.D.

    1984-05-01

    Projecting comprehensively the climatic and biological consequences of nuclear war brings into question the perceived security ascribed to policies of deterrence, as well as the efficacy of civil preparedness measures, particularly relocation plans. It is presumed the probability that nuclear war will occur is low, but the potential consequences are so great that the issue must be given full attention. Nuclear war is the greatest environmental threat we face. Yet the problem should be solvable. It is especially important that environmentally concerned citizens and scientists apply their knowledge and understanding to the problem because many of the changes in environmental quality that concerns us today, such as air and water pollution by a host of organic and inorganic agents, represent the principle mechanism whereby life could be threatened in the aftermath of nuclear war. 29 references.

  17. War, terrorism and the public's health.

    PubMed

    Sidel, Victor W

    2008-01-01

    War and terrorism, which are inseparable, cause death and disability, profound psychological damage, environmental destruction, disruption of the health infrastructure, refugee crises, and increased interpersonal, self-directed and collective violence. Weapons systems such as weapons of mass destruction and landmines have their own specific devastating effects. Preparation for war and preparedness for terrorism bring constraints on civil liberties and human rights, increase militarism, and divert resources from health care and from other needed services. War and terrorism may be best prevented through addressing their causes, which include limited resources, injustice, poverty and ethnic and religious enmity, and through strengthening the United Nations and the treaties controlling specific weapons systems, particularly weapons of mass destruction. In particular, the United States should cease its interference in the internal affairs of other nations and its advocacy of unilateral pre-emptive war. PMID:18771191

  18. Cold-War Echoes in American Children.

    ERIC Educational Resources Information Center

    Winn, Ira Jay

    1984-01-01

    The author believes a cold war ideology permeates our culture and poisons the minds of youth. The challenge to education is to awaken people to a historical and global perspective and raise public consciousness of the necessity for peace. (MD)

  19. Gulf War Illness: Challenges Persist

    PubMed Central

    Nettleman, Mary

    2015-01-01

    It has been more than 20 years since the United States and coalition forces entered Kuwait and Iraq. Actual combat was of remarkably short duration: less than 1 week of sustained ground activity and 6 weeks of air missions. Thus, it was surprising when approximately 200,000 returning US veterans were affected by a chronic multi-symptom illness that came to be known as Gulf War Illness (GWI). There were many challenges in investigating GWI, not least of which was that it took several years before the condition was officially taken seriously. There were multiple exposures to potentially causal agents on and off the battlefield, but these exposures were documented incompletely if at all, leaving epidemiologists to rely on self-report for information. In the past 2 years, significant controversy has arisen over the future directions of the field. Despite these challenges, several studies have implicated exposure to acetylcholinesterase inhibitors such as pyridostigmine bromide in the genesis of the condition. The story of GWI can inform research into other conditions and guide future work on veterans' health. PMID:26330683

  20. Gulf War Illness: Challenges Persist.

    PubMed

    Nettleman, Mary

    2015-01-01

    It has been more than 20 years since the United States and coalition forces entered Kuwait and Iraq. Actual combat was of remarkably short duration: less than 1 week of sustained ground activity and 6 weeks of air missions. Thus, it was surprising when approximately 200,000 returning US veterans were affected by a chronic multi-symptom illness that came to be known as Gulf War Illness (GWI). There were many challenges in investigating GWI, not least of which was that it took several years before the condition was officially taken seriously. There were multiple exposures to potentially causal agents on and off the battlefield, but these exposures were documented incompletely if at all, leaving epidemiologists to rely on self-report for information. In the past 2 years, significant controversy has arisen over the future directions of the field. Despite these challenges, several studies have implicated exposure to acetylcholinesterase inhibitors such as pyridostigmine bromide in the genesis of the condition. The story of GWI can inform research into other conditions and guide future work on veterans' health. PMID:26330683

  1. Delayed psychiatric sequelae among Falklands war veterans

    PubMed Central

    Jones, Gareth H.; Lovett, Jonathan W.T.

    1987-01-01

    The only published account to date of psychiatric complications among Falklands war veterans suggests that acute reactions are rare. Reported here are three cases of severe delayed reactions in Falklands veterans from South Wales. All three cases demonstrate a common pattern similar to that shown by Vietnam war veterans. Possible aetiological factors and prevention are discussed. It seems likely that relatives of combatants will also be affected and general practitioners are in a unique position to recognize and treat these problems. PMID:3668924

  2. War Peace Film Guide. Revised Edition.

    ERIC Educational Resources Information Center

    Dowling, John

    This filmography is a selective listing of 287 films dealing with the topics of war and peace for use with K-12 and college students and with adults. The annotated guide will be of use to anyone planning a world affairs program and of special value to those interested in the problem of war. A wide variety of subject areas are treated in the films.…

  3. Just war theory in the nuclear age

    SciTech Connect

    Jones, J.D.; Griesbach, M.F.

    1985-01-01

    This book presents papers on nuclear deterrence. Topics considered include the morality of war, the normative alternatives to war, national defense in the nuclear age, the environment of nuclear deterrence (empirical factors and moral judgments), morality and nuclear weaponry, the morality of nuclear deterrence and national defense in a changing strategic environment, alternatives to nuclear deterrence, and strengthening broadcasting capabilities into the USSR (e.g., Radio Liberty and Voice of America).

  4. Electrical injury

    MedlinePlus

    ... damage, especially to the heart, muscles, or brain. Electric current can cause injury in three ways: Cardiac arrest ... How long you were in contact with the electricity How the electricity moved through your body Your ...

  5. Sports Injuries

    MedlinePlus

    ... heart, to help decrease swelling. The Body’s Healing Process From the moment a bone breaks or a ... what happens at each stage of the healing process: At the moment of injury: Chemicals are released ...

  6. Corneal injury

    MedlinePlus

    ... at all times when using hand or power tools or chemicals, during high impact sports, or during other activities where you may get an eye injury. Wear sunglasses that screen ultraviolet light when you are ...

  7. Annual Energy Outlook Retrospective Review

    EIA Publications

    2015-01-01

    The Annual Energy Outlook Retrospective Review provides a yearly comparison between realized energy outcomes and the Reference case projections included in previous Annual Energy Outlooks (AEO) beginning with 1982. This edition of the report adds the AEO 2012 projections and updates the historical data to incorporate the latest data revisions.

  8. [Injury mechanisms in windsurfing regatta].

    PubMed

    Prymka, M; Plötz, G M; Jerosch, J

    1999-12-01

    In a retrospective study, we evaluated the injuries of 44 semi-professional competitors for the German Windsurf Cup, which were suffered from during one windsurfing season. This Cup is the national qualification tour for the annual "production fun board world championship". The subjects, participating in our study were randomly chosen. There were no surf-specific differences between the two groups. The average age was 24.63% had competitive surfing as their hobby, 37% were professional or semi-professional board sailors. The subjects surfed an average of 85 days in 1995. 23 (52%) windsurfers did not get hurt during the entire season. 21 (48%) of them got injured during the 1995 windsurf season. This is an incidence of only one injury per 174 windsurfing days. Only three windsurfers were injured during a competition. The other 18 occurred during training sessions. Most accidents happened because of an overpower situation, i.e. the sail was too big for the wind force (43%), or through negligence on the part of the windsurfer (19%). The most frequent type of the accident was the so called catapult crash (57%). The most common injuries were ligament ruptures of the lower leg (33%) and head burst wounds (19%). Compared with other competitive fun sports (e.g. snow boarding), windsurfing has a lower injury risk. In regard to the injury mechanisms, prophylactic recommendations are made. PMID:10670063

  9. Intercomparison of retrospective radon detectors.

    PubMed Central

    Field, R W; Steck, D J; Parkhurst, M A; Mahaffey, J A; Alavanja, M C

    1999-01-01

    We performed both a laboratory and a field intercomparison of two novel glass-based retrospective radon detectors previously used in major radon case-control studies performed in Missouri and Iowa. The new detectors estimate retrospective residential radon exposure from the accumulation of a long-lived radon decay product, (210)Pb, in glass. The detectors use track registration material in direct contact with glass surfaces to measure the alpha-emission of a (210)Pb-decay product, (210)Po. The detector's track density generation rate (tracks per square centimeter per hour) is proportional to the surface alpha-activity. In the absence of other strong sources of alpha-emission in the glass, the implanted surface alpha-activity should be proportional to the accumulated (210)Po, and hence to the cumulative radon gas exposure. The goals of the intercomparison were to a) perform collocated measurements using two different glass-based retrospective radon detectors in a controlled laboratory environment to compare their relative response to implanted polonium in the absence of environmental variation, b) perform collocated measurements using two different retrospective radon progeny detectors in a variety of residential settings to compare their detection of glass-implanted polonium activities, and c) examine the correlation between track density rates and contemporary radon gas concentrations. The laboratory results suggested that the materials and methods used by the studies produced similar track densities in detectors exposed to the same implanted (210)Po activity. The field phase of the intercomparison found excellent agreement between the track density rates for the two types of retrospective detectors. The correlation between the track density rates and direct contemporary radon concentration measurements was relatively high, considering that no adjustments were performed to account for either the residential depositional environment or glass surface type

  10. Children and war: risk, resilience, and recovery.

    PubMed

    Werner, Emmy E

    2012-05-01

    This article reviews and reflects on studies that have explored the effects of war on children around the world. Most are cross-sectional and based on self-reports. They describe a range of mental health problems, related to dose effects and to the negative impact of being a victim or witness of violent acts, threats to and loss of loved ones, prolonged parental absence, and forced displacement. The more recent the exposure to war, and the older the child, the higher was the likelihood of reported posttraumatic stress disorder symptoms. Especially vulnerable to long-term emotional distress were child soldiers, children who were raped, and children who had been forcibly displaced. In adulthood, war-traumatized children displayed significantly increased risks for a wide range of medical conditions, especially cardiovascular diseases. Among protective factors that moderated the impact of war-related adversities in children were a strong bond between the primary caregiver and the child, the social support of teachers and peers, and a shared sense of values. Among the few documented intervention studies for children of war, school-based interventions, implemented by teachers or locally trained paraprofessionals, proved to be a feasible and low-cost alternative to individual or group therapy. More longitudinal research with multiple informants is needed to document the trajectories of risk and resilience in war-affected children, to assess their long-term development and mental health, and to identify effective treatment approaches. PMID:22559130

  11. Children's conceptions of conventional and nuclear war

    SciTech Connect

    Boone, R.P.

    1985-01-01

    The general objective of this study was to investigate the development of the conceptions of conventional and nuclear war in the preadolescent and adolescent child. Subjects consisted of children in three age groups: 5-6, 9-10, and 13-14 year olds (N = 63) drawn from public and private schools in the metropolitan Los Angeles area. Children were administered an interview and supplementary measures. Parents were administered questionnaires examining related areas. The principal findings were as follows: (1) The development of the war concepts. Regarding the concept of conventional war, by the age of five or six, the child usually can recognize the word war and indicate that the word has to do with fighting between two or more parties. However, the notion of nationality is evidently not solidly grasped until around the ages of 8-11 years old. In this study, 45% of the 5 and 6 year olds were minimally aware of the concept of nuclear war. By the time the child reaches the age of 9 or 10, the proportion of those with minimal awareness rises to about 80%. By 13 and 14 years old, 100% are familiar with the concept. (2) Levels of Worry. Of the children aware of the subject of nuclear war, 76% indicated that they were very worried by its possibility.

  12. Electric injury, Part II: Specific injuries.

    PubMed

    Fish, R M

    2000-01-01

    Electric injury can cause disruption of cardiac rhythm and breathing, burns, fractures, dislocations, rhabdomyolysis, eye and ear injury, oral and gastrointestinal injury, vascular damage, disseminated intravascular coagulation, peripheral and spinal cord injury, and Reflex Sympathetic Dystrophy. Secondary trauma from falls, fires, flying debris, and inhalation injury can complicate the clinical picture. Diagnostic and treatment considerations for electric injuries are described in this article, which is the second part of a three-part series on electric injuries. PMID:10645833

  13. Intercomparison of Retrospective Radon Detectors

    SciTech Connect

    Field, R W.; Steck, D J.; Parkhurst, Maryann ); Mahaffey, Judith A. ); Alavanja, M C.

    1998-11-01

    We performed both a laboratory and field intercomparison of two novel glass-based retrospective radon detectors previously used in major radon case-control studies performed in Missouri and Iowa. The new detectors estimate retrospective residential radon exposure from the accumulation of a long-lived radon decay product, Pb-210, in glass. The detectors use track registration material in direct contact with glass surfaces to measure the alpha emission of a Pb-210 decay product, Po-210. The detector's track density generation rate (tracks cm{sup -2} hr{sup -1}) is proportional to the surface alpha activity. In the absence of other strong sources of alpha emission in the glass, the implanted surface alpha activity should be proportional to the accumulated Po-210 and hence, the cumulative radon gas exposure. The goals of the intercomparison were to: (1) perform collocated measurements using two different glass-based retrospective radon detectors in a controlled laboratory environment to compare their relative response to implanted polonium in the absence of environmental variation, (2) perform collocated measurements using two different retrospective radon progeny detectors in a variety of residential settings to compare their detection of glass implanted polonium activities, and (3) examine the correlation between track density rates and contemporary radon gas concentrations. The laboratory results suggested that the materials and methods used by the studies produced similar track densities in detectors exposed to the same implanted Po-210 activity. The field phase of the intercomparison found excellent agreement between the track density rates for the two types of retrospective detectors. The correlation between the track density rates and direct contemporary radon concentration measurements was relatively high, considering that no adjustments were performed to account for either the residential depositional environment or glass surface type.

  14. Injuries in a modern dance company effect of comprehensive management on injury incidence and cost.

    PubMed

    Ojofeitimi, Sheyi; Bronner, Shaw

    2011-09-01

    Injury costs strain the finances of many dance companies. The objectives of this study were to analyze the effect of comprehensive management on injury patterns, incidence, and time loss and examine its financial impact on workers compensation premiums in a modern dance company. In this retrospective-prospective cohort study, injury was defined as any physical insult that required financial outlay (workers compensation or self insurance) or caused a dancer to cease dancing beyond the day of injury (time-loss injury). Injury data and insurance premiums were analyzed over an eight-year period. Injuries were compared using a mixed linear model with phase and gender as fixed effects. It was found that comprehensive management resulted in 34% decline in total injury incidence, 66% decrease in workers compensation claims, and 56% decrease in lost days. These outcomes achieved substantial savings in workers compensation premiums. Thus, this study demonstrates the effectiveness of an injury prevention program in reducing injury-related costs and promoting dancers' health and wellness in a modern dance company. PMID:22040757

  15. Neurology and Neurologists during the Franco-Prussian War (1870-1871).

    PubMed

    Walusinski, Olivier

    2016-01-01

    The Franco-Prussian War (1870-1871) ended with the firm establishment of the French Republic and with German unity under Prussian leadership. After describing the events leading to the war, we explain how this conflict was the first involving the use of machine guns; soldiers were struck down by the thousands. Confronted with smallpox and typhus epidemics, military surgeons were quickly overwhelmed and gave priority to limb injuries, considering other wounds as inevitably fatal. Here, we present detailed descriptions of spinal and cranial injuries by Léon Legouest and of asepsis prior to trepanning by Ernst von Bergmann. Both the war and the Commune had disastrous effects on Paris. Jean-Martin Charcot continued to work intensely through the conflict, caring for numerous patients at La Salpêtrière Hospital according to his son Jean-Baptiste's account, which we've also excerpted below. As for young Dejerine, he treated the wounded from France who had taken refuge in Switzerland. Désiré-Magloire Bourneville also took heroic initiatives, as did Charles Lasègue, Alfred Vulpian, Alix Joffroy and Victor Cornil. PMID:27035594

  16. Long-term clinical outcomes of war-related bilateral lower extremities amputations.

    PubMed

    Ebrahimzadeh, Mohammad Hosein; Moradi, Ali; Khorasani, Mohammad Reza; Hallaj-Moghaddam, Mohammad; Kachooei, Amir Reza

    2015-02-01

    In a cross-sectional study, 291 out of 500 veterans with war-related bilateral lower limb amputations from Iran-Iraq war (1980-1988) accepted to participate in our study. Information related to amputees and amputated limbs were gathered and a Persian version of the Medical Outcomes Study Short Form 36 (SF-36) was filled. To evaluate the effect of amputation level on health related quality of life, we classified patients to seven types according to the functional remainder of major joints (ankles, knees, hips). 97% of patients were male and the average age at the time of injury was 20 years. The major cause of war injury was shells in 50. 54% of amputees were involved in sport activities. The most common amputation level was transtibial (48%).The major stump complaint was muscle spasm. History of being hospitalized for a psychiatric disorder was reported in 5.6%. The average SF-36 score in type 2 to type 6 were 68, 60, 60, 56, and 62, respectively. Except Energy/Fatigue domain, all the other domains were different from normal population. There was not any significant statistical correlation between amputation type and any domain of the SF-36. Type 6 amputees showed an increase in physical health domains compared with former types. PMID:25530410

  17. Long-term outcomes of war-related death of family members in Kosovar civilian war survivors.

    PubMed

    Morina, Nexhmedin; Reschke, Konrad; Hofmann, Stefan G

    2011-04-01

    Exposure to war-related experiences can comprise a broad variety of experiences and the very nature of certain war-related events has generally been neglected. To examine the long-term outcomes of war-related death of family members, the authors investigated the prevalence rates of major depressive episode (MDE), anxiety disorders, and quality of life among civilian war survivors with or without war-related death of first-degree family members 9 years after the war in Kosovo. Compared to participants without war-related death of family members, those who had experienced such loss had signficantly higher prevalence rates of MDE, posttraumatic stress disorder, and generalized anxiety disorder, and reported a lower quality of life 9 years after the war. These results indicate that bereaved civilian survivors of war experience significant mental health problems many years after the war. PMID:24501825

  18. A Retrospective Case Series of Surgical Implant Generation Network (SIGN) Placement at the Afghan National Police Hospital, Kabul, Afghanistan.

    PubMed

    Ertl, Christian W; Royal, David; Arzoiey, Humayoon Abdul; Shefa, Azizullah; Sultani, Salim; Mosafa, Mohammed Omar; Sadat, Safiullah; Zirkle, Lewis

    2016-01-01

    In Afghanistan, adequate and cost-effective medical care for even routine conditions is lacking; especially for complex injuries like long-bone fractures. The Surgical Implant Generation Network (SIGN) intramedullary nail is used for treatment of long-bone fractures from blunt injuries and does not require imaging. We are reporting for the first time results of the SIGN intramedullary nail at the Afghan National Police Hospital, a tertiary care facility in Kabul. 71 records from the SIGN Online Surgical Database were reviewed for gender, age, date of injury, implant date, patient's home of record, and type/ mechanism of injury. Mean age was 26.7 years, all but one being male; time from injury to implant ranged 1 to 401 days, with mean of 40.6 days. Long-bone fractures from motor vehicle accidents remained constant, and war injuries peaked in summer. Follow-up is limited because of security and financial burdens of travel. However, personal communication with Afghan National Police Hospital surgeons suggests that patients included in the current study have not experienced any adverse outcomes. While it remains to be seen if the SIGN Online Surgical Database will facilitate more comprehensive outcome studies, our results provide support for the efficacy of SIGN nails in treating long-bone fractures from war injuries. PMID:26741473

  19. Missile injuries of the anterior skull base.

    PubMed

    Bhatoe, Harjinder Singh

    2004-02-01

    Missile injuries of the anterior skull base usually occur during war or war-like situations. These injuries may be isolated or associated with multiple traumatic injuries. We report 23 such cases managed during military conflicts and peacekeeping operations. All were adult males. Four of these patients sustained bullet injuries; the rest were injured from shrapnel. Eighteen patients had injury to the visual apparatus with permanent blindness. Proptosis was seen in 16, cerebrospinal fluid (CSF) leak from the wound in seven, and CSF orbitorrhea in three patients. Sixteen had irreparable injury to the eye necessitating evisceration/enucleation, and two had retrobulbar optic nerve injury. Three patients were comatose [Glasgow Coma Scale (GCS) 3/15], and 14 had altered sensorium. Six patients were fully conscious. All were investigated by computed tomography (CT), which revealed injury to the eyeball and skull base, orbital fracture, frontal hematoma, contusion, and pneumocephalus. Seventeen patients underwent emergency surgery, and six patients were initially managed conservatively. Neurosurgical management consisted of making bifrontal flaps, craniotomy/craniectomy, debridement, and repair of the base with fascia lata. Reconstruction of the orbital rim was required in three cases. All were managed postoperatively with cerebral decongestants and antibiotics in anti-meningitic dosages. There was one death in the postoperative period; outcome was good in 16 and moderate in four patients. Twelve patients had retained intracranial splinters; three of these developed recurrent suppurative meningitis. Of the six patients initially managed conservatively, three were subsequently operated for CSF rhinorrhea. Gross communition, dural loss, and injury to the frontal scalp often preclude the use of pericranial repair of the skull base. Fascia lata is extremely useful for reconstruction and repair. Anterior cranial fossa injury probably carries a better prognosis; however, there

  20. Coalmining and the National Scheme for Disabled Ex-Servicemen after the First World War

    PubMed Central

    Mantin, Mike

    2016-01-01

    Abstract After the First World War, disabled British veterans returned home to an uncertain future of work. In addition to voluntary efforts, the government’s response to the national employment crisis – the National Scheme for Disabled Ex-Servicemen (commonly known as the King’s Roll) – was established in 1919 to encourage employers to hire a five per cent quota of disabled ex-servicemen. Historians have recently revisited the scheme, noting that in many cases the process was slow and fraught, with many disabled veterans facing the prospect of unemployment, yet few have paid attention to soldiers’ pre-war working backgrounds and the specific requests of British industries. This article focuses on British coalminers returning from war. What role was there in this national situation for an industry known for its own high rate of accident and injury? Although the King’s Roll made some attempt to find veterans specifically targeted jobs above and below ground according to their impairments, it proved unable to incorporate coalmining. Instead, many disabled ex-servicemen returned to the workplace and utilized their existing identities as miners to navigate the process. With the industry beginning to decline, many faced potential regression in job status, exploitation or unemployment. By shifting to an industry-specific focus, this case study explores the contested nature of work for disabled people after the First World War, and highlights the interrelation and importance of workplace identity for the returning disabled veteran. PMID:27134339

  1. Trends in incidence of pediatric injury hospitalizations in Pennsylvania.

    PubMed Central

    Durbin, D R; Schwarz, D F; Localio, A R; MacKenzie, E J

    2000-01-01

    OBJECTIVES: This study analyzed short-term trends in pediatric injury hospitalizations. METHODS: We used a population-based retrospective cohort design to study all children 15 years or younger who were admitted to all acute care hospitals in Pennsylvania with traumatic injuries between 1991 and 1995. RESULTS: Injuries accounted for 9% of all acute hospitalizations for children. Between 1991 and 1995, admissions of children with minor injuries decreased by 29% (P < .001). However, admissions for children with moderate (P = .69) or serious (P = .41) injuries did not change. CONCLUSIONS: Significant declines in pediatric admissions for minor injuries were noted and may reflect both real reductions in injury incidence and changes in admission practices over the period of the study. PMID:11076251

  2. DEFINING PATTERNS OF GENITAL INJURY FROM SEXUAL ASSAULT

    PubMed Central

    SOMMERS, MARILYN SAWYER

    2011-01-01

    The forensic examination following rape has two primary purposes: to provide health care and to collect evidence. Physical injuries need treatment so that they heal without adverse consequences. The pattern of injuries also has a forensic significance in that injuries are linked to the outcome of legal proceedings. This literature review investigates the variables related to genital injury prevalence and location that are reported in a series of retrospective reviews of medical records. The author builds the case that the prevalence and location of genital injury provide only a partial description of the nature of genital trauma associated with sexual assault and suggests a multidimensional definition of genital injury pattern. Several of the cited studies indicate that new avenues of investigation, such as refined measurement strategies for injury severity and skin color, may lead to advancements in health care, forensic, and criminal justice science. PMID:17596344

  3. Matricides in South Australia - a 20-year retrospective review.

    PubMed

    Wick, Regula; Mitchell, Elizabeth; Gilbert, John D; Byard, Roger W

    2008-04-01

    A 20-year retrospective review of files at Forensic Science SA, Adelaide, Australia was undertaken for cases of matricide occurring between the years 1985 and 2004. A total of 11 cases were identified: 10 males and 1 female. The victims were aged between 42 and 83 years (mean=61 years) and the perpetrators were aged between 15 and 53 years (mean=28.7 years). In all 11 cases weapons such as blunt objects (N=5), knives (N=5), firearms (N=3), or ligatures (N=1) were involved in the assaults, with injuries inflicted by the weapons causing death in 10 cases. In five cases trauma was caused by more than one injurious agent/action; e.g. there was evidence of immersion and burning in two cases. In four cases there were multiple (>10) significant injuries inflicted by perpetrators suffering from schizophrenia (N=2), 'mental impairment' (N=1) and a 'combination of psychiatric disorders' (N=1). One perpetrator committed suicide after killing his mother. Six of the ten surviving perpetrators were found not guilty of murder on the grounds of mental illness or impairment, and one perpetrator had the charge reduced from murder to manslaughter due to underlying mental conditions that included previous brain injury. Matricides are uncommon forms of homicide that have similar features in most communities studied. Intra-familial tensions with underlying psychiatric illness in the perpetrator are common findings. PMID:18313012

  4. Student attitudes toward the threat of nuclear war: Friends as influential reference persons

    SciTech Connect

    Marasch, M.J.

    1992-01-01

    A renewed interest in research into the psychology of the threat of nuclear war occurred in the past decade as national attention focused increasingly on the arms race between the US and the USSR. Some of this research began the task of exploring the social influences upon attitudes and responses to the nuclear threat. Research on friends as potential influences upon nuclear attitudes was minimal. The present study investigated the role of college friends as potential reference persons in the formation of nuclear attitudes. A battery of questionnaires addressing various nuclear war and non-nuclear war attitudes was completed by 200 student-friend dyads from introductory psychology and sociology courses at the University of North Dakota. Three hypotheses were presented in this study. One hypothesis was that students would perceive their friends as having similar attitudes toward the threat of nuclear war. A second hypothesis was that the actual attitudes between pairs of students and friends would be similar. The third hypothesis was that the attitudes would have become more similar over the course of the development of the friendship (as measured retrospectively). The first hypothesis was borne out by the data. The second and third hypotheses were not supported. There are several implications of the findings. One implication is that the nuclear issue may not be as salient to college students as other, more immediate, issues. Another implication is that a relative lack of communication between college students on political issues precludes more effective mutual influence upon the development and change of such attitudes. A false consensus bias appeared to be operative when the students perceived that their attitudes were similar. Further discussion is presented in regard to past and future psychological research upon nuclear war attitudes.

  5. Cold War Paradigms and the Post-Cold War High School History Curriculum.

    ERIC Educational Resources Information Center

    McAninch, Stuart A.

    1995-01-01

    Discusses how Cold War ideological models provide a way to examine the U.S. role in world affairs. Discusses and compares on the writings of Paul Gagnon and Noam Chomsky on this topic. Concludes that students should stand outside both models to develop a meaningful perspective on the U.S. role during the Cold War. (CFR)

  6. Researching the Viet Nam War inside Viet Nam: U.S. Student Teachers Explore War Myths

    ERIC Educational Resources Information Center

    Vadas, Robert E.

    2007-01-01

    The author asserts that it is time for social studies teachers to engage students in a review of the rift between historical reality and mythology about Viet Nam, especially in light of recent comparisons that many have made between the Viet Nam War and the current situation in Iraq. Few teachers dealt with Viet Nam at the time of the war, and…

  7. Dialectical Disorientation in Vietnam War Films: Subversion of the Mythology of War.

    ERIC Educational Resources Information Center

    Rasmussen, Karen; Downey, Sharon D.

    1991-01-01

    Examines the dynamics of "dialectical disorientation," a rhetorical form that creates ambiguity through confrontation between competitive but complementary orientations. Applies the form to the Vietnam War movies "The Deer Hunter,""Apocalypse Now,""Platoon," and "Full Metal Jacket." Observes that the films portray the war as destructive and…

  8. American military dentists as prisoners-of-war in the Pacific theatre during World War II.

    PubMed

    Bober-Moken, I G

    1994-03-01

    Fifty-three American Military dentists were held by the Japanese as Prisoners-of-War during World War II. Throughout 40 months of captivity these men served their fellow prisoners providing dental treatment in an austere environment with "jury-rigged" equipment and supplies. A brief overview of their experiences is presented in this paper. PMID:8061507

  9. Psychological Consequences of the World War II Prisoner of War Experience: Implications for Treatment.

    ERIC Educational Resources Information Center

    Engdahl, Brian E.

    The Former Prisoners of War Act (1981) mandated complete health examinations for all interested prisoners of war (POWs). This paper reports on examinations of more than two-thirds of the POWs in the Minneapolis Veterans Administration Medical Center catchment area under the established POW protocol and special psychiatric examinations. The…

  10. The War and Post-War Impact on the Educational System of Bosnia and Herzegovina

    ERIC Educational Resources Information Center

    Kreso, Adila Pasalic

    2008-01-01

    Bosnia and Herzegovina (BiH), much like other eastern-European countries, has faced a brief period of transition from the socialist system to capitalism. However, this was interrupted in BiH by a brutal war lasting four years. Social systems and infrastructure were damaged or destroyed, including education, which was harnessed during the war to…

  11. Suicidal behavior in war veterans.

    PubMed

    Rice, Timothy R; Sher, Leo

    2012-05-01

    Military veterans represent a unique, heterogeneous population with suicide prevalence rates, risk factors and preventative management needs that differ from those of the rest of community. Veterans worldwide receive high proportions of their healthcare from community providers, and sensitivity to these distinct needs is required for optimized care. An overview of the recent prevalence-study literature, with a focus upon statistical design, is presented in order to provide a critical orientation within this field with high levels of popular media attention. Attention to psychiatric comorbidity, subthreshold symptomology, select signature disorders of contemporary conflicts (namely, post-traumatic stress disorder and traumatic brain injury), and veteran life narratives before, within and beyond military service will guide our review of risk factor assessment and management strategies. This critical review of the literature provides an overview of this active field of neuropsychiatric research with a select focus upon these topics of special interest. PMID:22550989

  12. Cold injuries.

    PubMed

    Long, William B; Edlich, Richard F; Winters, Kathryne L; Britt, L D

    2005-01-01

    Exposure to cold can produce a variety of injuries that occur as a result of man's inability to adapt to cold. These injuries can be divided into localized injury to a body part, systemic hypothermia, or a combination of both. Body temperature may fall as a result of heat loss by radiation, evaporation, conduction, and convection. Hypothermia or systemic cold injury occurs when the core body temperature has decreased to 35 degrees C (95 degrees F) or less. The causes of hypothermia are either primary or secondary. Primary, or accidental, hypothermia occurs in healthy individuals inadequately clothed and exposed to severe cooling. In secondary hypothermia, another illness predisposes the individual to accidental hypothermia. Hypothermia affects multiple organs with symptoms of hypothermia that vary according to the severity of cold injury. The diagnosis of hypothermia is easy if the patient is a mountaineer who is stranded in cold weather. However, it may be more difficult in an elderly patient who has been exposed to a cold environment. In either case, the rectal temperature should be checked with a low-reading thermometer. The general principals of prehospital management are to (1) prevent further heat loss, (2) rewarm the body core temperature in advance of the shell, and (3) avoid precipitating ventricular fibrillation. There are two general techniques of rewarming--passive and active. The mechanisms of peripheral cold injury can be divided into phenomena that affect cells and extracellular fluids (direct effects) and those that disrupt the function of the organized tissue and the integrity of the circulation (indirect effects). Generally, no serious damage is seen until tissue freezing occurs. The mildest form of peripheral cold injury is frostnip. Chilblains represent a more severe form of cold injury than frostnip and occur after exposure to nonfreezing temperatures and damp conditions. Immersion (trench) foot, a disease of the sympathetic nerves and blood

  13. Factory floor injury in a Lagos sawmill.

    PubMed

    Bode, C O; Giwa, S O; Oke, D A

    2001-01-01

    We retrospectively reviewed injuries sustained in 36 consecutive accidents in a wood-processing factory and managed at a private hospital over a 2-year period in Lagos. The commonest injuries were lacerations by revolving saws, followed by crush injuries from entrapment by machines and from falling logs and planks. The upper limbs were involved in 24 (66%) of these accidents cases. Of 137 workers on the factory floor, the highest injury rate (64%) occurred among machine operators. While 80.6% of these injuries were simple ones treated by suturing and dressing, 7 (19.4%) were life-threatening enough to warrant hospitalisation and major surgery, with 6 sustaining a mean permanent disability of 7.1 +/- 6%. Although factory-floor injuries constituted only 6.5% of 553 hospital attendance recorded within the period from the company, they were responsible for 44.2% of total medical expenditure by the company within the same period. Non-use of protective gears and disregard for safety procedures were noted in most of the accidents. The in-house first-aid program was adjudged as life-saving in the few major cases managed. We concluded that while many factory-floor injuries in wood-processing factories may be minor hand injuries, provision and strict observance of safety protocols as well as an active first-aid program are invaluable to minimise morbidity, cost and loss of productive man-hours in wood processing factories. PMID:11885883

  14. Eye injuries in Canadian amateur hockey.

    PubMed

    Pashby, T J

    1979-01-01

    Two studies, one retrospective (1972 to 1973) and one prospective (1974 to 1975), CONcerning eye injuries incurred by hockey players were conducted by the Canadian Ophthalmological Society with questionnaires to its members. Responses to the questionnaires were analyzed by age, type of injury, cause (i.e., hockey stick, puck, or other means), and results to visual acuity. The results were also designated by organized or unorganized participation. Almost 300 eye injuries were reported in each study. In the first study, 13.7% of the injured players became legally blind as a result of the injury; in the second study, 16% became legally blind. Organized hockey produced more injuries than unorganized hockey. The majority of the injuries were caused by the hockey stick. The injuries were both intraocular and extraocular. The group of 11- to 15-year olds received the highest number of injuries, and the older age group had the higher incidence of blindness. Studies have led to setting more rigid standards, altering rules of the game, and selecting face protectors for hockey players. Older players who care for their equipment prefer the plastic shield face protectors, and the younger players (who complain of fogging and scratching of the plastic) prefer mesh protectors through which neither the stick nor the puck can penetrate. New high sticking (above the shoulder level) rules were included in the 1976 official rule book for Canadian amateur hockey. PMID:474867

  15. Neglected Thoraco Lumbar Traumatic Spine Injuries

    PubMed Central

    Khatri, Kavin; Sharma, Vijay; Gupta, Babita; Gamanagatti, Shivanand

    2016-01-01

    Study Design Retrospective study. Purpose To outline the etiology, complications and management difficulties encountered in the management of neglected thoracolumbar spine injuries. Overview of Literature The English literature describes overlooked diagnosis as the most common cause of neglected spine injuries. However, the reasons differ in developing or under-developed nations. Moreover, there is scarcity of literature about the neglected spinal injuries. Methods Patients presenting with thoracolumbar traumatic injuries who had not received any form of treatment for more than three weeks were included in the study. The demographic details, operative procedure performed and complications encountered, along with American Spinal Injury Association grade and spinal cord independence measure score recorded on the history sheets were noted. The data were analyzed. Results Forty patients were included in the study. Inadequate treatment at the first contact hospital (45%) followed by late presentation (38%) and missed injury (17%) were the major etiological factors for the neglected traumatic injuries in the thoracolumbar spine. The most common complications seen in the management of these cases were pressure sores (58%), back pain (57%), urinary tract infection (42%) and residual kyphotic deformity (42%). Conclusions Management of neglected thoracolumbar injuries is challenging. The delay in presentation should not prevent spine surgeon in proceeding with operative intervention as good results can be expected. PMID:27559447

  16. Retrospective

    NASA Astrophysics Data System (ADS)

    Brooks, David A.

    Charting a course toward an uncertain future is always a risky business, especially among shoals of fiscal restraint or national tragedy, and the prudent navigator is well advised to remember where he's been as he looks ahead. The ocean and space sciences are poised for grand joint adventures, but shrinking budgets and the lingering Challenger numbness are restrictive lee shores that must be considered when laying plans. To sharpen the focus on future choices, it may be helpful to glance in the geophysical rearview mirror and remember some of the challenges and opportunities of a different era.A quarter century is a long time, but many images from 25 years ago can still be recalled in crisp detail, like photographs in a scrapbook. In 1961, results from the International Geophysical Year (IGY) filled the pages of the Transactions of the American Geophysical Union, and the U.S. program of space exploration finally was underway with conviction. The Indian Ocean Expedition, conceived during the IGY, ushered in a new era of international oceanography. The TIROS III satellite beamed to earth fuzzy pictures of tropical storms and revealed the intricate writhings of the Gulf Stream. Forecasters and fluid dynamicists suddenly saw new horizons, and geophysical turbulence became a major topic at the IUGG Symposium in Marseilles, France. Papers with prescient themes were presented at the AGU Ocean Section meeting: June Pattullo (then at Oregon State College, Corvallis) on heat storage in the Pacific; Ferris Webster (then at Woods Hole Oceanographic Institution, Woods Hole, Mass.) on Gulf Stream meanders. Polar oceanography was well represented in AGU journals: Kenneth Hunkins (at what was then called the Lamont Geological Observatory, Palisades, N.Y.) described the Alpha Rise, discovered from a drifting Arctic ice island, and Edward Thiel (then at the University of Minnesota, Minneapolis) and his co-workers discussed open ocean tides, gravimetrically measured from Antarctic ice shelves.

  17. Retrospect

    ERIC Educational Resources Information Center

    Weaver, Anthony

    1971-01-01

    A collection of essays on education printed in The New Era during the 1920-1930 era and written by: Beatrice Ensor, A. S. Neill, G. Bernard Shaw, Adolphe Ferriere, C. G. Jung, Martin Buber, Alfred Adler, Harold Rugg, Ovide Decroly, and Paul Langevin. (SE)

  18. Pediatric hand treadmill injuries.

    PubMed

    Banever, Gregory T; Moriarty, Kevin P; Sachs, Barry F; Courtney, Richard A; Konefal, Stanley H; Barbeau, Lori

    2003-07-01

    The great popularity of physical fitness in modern society has brought many pieces of exercise equipment into our homes for convenience and privacy. This trend has come with an increasing rate of injuries to children who curiously touch moving parts, including treadmill belts. Experience with a recent series of treadmill contact burns to children's hands is described in this article. A retrospective chart review at a tertiary referral center from June 1998 until June 2001 found six children sustaining hand burns from treadmills. The patients' ages at presentation ranged from 15 to 45 months (average of 31 months, three boys and three girls). All injuries occurred in the home while a parent was using the treadmill. Burns involved the palmar aspect of the hand, mostly confined to the fingers, and the severity ranged from partialto full-thickness burns. All patients were initially managed with collagenase and bacitracin zinc/polymyxin B powder dressings to second- and third-degree burns, along with splinting and range-of-motion exercises. Two patients required skin grafting at 2 weeks and 2 months for full-thickness tissue loss and tight joint contracture, respectively. At an average follow-up of 12 months, all patients had full range of motion and no physical limitation. The rate of children injured by exercise equipment is expected to increase. Friction burns to the hands remain a concern, although early recognition and appropriate management are associated with excellent functional outcomes. Protective modification of exercise machines seems to be the best approach to eliminating these injuries. PMID:12867861

  19. Should blunt segmental vascular renal injuries be considered an AAST grade 4 renal injury?

    PubMed Central

    Malaeb, Bahaa; Figler, Brad; Wessells, Hunter; Voelzke, Bryan B.

    2013-01-01

    Background Renal segmental vascular injury (SVI) following blunt abdominal trauma is not part of the original AAST renal injury grading system. Recent recommendations support classifying SVI as an AAST grade 4 injury. Our primary aim was to compare outcomes following blunt renal SVI and blunt renal collecting system lacerations (CSL). We hypothesize that renal SVI fare well with conservative management alone and should be relegated a less severe renal AAST grade. Methods We retrospectively identified patients with SVI and G4 CSL admitted to a Level 1 trauma center between 2003–2010. Penetrating trauma was excluded. Need for surgical intervention, length of stay, kidney salvage (>25% renal preservation on renography 6–12 weeks after injury), and delayed complication rates were compared between the SVI and CSL injuries. Statistical analysis utilized chi squared, Fisher exact, and t-test. Results 56 patients with SVI and 88 patients with G4 CSL sustained blunt trauma. Age, injury severity score, and length of stay were similar for the two groups. Five patients in each group died of concomitant, non-renal injuries. In the G4 CSL group, 15 patients underwent major interventions and 32 patients underwent minor interventions. Only one patient in the SVI group underwent a major intervention. The renal salvage rate was 85.7% following SVI versus 62.5% following CSL (p=0.107). Conclusions Overall surgical interventions are significantly lower among the SVI cohort than G4 CSL cohort. Further analysis using a larger cohort of patients is recommended before revising the current renal grading system. Adding SVI as a grade 4 injury could potentially increase the heterogeneity of grade 4 injuries and decrease the ability of the AAST renal injury grading system to predict outcomes, such as nephrectomy rate. Level of Evidence IV (retrospective, cohort study) PMID:24458054

  20. Blast injury.

    PubMed

    de Candole, C A

    1967-01-28

    The shock wave generated by an explosion ("blast wave") may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742

  1. Blast Injury

    PubMed Central

    de Candole, C. A.

    1967-01-01

    The shock wave generated by an explosion (“blast wave”) may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742

  2. [Clinical implications of the "war against cancer"].

    PubMed

    Rojas Miranda, Daniela; Fernández González, Loreto

    2015-03-01

    This article discusses the origin and implications of the "war on cancer" metaphor. Commonly present in mass media, the "war on cancer" notion circulates also among patients, their loved ones, their support networks, and oncological multidisciplinary teams. In our view when cancer is uprooted of its illness status, and conceptualized as an "enemy", myths about disease and those who suffer it (especially the idea of psychogenesis) are strengthened. Two topics in which the war metaphor is particularly problematic in the clinical context, are analyzed in depth. The first one is the relationship between the oncologic patient and his or her loved ones and support networks. When patients are insistently prompted to fight the disease and think positive, the expression of emotions associated to the adaptive process of receiving a diagnosis of cancer may be inhibited. Secondly, the war metaphor promotes an authoritarian view among the health teams and on the physician-patient relationship, undermining the patent's autonomy in the decision-making process, which may affect his global quality of life. Also, it encourages emotional isolation, concealment of psychiatric symptoms and conspiracies of silence. It is concluded that public policies to avoid the "war on" notion are required. Instead, education of the general population about wrong beliefs about cancer should be encouraged. PMID:26005822

  3. Proportionality, just war theory and weapons innovation.

    PubMed

    Forge, John

    2009-03-01

    Just wars are supposed to be proportional responses to aggression: the costs of war must not greatly exceed the benefits. This proportionality principle raises a corresponding 'interpretation problem': what are the costs and benefits of war, how are they to be determined, and a 'measurement problem': how are costs and benefits to be balanced? And it raises a problem about scope: how far into the future do the states of affairs to be measured stretch? It is argued here that weapons innovation always introduces costs, and that these costs cannot be determined in advance of going to war. Three examples, the atomic bomb, the AK-47 and the ancient Greek catapult, are given as examples. It is therefore argued that the proportionality principle is inapplicable prospectively. Some replies to the argument are discussed and rejected. Some more general defences of the proportionality principle are considered and also rejected. Finally, the significance of the argument for Just War Theory as a whole is discussed. PMID:18802788

  4. French Neurologists during World War I.

    PubMed

    Walusinski, Olivier; Tatu, Laurent; Bogousslavsky, Julien

    2016-01-01

    The Great War accelerated the development of neurological knowledge. Many neurological signs and syndromes, as well as new nosological entities such as war psychoneuroses, were described during the conflict. The period between 1914 and 1918 was the first time in which many neurologists were concentrated in wartime neurology centres and confronted with a number of neurological patients never seen before. This concentration led to the publication of papers concerning all fields of neurological sciences, and these reports pervaded scientific journals during the conflict and the post-war years. The careers of French neurologists during the war were highly varied. Some were mobilised, whilst others enlisted voluntarily. They worked as regiment physicians at the front or in wartime neurology centres at the front or at the rear. Others were academics who were already authoritative names in the field of neurology. Whilst they were too old to be officially mobilised, they nevertheless worked in their militarised neurology departments of civil hospitals. We present here the careers of a few French neurologists during the Great War, including Charles Foix (1882-1927), René Cruchet (1875-1959), Georges Guillain (1876-1961), Jean Lhermitte (1877-1959), Clovis Vincent (1879-1947), Gustave Roussy (1874-1948), and Paul Sollier (1861-1933). PMID:27035726

  5. Physics in WWI: Fighting the Acoustic War

    NASA Astrophysics Data System (ADS)

    Kevles, Daniel

    2015-01-01

    World War I was the first high-technology war, and when the United States began to prepare for it in 1915 the federal government turned to the storied inventor Thomas Edison. Edison formed a board that included industrial executives and engineers but only one physicist, its members holding that they wanted people who would do things and not just talk about them. However, in 1916, the nation's scientists managed to create a place for themselves in the preparedness effort by organizing the National Research Council under the National Academy of Sciences. Once the United States went to war, in April 1917, the NRC brought academic and industrial physicists together in efforts to detect incoming aircraft, submerged submarines, and the location of long-range artillery. The efforts employed devices that relied in the main on the detection and identification of sound waves from these weapons. The devices were passive responders, but they were marked by increasing sophistication and enabled the United States and its allies to prosecute an acoustic war. That branch of the war was militarily effective, overshadowed the work of Edison's group, and gained physicists high standing among leaders in both the military and industry.

  6. Spinal Cord Injury Map

    MedlinePlus

    ... on the severity of the injury. Tap this spinal column to see how the level of injury affects loss of function and control. Learn more about spinal cord injuries. A spinal cord injury affects the ...

  7. Eye Injuries at Home

    MedlinePlus

    ... Patient Stories Español Eye Health / Tips & Prevention Eye Injuries Sections Preventing Eye Injuries Recognizing and Treating Eye ... Sports Eye Injuries by the Numbers — Infographic Eye Injuries at Home Reviewed by: Brenda Pagan-Duran MD ...

  8. Injury rates and injury risk factors among federal bureau of investigation new agent trainees

    PubMed Central

    2011-01-01

    Background A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training. Methods Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy. Results A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity. Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents. PMID:22166096

  9. Physical and Mental Health Costs of Traumatic War Experiences Among Civil War Veterans

    PubMed Central

    Pizarro, Judith; Silver, Roxane Cohen; Prause, JoAnn

    2006-01-01

    Context Hundreds of thousands of soldiers face exposure to combat during wars across the globe. The health impact of traumatic war experiences has not been adequately assessed across the lifetime of these veterans. Objective Identify the role of traumatic war experiences in predicting post-war nervous and physical disease and mortality using archival data from military and medical records of veterans from the Civil War. Design An archival examination of military and medical records of Civil War veterans was conducted. Degree of trauma experienced (POW experience, percentage of company killed, being wounded, early age at enlistment), signs of lifetime physician-diagnosed disease, and age at death were recorded. Setting and Participants US Pension board surgeons conducted standardized medical examinations of Civil War veterans over their post-war lifetimes. Military records of 17,700 Civil War veterans were matched to post-war medical records. Main Outcome Measures Signs of physician-diagnosed disease including cardiac, gastrointestinal (GI), and nervous disease, and number of unique ailments within each disease; mortality. Results Military trauma was related to signs of disease and mortality. Greater percentage of company killed was associated with signs of post-war cardiac and GI disease (IRR=1.34, p<.02), co-morbid nervous and physical disease (IRR=1.51, p<.005), and greater number of unique ailments within each disease (IRR=1.14, p<.01). Younger soldiers (≤18 years old), compared to older enlistees (> 30 years old), showed higher mortality risk (HR=1.52, p<.005), signs of co-morbid nervous and physical disease (IRR=1.93, p<.005), and a greater number of unique ailments within each disease (IRR=1.32, p<.005), controlling for length of time lived and other covariates. Conclusions Greater exposure to death of military comrades and younger exposure to war trauma was related to signs of physician-diagnosed cardiac, GI and nervous disease, and a greater number of

  10. Cross-border firing and injury patterns

    PubMed Central

    Gupta, Nital; Hackla, Shafiq; Bhagat, Virendar; Singh, Satvir; Hussain, Farid; Gupta, Anil

    2016-01-01

    Introduction: Cross-border firing are increasingly being common in the modern era. The injuries resulting from these low intensity conflicts are a source of anxiety among treating physicians and their respective governments. The provisions are required to minimise the suffering of the victims viz. Mode of injuries, mortality patterns, adequacy of treatment at pre-hospital and tertiary care hospital and provisions to decrease morbidity and mortality for the people living in these areas. Materials and Methods: A retrospective study was conducted in GMCH, Jammu who suffered injuries due to cross border firing in the month of October, 2014. 68 patients were reported in the causality wing. All the patients were referred from level 2 trauma centre. There were 51 males and 17 females out of which 5 were children. The cause of injury, involvement of organ system, cause of mortality and morbidity and loopholes in prehospital management were identified. Results: Sharpnel were the most common cause of injury followed by indirect trauma. The common cause of mortality was abdominal and thoracic injuries. There were 4 deaths at hospital 2 of which were brought dead and 2 died during the course of treatment. There were twenty patients with extremity injuries, fourteen with chest trauma, eleven with abdomen including parineal injuries, three with head injuries, eight with ENT injuries, three with eye injuries and nine with splinters in the back out of which two were in the spinal canal. Conclusion: Prehospital stabilisation, early transport, in-transit resuscitation, immediate surgery if required and implementation of triage model and ATLS protocol has been the key to reduce mortality and morbidity. PMID:26957821

  11. War and deforestation in Sierra Leone

    NASA Astrophysics Data System (ADS)

    Burgess, Robin; Miguel, Edward; Stanton, Charlotte

    2015-09-01

    The impact of armed conflict on the environment is of major public policy importance. We use a geographically disaggregated dataset of civil war violence together with satellite imagery of land cover to test whether war facilitated or prevented forest loss in Sierra Leone. The conflict data set allows us to establish where rebel groups were stationed and where battles and attacks occurred. The satellite data enables to us to monitor the change in forest cover (total, primary, and secondary) in all of Sierra Leone’s 151 chiefdoms, between 1990 (prior to the war) and 2000 (just prior to its end). The results suggest that conflict in Sierra Leone acted as a brake on local deforestation: conflict-ridden areas experienced significantly less forest loss relative to their more conflict-free counterparts.

  12. Nuclear war: the facts on our survival

    SciTech Connect

    Goodwin, P.

    1981-01-01

    Unless we reject the premise that a nuclear war can be waged rationally and one side can emerge victorious, a nuclear war could happen. Goodwin describes what will happen during and after a nuclear exchange. He describes the effects of heat and blast, and the effects and treatment of radiation exposure, then outlines simple protective steps individuals can take to improve their margin of safety. He describes a variety of civil defense and individual shelters that can be built, but questions how many will go to the necessary trouble. Photographs of Hiroshima and nuclear test sites illustrate the text. Public policy should focus first on sustaining deterrence and preventing war, according to Goodwin. 36 references, 40 figures, 4 tables. (DCK)

  13. Perceptions of conventional war: late adolescents' views.

    PubMed

    Stevenson, B W; Roscoe, B; Kennedy, D

    1988-01-01

    Late adolescents' views concerning conventional war were assessed in order to better understand the thinking of today's youth and to compare their views with those of early adolescents previously reported in the literature. Three hundred ninety-nine college undergraduates from two universities were surveyed regarding conventional warfare in general and United States military involvement in Latin America specifically. Results suggest that attitudes toward war were related to sex, socioeconomic status, and political affiliation. Although two-thirds of the respondents believed wars were sometimes needed, there was little support for United States military involvement in Latin America and much skepticism of President Reagan's honesty on the issue. Overall, late adolescents' views were less positive and less extreme than were those of early adolescents. PMID:3195377

  14. The Public Health Implications of Resource Wars

    PubMed Central

    Klare, Michael T.; Sidel, Victor W.

    2011-01-01

    Competition for resources between or within nations is likely to become an increasingly common cause of armed conflict. Competition for petroleum is especially likely to trigger armed conflict because petroleum is a highly valuable resource whose supply is destined to contract. Wars fought over petroleum and other resources can create public health concerns by causing morbidity and mortality, damaging societal infrastructure, diverting resources, uprooting people, and violating human rights. Public health workers and the organizations with which they are affiliated can help prevent resource wars and minimize their consequences by (1) promoting renewable energy and conservation, (2) documenting the impact of past and potential future resource wars, (3) protecting the human rights of affected noncombatant civilian populations during armed conflict, and (4) developing and advocating for policies that promote peaceful dispute resolution. PMID:21778501

  15. ACUTE LESION OF THE MOTOR BRANCH OF THE ULNAR NERVE IN THE WRIST AFTER TUG-OF-WAR TRAINING

    PubMed Central

    Seguti, Vladimir Ferreira; Bonavides, Aloísio Fernandes; Flores, Leandro Pretto; Ferreira, Lisiane Seguti

    2015-01-01

    Papers correlating clinical and electrophysiological findings relating to ulnar nerve lesions in the wrist are uncommon in the literature, if compared with elbow injuries. We present the case of a patient with atrophy of the intrinsic musculature of the hand, secondary to injury only of the motor branch of the ulnar nerve, which is located in Guyon's canal close to the hamate hook. We review the anatomical, clinical and neurophysiological aspects of distal ulnar nerve injuries and we emphasize the importance of multidisciplinary approaches. Specifically in relation to the mechanism of injury of this patient (tug-of-war), we did not find any similar cases in the literature. We issue an alert regarding the risks during military physical training. PMID:27047837

  16. Impact of World War I on Chemistry

    NASA Astrophysics Data System (ADS)

    Trimble, Virginia L.

    2015-01-01

    Mention chemistry and the Great "War to End all Wars" in the same sentence, and nearly everybody who ever had a history class will nod sorrowfully and say,"Yes, poison gases." True enough, and Fritz Haber, who led the development of them for the Central Powers, was the one German scientist whom Rutherford never forgave or spoke to again. Such substances (not all really gaseous, and something like 50 have been tried) were used by both sides from 1915 onward, killed about 90,000 people (about 1% of the total), maimed many more, and arguably loosened constraints on future uses of chemical weapons in other wars, prison camps, and terrorist actions. But the war was not determined by them and could have been fought without them. On the other hand, the sudden blockading of ports and termination of most international trade forced Germany (etc) to expand very quickly processes for fixing nitrogen for explosives and for fertilizers in lieu of Chilean guano (yes there is also a Haber process for that). They needed in addition to find domestic replacements for rubber (for tires, hoses, and gas masks) and liquid fuels for tanks and aircraft. The Allies, for their part, had been heavily dependent on German dyestuffs, optical-quality glass for binoculars, and phosphates (fertilizer again). Production facilities for derivatives of coal tars, cottonseed oil, etc. were of necessity scaled up rapidly. And once people have learned to do these things, there is no way to have them be forgotten. The same is, of course, true of the nuclear weapons of World War II and of whatever biological and/or cybernetic entities prove to be essential in the next war.

  17. Electrical Injuries

    MedlinePlus

    ... your injuries are depends on how strong the electric current was, what type of current it was, how it moved through your body, and how long you were exposed. Other factors include how ... you should see a doctor. You may have internal damage and not realize it.

  18. Inhalation Injuries

    MedlinePlus

    ... increase mortality 30% to 40% when patients with cutaneous burns and inhalation injury are compared with patients ... nasal hairs • Facial burns • Burns around the mouth • Mineral spirits – 104º F – paint thinner, brush cleaner. • Redness, ...

  19. The environmental effects of nuclear war

    SciTech Connect

    MacCracken, M.C.

    1988-09-01

    Substantial environmental disruption will significantly add to the disastrous consequences caused by the direct thermal, blast, and radiological effects brought on by a major nuclear war. Local fallout could cover several percent of the Northern Hemisphere with potentially lethal doses. Smoke from post-nuclear fires could darken the skies and induce temperature decreases of tens of degrees in continental interiors. Stratospheric ozone could be significantly reduced due to nitric oxide injections and smoke-induced circulation changes. The environmental effects spread the consequences of a nuclear war to the world population, adding to the potentially large disruptive effects a further reason to avoid such a catastrophe. 27 refs., 4 figs.

  20. "I Was My War; My War Was I": Vera Brittain, Autobiography and University Fiction during the Great War

    ERIC Educational Resources Information Center

    McClellan, Ann K.

    2016-01-01

    Applying the critical lenses of feminism, autographical theory and literary analysis, this essay performs a triple reading of Vera Brittain's multi-genre writings about gender, war,and university education. Focusing specifically on "The Dark Tide" (1923), "Testament of Youth" (1933) and "The Women of Oxford" (1960),…