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Sample records for war injuries retrospective

  1. Laryngeal war injuries.

    PubMed

    Danić, D; Milicić, D; Prgomet, D; Leović, D

    1995-01-01

    During the war in Croatia in the region of Brodska Posavina at the Medical Center in Slavonski Brod, 7,043 wounded were treated. The Otolaryngology and Oral Surgery Service treated 728 wounded, of whom 20 had laryngeal injuries. Most of the injuries were caused by shrapnel from shells, mines, and hand grenades. Nineteen wounded had associated injuries of the neck, head, and the neck and/or other parts of the body. The authors performed in 8 surgical explorations and immediate reconstruction with the median layer of the deep cervical fascia (MLDCF). Upon termination of the treatment, the nineteen wounded had good respiration without signs of stenosis of the larynx. Twelve had good phonation, five satisfactory phonation, and two bad. None had swallowing difficulties. Among the eight wounded on whom the reconstruction of the larynx was done with cervical fascia, four had very good phonation, three satisfactory, and the eight died on the sixth postoperative day because of associated injuries to the cervical spine. The cervical fascia proved itself to be a suitable material in the immediate reconstruction of exogenous war injuries of the larynx.

  2. War injuries of the extremities.

    PubMed

    Korzinek, K

    1993-05-01

    This paper describes experience acquired during the war against Croatia under improvised conditions at the Kutina War Hospital in the immediate vicinity of the first front lines. Over a period of almost 6 months a total of 701 soldiers and civilians, 546 of whom had been wounded by firearm missiles, were treated at the Kutina War Hospital, which has a capacity of 30-40 beds. As many as 87% of the injuries were due to mine, bomb or artillery shell shrapnel. The percentage of gunshot wounds was very low, mainly caused by sniper shots. Most patients (419, or 76.7%) were admitted with injuries to the extremities, including 893 severe soft tissue injuries and 182 fractures (32.3%). Soft tissue injuries were treated by routine procedures of war surgery, associated with ample use of Lavasept, an antiseptic solution (Fresenius, Stans, Switzerland), which has proved to be highly efficacious in preventing and decontaminating infection without disturbance of the wound healing process. Long bone fractures were fixed with the aid of external fixators of various designs, including the CMC external fixator of our own construction. External fixators have once again proved indispensable in the treatment of open fractures sustained in war settings. Amputations were performed in 10.4% of cases, including fingers and toes. Only 8 patients died during or immediately after surgery, corresponding to a very low mortality rate of 1.46%. The main prerequisites for successful treatment are a professional relationship to war surgery and its specific requirements, satisfactory technical equipment, and excellent organization of medical and non-medical services.

  3. War injuries of the talus.

    PubMed

    Davila, S; Mikulić, D

    2001-08-01

    Twenty-eight patients with war fractures of the talus were reviewed to determine the incidence of infection and late functional results. The average age of our patients was 37.5 years. Twenty-one injuries were explosive fractures that resulted from shell fragments or mines; seven fractures resulted from gunshot missiles. Seven patients had isolated talus injuries, whereas 21 patients had associated fractures of other bones of the foot or lower leg. All patients were initially treated with debridement, tetanus immunization, intravenous antibiotics, and stabilization, either with cast immobilization or an external fixator. Five days after injury, wound cultures were positive in 25 of 28 feet. Infection was eventually eradicated in all patients, allowing for soft tissue coverage. One patient eventually required a below-knee amputation. The patients were reviewed for functional outcome at 36 to 60 months after injury. Most patients reported a certain degree of residual complaints. The overall result can be considered excellent in only one patient.

  4. 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

  5. Assessment of war and accidental nerve injuries in children.

    PubMed

    Barisić, N; Perović, D; Mitrović, Z; Jurenić, D; Zagar, M

    1999-07-01

    Eleven children with war-related peripheral nerve injury and 16 children with accident-related nerve injury between the ages of 3 and 15 years were assessed clinically and electromyoneurographically for 1-15 months. Lesions of 32 peripheral nerves were registered in children with war injuries. Children with accidentally acquired injuries had lesions of 27 peripheral nerves. A complete loss of voluntary motor unit potentials and signs of total axonal damage were recorded in the upper arms of seven of 11 children with war injuries and in five of 16 children with accidental injuries. There was a diminished number of motor unit potentials and a reduction in compound muscle action potential amplitudes, indicating partial nerve lesions, in 11 of 16 children with accidental injuries (mostly after humeral fracture) and in three of 11 children with brachial plexus war injuries. Reinnervation signs first occurred after 5-9 months (mean = 6.2 months) in war-injured children receiving conservative treatment and after 2-7 months (mean = 3.4 months) in children with accidentally acquired injuries. War-related peripheral nerve injuries in children are more frequently associated with complete denervation followed by slower or delayed nerve regeneration. In children with accidentally acquired nerve injuries the course is significantly better.

  6. Extremity War Injuries VIII: sequelae of combat injuries.

    PubMed

    Andersen, Romney C; D'Alleyrand, Jean-Claude G; Swiontkowski, Marc F; Ficke, James R

    2014-01-01

    The 2013 Extremity War Injury symposium focused on the sequelae of combat-related injuries, including posttraumatic osteoarthritis, amputations, and infections. Much remains to be learned about posttraumatic arthritis, and there are few circumstances in which a definitive arthroplasty should be performed in an acutely injured and open joint. Although the last decade has seen tremendous advances in the treatment of combat upper extremity injuries, many questions remain unanswered, and continued research focusing on improving reconstruction of large segmental defects remains critical. Discussion of infection centered on the need for novel methods to reduce the bacterial load following the initial débridement procedures. Novel methods of delivering antimicrobial therapy and anti-inflammatory medications directly to the wound were discussed as well as the need for near real-time assessment of bacterial and fungal burden and further means of prevention and treatment of biofilm formation and the importance of animal models to test therapies discussed. Moderators and lecturers of focus groups noted the continuing need for improved prehospital care in the management of junctional injuries, identified optimal strategies for both surgical repair and/or reconstruction of the ligaments in multiligamentous injuries, and noted the need to mitigate bone mineral density loss following amputation and/or limb salvage as well as the necessity of developing better methods of anticipating and managing heterotopic ossification.

  7. Late sequelae of retained foreign bodies after world war II missile injuries.

    PubMed

    Surov, Alexey; Thermann, Florian; Behrmann, Curd; Spielmann, Rolf-Peter; Kornhuber, Malte

    2012-09-01

    A number of people injured during the second world war harbour foreign bodies such as grenade splinters or bullets in some part of the body. Most of these metal fragments remain clinically silent. Some of them, however, may cause delayed complications. The purpose of this study was to determine the characteristics of delayed complications associated with foreign bodies after world war II injuries. 159 patients with retained foreign bodies after world war II injuries were retrospectively identified radiologically in our data bases in the time interval from 1997 to 2009. Diverse delayed complications secondary to the metal objects were diagnosed in 3 cases (2%): one patient with grenade splinter migration into the choledochal duct, one case with pseudotumoural tissue reaction, and one patient with late osteomyelitis. The time from injury to clinical presentation varied from 56 to 61 years. PubMed and Medline were screened for additional cases with delayed sequelae after foreign body acquisition during the 2nd world war. A 30 year search period from 1980 up to date was selected. 15 cases were identified here. Our study demonstrates that health consequences of the 2nd world war extend into the present time, and therefore physicians should be aware of the presence of hidden foreign bodies and their different possible late reactions.

  8. 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

  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. Frontoethmoidal fractures as a result of war injuries.

    PubMed

    Ivanović, A; Jović, N; Vukelić-Marković, S

    1996-03-01

    Ninety frontoethmoidal fractures, as a result of war injuries from 1991 to 1994, produced 0.7% of all war injuries (i.e., 9% of head and neck injuries treated in the Military Medical Academy, Belgrade). These injuries were mainly part of complex endocranial, orbital, and zygomaticomaxillary injuries, and were rarely isolated. The central part of these injuries were in the ethmoidal region, which was isolatedly injured in 23.3% of the cases. There was 53.3% injuries with small fragments of explosive devices inside the wound, and 16.7% of through-and-through wounds were caused by sniper bullets. The priority over all definitive operative procedures belonged to osteoplasties whenever possible, because the primary goal was protection of life. About 3.3% of the patients died because of severe hemorrhagic shock and endocranial injury. There was only one case of recurrent meningitis. Most of the patients had multiple injuries and were mutually operated on by two different surgical teams.

  11. [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.

  12. Extremity War Injuries IX: Reducing Disability Within the Military.

    PubMed

    Andersen, Col Romney C; Schmidt, Andrew H; Fitzgerald, Capt Brian T; Tintle, Lcdr Scott M; Helgeson, Maj Melvin D; Lehman, Ltc Ronald A; Davila, Col Jeffrey N; Potter, Benjamin K; Burns, Maj Travis C; Swiontkowski, Marc F; Ficke, Col James R

    2015-08-01

    Extremity War Injury Symposium IX focused on reducing disability within the military, centering on cartilage defects, amputations, and spinal cord injury. Many areas of upper and lower extremity trauma and disability were discussed, including segmental nerve injuries, upper extremity allotransplantation, and the importance of patient-reported functional outcomes compared with the traditionally reported measures. Strategic planning addressed progression toward clinical solutions by setting clear objectives and goals and outlining pathways to address the "translation gap" that often prevents bridging of basic science to clinical application.

  13. 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.

  14. 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.

  15. 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)

  16. Cardiovascular and thoracic battle injuries in the Lebanon War. Analysis of 3,000 personal cases.

    PubMed

    Zakharia, A T

    1985-05-01

    This report comprises 3,000 casualties of the Lebanon War whom I operated upon for cardiovascular-thoracic injuries in twelve Lebanese hospitals between January, 1969, and July, 1982. These patients were studied retrospectively through 1978 and prospectively thereafter. The logistics, weapons, wounds, and operative results in this study were unique. The patients' injuries can be categorized as follows: primarily thoracic, 1,251 (42%); peripheral vascular, 1,008 (34%); cardiac, 285 (9%); and thoracic mixed, 456 (15%). The male to female ratio was 3.6:1, the mean age 20 years, and the military to civilian ratio 1.7:1. The mean transport distance was 2 miles in 1,740 patients (58%). In patients with thoracic wounds, the incidence of cardiac involvement (14%) was higher than in World War II and Vietnam. The overall survival rate in casualties with cardiac injuries was 73%--best in pericardial, coronary, and right atrial wounds and dropping to 46% in left ventricular wounds, wherein pump failure was also a factor. A 13% (seven deaths) mortality for patients with injuries to the thoracic great vessels contrasted with the 1.2% (14 deaths) mortality for the rest of the patients with noncardiac thoracic wounds. Open thoracotomy in 818 operations (55%) reflected massive wounds and logistics. Pulmonary resection (310 operations) carried a 1.9% (five deaths) mortality and tube thoracostomy (683 operations) for lesser injuries, 0.7% (four deaths.) Thoracoabdominal injuries were 1.5 times more lethal. Fifty percent (504) of nonthoracic vascular wounds occurred in the femoral-popliteal area as a result of sniper attacks. Subintimal damage averaged 8 cm and mandated saphenous vein grafts in 72%. The mortality for injury to the aorta was 60% (12 deaths), contrasted with 1% (three deaths) for injury to extremity vessels. Hemorrhage and cardiac rupture were the most frequent causes of death. Early, proficient, open surgical control after or concomitant with intensive resuscitation

  17. [Reconstructive procedures in war injuries of the larynx and trachea].

    PubMed

    Zelený, M; Voldrich, Z; Kozák, J; Sobota, J

    1990-08-01

    In recent years the authors operated three casualties from non-European battlefields with severe laryngotracheal stenoses due to war injuries. Median laryngotomy (thyrocricotracheotomy) made a revision and modification of the internal injury possible. An implanted tube from a vascular prosthesis, packed in Hydron kept the replaced cartilaginous cross bar and possibly mucous grafts from a gingivobuccal fold in the correct position. A cross bar made from a cartilaginous or bony portion of a rib also dilated the lumen. It was kept in position by the perichondrium of the cartilaginous cross bar sutured to the margin of the mucosal remnants. All three patients were decannulated. PMID:2289240

  18. 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

  19. [Types of abdominal war injuries in relation to colonic injuries analyzed during 2 war years of treatment at the Clinic for Abdominal Surgery in Sarajevo].

    PubMed

    Tanović, Haris

    2003-01-01

    The basic characteristics of war in Sarajevo are occasional shelling, sniper fire, unexpected shelling and a lack of a front line in the classic sense of the word. The extent of the wound is the key factor in deciding how the patient is to be treated. A primary contamination of this kind of wound has all the conditions to turn into a manifest infection. The abdomen wounds, because of their severity and direct threat to life, are among the most dangerous wounds altogether. They make up on average 10% of all war wounds and the mortality of these patients by today's literature is high, about 6%. The aims of this paper are to show which organs in the abdomen are wounded and what is their relationship to the wounding of the colon, and to show what is the relation between multiple and isolated wounding of the abdomen. During the years 1992 and 1993, 1106 patients with war wounds were treated at the clinic for the abdominal surgery. From that number 71 patients were treated with explorative laparotomy. The large intestine was injured in 274 patients while 221 patients had injuries of the small intestine. An injury of the liver was found in 165 cases. The gall bladder was injured in 18 cases. The stomach was injured in 324 patients. The pancreas was damaged in 72 patients. There were 94 cases of injured spleens. The kidneys were wounded in 30 cases. In 40 cases there was bleeding from the retroperitoncum. Treatment of the omentumen was carried out in 753 patients. The number of patients who did not survive is 135 of which 44 had an injury of the large intestine. A retrospective analysis data shows that the number of multiple wounds makes up over 98% of all wounds. Isolated wounds of abdominal organs are found in less than 2% of all cases. The increase mortality in our research can be explained greater energy of the projectiles which amplify the acceleration at asphalt surfaces which product the greater destructions of the tissue and the massiveness of the injuries.

  20. Cerebrospinal fluid fistula as a consequence of war head injury.

    PubMed

    Melada, Ante; Marcikić, Marcel; Mrak, Goran; Stimac, Dinko; Sćap, Miroslav

    2002-08-01

    Cerebrospinal fluid (CSF) fistula as a consequence of brain missile injury and following infectious complications has been recognized for years. Different methods of treatment have been advocated. Missiles used in war cause extensive destruction of the skull and brain as a result of their high kinetic energy. On its transfer through the skull, such high kinetic energy causes fractures called "discontinuous fractures," which are distant from the entry wound and not related to the fracture of the vault. The role of the timely diagnosis of CSF fistulas and their early repair in the management of these wounds is emphasized. Data on 312 patients with missile injuries of the brain inflicted during the war in Croatia were retrieved and analyzed, with special reference to the complications of CSF fistulas and infection. Forty-five patients developed CSF fistula, 15 (33%) of them at the wound site, 23 (51%) as CSF rhinorrhea, and seven (15%) as CSF otorrhea. Six patients developed infectious complications. The presented strategy and operative approach resulted in a low incidence of infectious complications in the study series.

  1. 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

  2. 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.

  3. 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

  4. 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

  5. Standard wound coverage techniques for extremity war injury.

    PubMed

    Kumar, Anand R

    2006-01-01

    Reconstruction of extremity war injuries begins with aggressive forward resuscitative care and stabilization of the trauma patient. After serial care in progressively better supported medical environments, definitive management is done at the level V military treatment facility. Aggressive forward care coupled with rapid air transport has enabled increasingly complex care to be administered at the continental United States military facilities; however, it has also made the decision between limb salvage and amputation more challenging. Yet to be determined are (1) the optimal timing of definitive wound closure or coverage in coordination with fracture stabilization and (2) the optimal types of flap for both upper and lower extremity reconstruction. Records of patients with complex lower and upper extremity wounds who were treated at the National Naval Medical Center between September 2004 and June 2006 reveal useful short-term data. Longer-term data, such as fracture union rate, time to ambulation, range of motion and global function of salvaged limbs, patient satisfaction with limb salvage, and average cost, are not yet available.

  6. 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

  7. 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…

  8. Lessons of War: Combat-related Injury Infections during the Vietnam War and Operation Iraqi and Enduring Freedom

    PubMed Central

    Blyth, Dana M.; Yun, Heather C.; Tribble, David R.; Murray, Clinton K.

    2015-01-01

    Summary In over a decade of war, numerous advancements have been made to improve overall combat-related mortality, but infectious complications remain a leading cause of both morbidity and mortality in combat-related injured personnel. Here we will attempt to compare the challenges and lessons of combat-related injuries and infections from the Vietnam War with those of OIF/OEF. Throughout the Vietnam War and OIF/OEF, there have been similar infection-related challenges faced in caring for combat-related trauma patients. Both conflicts reinforced the importance of rapid medical evacuation and definitive surgical management of war wounds. They revealed the constant evolution of infecting organisms and the challenge of increasing antimicrobial resistance. We have also seen that with decreased mortality of severely injured personnel new morbidities must be addressed. Using the foundation of fragmented research from the Vietnam War, previously successful models were assembled into joint service research institutions which have allowed these questions to be addressed. However, many questions regarding measures to reduce infectious complications in our combat-injured personnel remain unanswered. Continued research building on established knowledge is critical for continued improvements in the care of combat-related trauma patients. PMID:26406435

  9. 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.

  10. 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

  11. Burn injury and prevention in the Lebanon War, 1982.

    PubMed

    Shafir, R; Nili, E; Kedem, R

    1984-04-01

    Measures taken during the Lebanon War, 1982, to prevent and minimize the extent and severity of tank-crew combat burns proved to be of value. Since 98% of tank crewmen who were burned were wearing fireproof suits at the time, only 12% sustained abdominal burns; 77% had facial burns, as none of them were wearing fireproof masks. Only 9% of the burned soldiers who wore fireproof gloves sustained hand burns, compared with 75% who did not wear the gloves. A comparison of the extent of tank-crew burns in the Lebanon War and the October 1973 War revealed that 51% of the burns in 1982 were minor, compared with 21% in 1973. Of the burns sustained in 1973, 29% covered greater than 40% of the body surface area, compared with 18% in 1982.

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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

  17. Reconstruction of laryngotracheal war injuries with the median layer of the deep cervical fascia.

    PubMed

    Danić, D; Milicić, D; Prgomet, D; Simovíc, S

    1995-02-01

    Surgical exploration and immediate reconstruction with the median layer of the deep cervical fascia (MLDCF) was performed in 8 of 22 patients with exogenous war injuries of larynx and cervical trachea. A surgical technique of reconstruction with the median layer of the deep cervical fascia is described. The 7 surviving patients had good respiration without signs of stenosis of the larynx and/or the trachea. Four had good and 3 satisfactory, phonation, and none had swallowing difficulties. Owing to the simplicity of the surgical approach, its size and biological properties, the median layer of deep cervical fascia proved itself to be a suitable material in the immediate reconstruction of exogenerous war injuries of the larynx and cervical trachea.

  18. 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.

  19. 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.

  20. 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

  1. Epidemiology of injuries in elite taekwondo athletes: two Olympic periods cross-sectional retrospective study

    PubMed Central

    Altarriba-Bartes, Albert; Drobnic, Franchek; Til, Lluís; Malliaropoulos, Nikolaos; Montoro, José Bruno; Irurtia, Alfredo

    2014-01-01

    Objective Taekwondo injuries differ according to the characteristics of the athletes and the competition. This analytical cross-sectional retrospective cohort study aimed to describe reported taekwondo injuries and to determine the prevalence, characteristics and possible risk factors for injuries sustained by athletes of the Spanish national team. In addition, we compared each identified risk factor—age, weight category, annual quarter, injury timing and competition difficulty level—with its relation to injury location and type. Settings Injury occurrences in taekwondo athletes of the Spanish national team during two Olympic periods at the High Performance Centre in Barcelona were analysed. Participants 48 taekwondo athletes (22 male, 26 female; age range 15–31 years) were studied; 1678 injury episodes occurred. Inclusion criteria were: (1) having trained with the national taekwondo group for a minimum of one sports season; (2) being a member of the Spanish national team. Results Independently of sex or Olympic period, the anatomical sites with most injury episodes were knee (21.3%), foot (17.0%), ankle (12.2%), thigh (11.4%) and lower leg (8.8%). Contusions (29.3%) and cartilage (17.6%) and joint (15.7%) injuries were the prevalent types of injury. Chronological age, weight category and annual quarter can be considered risk factors for sustaining injuries in male and female elite taekwondists according to their location and type (p≤0.001). Conclusions This study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies and recommendations to reduce the number of injuries in taekwondo competition. PMID:24531455

  2. 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.

  3. 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

  4. Methamphetamine-associated burn injuries: a retrospective analysis.

    PubMed

    Danks, Roy R; Wibbenmeyer, Lucy A; Faucher, Lee D; Sihler, Kristen C; Kealey, G Patrick; Chang, Phyllis; Amelon, Marge; Lewis, Robert W

    2004-01-01

    Methamphetamine production and use has increased dramatically during the past 10 years. Methamphetamine production requires combining hazardous and volatile chemicals that expose the manufacturer to burn injuries from explosions and chemical spills. We sought to review the epidemiology of burn injuries in a rural burn center secondary to the use of amphetamine or methamphetamine and/or the manufacture of methamphetamine. Review of the records of 507 patients who were admitted to our burn unit from December 1, 1998, to December 31, 2001, revealed 34 patients who were involved in the use of amphetamines or methamphetamines and/or the manufacture of methamphetamine. Thirty-one patients tested positive for either amphetamine (n = 2) or methamphetamine (n = 29) on routine admission urine drug screens. Twenty of these patients were involved in the manufacture of methamphetamines. Three additional patients were identified as methamphetamine manufacturers but tested negative for the use of methamphetamines. The mean age of the study population was 31.88 +/- 7.65 years, with a male:female ratio of 10.3:1. The average burn size was 18.86 +/- 20.72, with the majority secondary to flame (n = 26). Patient burn admission histories were vague, and the patient's involvement in the manufacture of methamphetamine was often only later confirmed by media, the fire marshal, family members, or the patient. Fifteen patients showed the usual withdrawal pattern of agitation and hypersomnolence, with seven patients requiring detoxification with benzodiazepines. Two were admitted acutely to the psychiatric ward for uncontrollable agitation. Eighteen patients were offered chemical dependency treatment, and two completed therapy. There was one mortality. The mean cost per person was US 77,580 dollars (range, US 112 dollars - US 426,386 dollars). The increasing use of and manufacture of methamphetamine presents new challenges for the burn team because these patients can become violent and

  5. 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

  6. 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.

  7. 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

  8. 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

  9. Nursing care of service members with head injury during the Vietnam war.

    PubMed

    Yost, Terri L

    2012-06-01

    The purpose of this article was to describe and analyze the nursing management of head-injured soldiers by military nurses serving in the Vietnam War. This study used traditional historical methods and a military history framework. Primary sources included original military reports, letters, and policies from the Vietnam War period (located in the archives of the Army Medical Department, Office of Medical History in Falls Church, VA); journal articles of the time period; and autobiographical texts. Secondary sources consisted of biographical and historical texts and Web sites of historical societies. Findings supported that advances in medicine, nursing, and technology throughout the 1960s have an overall positive impact on patient care in a combat zone. The Vietnam War was a time when new theories in the management of head injuries led directly to overall improvements in survival. In conclusion, nurses were professionally and emotionally challenged on a near daily basis but were able to directly apply new nursing science in a combat environment to help improve survivability for those who may not have previously survived off the battlefield.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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

  16. Retrospective Cohort Analysis of Chest Injury Characteristics and Concurrent Injuries in Patients Admitted to Hospital in the Wenchuan and Lushan Earthquakes in Sichuan, China

    PubMed Central

    Yuan, Yong; Zhao, Yong-Fan

    2014-01-01

    Background The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. Methods We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. Results The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. Conclusions Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries. PMID

  17. Penetrating heart wounds repaired without cardiopulmonary bypass. Evaluation and follow-up of recent war injuries.

    PubMed Central

    Catipović-Veselica, K; Sincić, V; Durijanĕk, J; Kozmar, D; Burić, D; Juranić, B; Kristek, J; Amidzić, V

    1993-01-01

    Penetrating cardiac injuries requires urgent management. Between September 1991 and June 1992, 10 patients with penetrating cardiac injuries sustained in war were treated at our hospital in Croatia, which does not have cardiopulmonary bypass facilities. Seven of these patients survived cardiorrhaphy and were discharged from the hospital, subject to follow-up. In 5 of the survivors, the injuries were inflicted by fragments from explosive devices; in 1 survivor, by a bullet; and in 1 survivor, by a rib fragment. The left ventricle was lacerated in 4 patients, the right ventricle in 2, the left atrium in 1, and the right atrium in 2. One patient had sustained laceration of the left anterior descending coronary artery in addition to a left ventricular laceration. During early post-cardiorrhaphy evaluation, all patients showed ST segment changes on electrocardiography. The most common echocardiographic findings were pericardial effusion in 5 patients (71%) and intramyocardial foreign bodies in 3 patients (43%). After 5 to 10 months of follow-up, the most common echocardiographic findings were enlargement of the injured chamber in 6 patients (86%), intramyocardial foreign bodies in 3 patients (43%), and hypokinesis of the injured wall in 2 patients (29%). Resting electrocardiographic results and exercise testing results were normal in all patients. One patient had arrhythmias during 24-hour Holter monitoring. Patients surviving operation had a rapid recovery, and were asymptomatic when last seen at follow-up. This demonstrates that treatment of penetrating injuries of the heart can be very successful, at least in the short term, even in hospitals without cardiopulmonary bypass facilities. Images PMID:8334372

  18. 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

  19. A retrospective survey on injuries in Croatian football/soccer referees

    PubMed Central

    2013-01-01

    Background Injury among soccer referees is rarely studied, especially with regard to differences in the quality level of the refereeing. Additionally, we have found no study that has reported injury occurrence during official physical fitness testing for soccer referees. The aim of this study was to investigate the frequency, type and consequences of match-related and fitness-testing related injuries among soccer referees of different competitive levels. Methods We studied 342 soccer referees (all males; mean age 32.9 ± 5.02 years). The study was retrospective, and a self-administered questionnaire was used. In the first phase of the study, the questionnaire was tested for its reliability and applicability. The questionnaire included morphological/anthropometric data, refereeing variables, and musculoskeletal disorders together with the consequences. Results The sample comprised 157 main referees (MR; mean age 31.4 ± 4.9 years) and 185 assistant referees (AR; mean age 34.1 ± 5.1 years) divided into: international level (Union of European Football Associations-UEFA) referees (N = 18; 6 MRs; 12 ARs) ; 1st (N = 78; 31 MRs; 47 ARs), 2nd (N = 91; 45 MRs; 46 ARs); or 3rd national level referees (N = 155; 75 MRs; 80 ARs). In total, 29% (95%CI: 0.23–0.37) of the MRs and 30% (95%CI: 0.22–0.36) of the ARs had experienced an injury during the previous year, while 13% (95%CI: 0.05–0.14) of the MRs, and 19% (95%CI: 0.14–0.25) of the ARs suffered from an injury that occurred during fitness testing. There was an obvious increase in injury severity as the refereeing advanced at the national level, but the UEFA referees were the least injured of all referees. The results showed a relatively high prevalence of injuries to the upper leg (i.e., quadriceps and hamstrings) during physical fitness testing for all but the UEFA referees. During game refereeing, the ankles and lower legs were the most commonly injured regions. The MRs primarily

  20. 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.

  1. 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

  2. Multiple injuries after earthquakes: a retrospective analysis on 1,871 injured patients from the 2008 Wenchuan earthquake

    PubMed Central

    2012-01-01

    Introduction Multiple injuries have been highlighted as an important clinical dimension of the injury profile following earthquakes, but studies are scarce. We investigated the pattern and combination of injuries among patients with two injuries following the 2008 Wenchuan earthquake. We also described the general injury profile, causes of injury and socio-demographic characteristics of the injured patients. Methods A retrospective hospital-based analysis of 1,871 earthquake injured patients, totaling 3,177 injuries, admitted between 12 and 31 May 2008 to the People's Hospital of Deyang city (PHDC). An electronic, webserver-based database with International Classification of Diseases (ICD)-10-based classification of earthquake-related injury diagnoses (IDs), anatomical sites and additional background variables of the inpatients was used. We analyzed this dataset for injury profile and number of injuries per patient. We then included all patients (856) with two injuries for more in-depth analysis. Possible spatial anatomical associations were determined a priori. Cross-tabulation and more complex frequency matrices for combination analyses were used to investigate the injury profile. Results Out of the 1,871 injured patients, 810 (43.3%) presented with a single injury. The rest had multiple injuries; 856 (45.8%) had two, 169 (9.0%) patients had three, 32 (1.7%) presented with four injuries, while only 4 (0.2%) were diagnosed with five injuries. The injury diagnoses of patients presenting with two-injuries showed important anatomical intra-site or neighboring clustering, which explained 49.1% of the combinations. For fractures, the result was even more marked as spatial clustering explained 57.9% of the association pattern. The most frequent combination of IDs was a double-fracture, affecting 20.7% of the two-injury patients (n = 177). Another 108 patients (12.6%) presented with fractures associated with crush injury and organ-soft tissue injury. Of the 3

  3. Injuries and allegations of oral rape: A retrospective review of patients presenting to a London sexual assault referral centre.

    PubMed

    Brew-Graves, Emmeline; Morgan, Louise

    2015-08-01

    A retrospective review was carried out of patients seen at the Haven sexual assault referral centre in South East London between January 2009 and September 2010 to determine the frequency and nature of oral injuries found in people reporting oral rape. Ninety five eligible patients were identified and relevant information was extracted from standardised Haven forms completed during forensic medical examination. The main outcome measures were prevalence, type and location of oral injury. Eighteen (19%) were found to have sustained an oral injury. The most common injury was abrasions, followed by bruising and petechiae. The lips were the most common site of injury followed by the soft palate and the inside of the cheeks. It was concluded that injuries in the mouth were not common after an allegation of oral rape. Injuries were minor and did not require treatment.

  4. 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

  5. Radial nerve injury associated with humeral shaft fracture: a retrospective study

    PubMed Central

    Ricci, Flávia Pessoni Faleiros Macêdo; Barbosa, Rafael Inácio; Elui, Valéria Meirelles Carril; Barbieri, Cláudio Henrique; Mazzer, Nilton; Fonseca, Marisa de Cássia Registro

    2015-01-01

    Objective: To determine the profile of patients with humeral diaphyseal fractures in a tertiary hospital. Methods: We conducted a survey from January 2010 to July 2012, including data from patients classified under humeral diaphyseal fracture (S42.3) according to the International Classification of Diseases (ICD-10). The variables analyzed were: age, gender, presence of radial nerve injury, causal agent and the type of treatment carried out. Results: The main causes of trauma were car accidents. The radial nerve lesion was present in some cases and was caused by the same trauma that caused the fracture or iatrogenic injury. Most of these fractures occurred in the middle third of humeral diaphysis and was treated conservatively. Conclusion: The profile of patients with fracture of humeral shaft, in this specific sample, was composed mainly of adult men involved in traffic accidents; the associated radial nerve lesion was present in most of these fractures and its cause was strongly related to the trauma mechanism. Level of Evidence II, Retrospective Study. PMID:26327789

  6. Military cold injury during the war in the Falkland Islands 1982: an evaluation of possible risk factors.

    PubMed

    Craig, R P

    1984-06-01

    Throughout the history of war, there have been many instances when the cold has ravaged armies more effectively than their enemies. Delineated risk factors are restricted to negro origins, previous cod injury, moderate but not heavy cigarette smoking and the possession of blood group O. No attention has been directed to the possibility that abnormal blood constituents could feasibly predispose to the development of local cold injury. This study considers this possibility and investigates the potential contribution of certain components of the circulating blood which might do so. Three groups of soldiers from two of the battalions who served during the war in the Falkland Islands in 1982 were investigated. The risk factors which were sought included the presence or absence of asymptomatic cryoglobulinaemia, abnormal total protein, albumin, individual gamma globulin or complement C3 or C4 levels, plasma hyperviscosity or evidence of chronic alcoholism manifesting as high haemoglobin, PCV, RBC, MCV or gamma glutamyl transpeptidase (GGT). No cases of cryoglobulinaemia were isolated and there was no haematological evidence to suggest that any of those men who had developed cold injury, one year before this study was performed, had abnormal circulating proteins, plasma hyperviscosity or indicators of alcohol abuse. Individual blood groups were not incriminated as a predisposing factor although the small numbers of negroes in this series fared badly. Although this investigation has excluded a range of potential risk factors which could contribute to the development of cold injury, the problem persists.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. 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

  8. 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.

  9. 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

    2015-08-31

    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.

  10. 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

  11. 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

  12. 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

  13. 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.

  14. 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

  15. Sixty-four-slice CT angiography to determine the three dimensional relationships of vascular and soft tissue wounds in lower extremity war time injuries.

    PubMed

    Smith, Jennifer M; Fox, Charles J; Brazaitis, Michael P; Via, Kathy; Garcia, Roman; Feuerstein, Irwin M

    2010-01-01

    This article analyzes the use and benefits of the 64-slice CT scanner in determining the 3D relationships of vascular and soft tissue wounds in lower extremity war time injuries. A brief overview of CT scanning is given as well as the techniques used to produce the images needed for diagnosis. The series follows two similar cases of war time injury patients at the Walter Reed Army Medical Center. The first case is a 30-year-old active duty male, who presented with multiple trauma from a motor vehicle accident because of an improvised explosive device (IED) blast, sustaining substantial lower extremity injuries. The second case is a 34-year-old active duty male, who presented with multiple trauma blast injuries. Both cases were of interest because the vasculature was found to be very close to the surface of the wound, which put the arteries at risk for rupture and for iatrogenic injury during repeated debridements.

  16. Magnitude of pedestrian head injuries & fatalities in Bangalore, south India: A retrospective study from an apex neurotrauma center

    PubMed Central

    Pruthi, Nupur; Ashok, M.; Shiva, Kumar V.; Jhavar, Ketaki; Sampath, S.; Devi, B. Indira

    2012-01-01

    Background & objectives: Pedestrians contribute to 30-40 per cent of all road traffic injuries in India. However, there is a paucity of literature on pedestrian head injury as compared to two wheeler trauma. The purpose of the present study was to study the pattern of pedestrian injuries and their outcome with a special focus on head injuries. Methods: The study was conducted in two parts in the Trauma Center at National Institute of Mental Health & Neuro Sciences, Bangalore. A retrospective study was conducted at the casualty services of the hospital in which 529 consecutive pedestrians who sustained injury in a road traffic accident were studied from June to September 2009. In the second part, records from the hospital mortuary were retrospectively analyzed from 2007 to 2009. An analysis of 326 patients who died as a pedestrian in road accidents during this period was performed. Results: Patients in both paediatric and elderly age groups constituted 47.6 per cent (252/529) of all casualty admissions. Majority of the pedestrian injuries (41.7%, 221/529) occurred between 1600 - 2100 h; 87.1 per cent of all patients received some primary care before admission. The most common offending vehicle was a two wheeler (49.1%, 260/529). At the time of admission, 55.2 per cent (292/529) patients had sustained a moderate or severe head injury (GCS 3-13), and 40.5 per cent (214/529) had an abnormal CT scan. In addition, 90.4 per cent (478/529) patients had also sustained associated injuries. Major thoracoabdominal trauma was seen in 4 per cent and spine injury in 2.3 per cent of the patients. The mortality rate was 6.6 per cent. In the postmortem group, pedestrian deaths constituted 26.2 per cent of all the postmortems conducted. Two wheelers were the offending vehicle in the majority of the fatal crashes (39.9%). Interpretation & conclusions: Pedestrian injuries form a major part of the workload of a neurotrauma emergency. Majority of them sustained moderate to severe head

  17. Military cold injury during the war in the Falkland Islands 1982: an evaluation of possible risk factors.

    PubMed

    Craig, R P

    2007-01-01

    Throughout the history of war, there have been many instances when the cold has ravaged armies more effectively than their enemies. Delineated risk factors are restricted to negro origins, previous cold injury, moderate but not heavy smoking and the possession of blood group O. No attention has been directed to the possibility that abnormal blood constituents could feasibly predispose to the development of local cold injury. This study considers this possibility and investigates the potential contribution of certain components of the circulating blood which might do so. Three groups of soldiers from two of the battalions who served during the war in the Falklands Islands in 1982 were investigated. The risk factors which were sought included the presence or absence of asymptomatic cryoglobulinaemia, abnormal total protein, albumin, individual gamma globulin or complement C3 or C4 levels, plasma hyperviscosity or evidence of chronic alcoholism manifesting as high haemoglobin, PCV, RBC, MCV or gamma glutamyl transpeptidase (GGT). No cases of cryoglobulinaemia were isolated and there was no haematological evidence to suggest that any of those men who had developed cold injury, one year before this study was performed, had abnormal circulating proteins, plasma hyperviscosity or indicators of alcohol abuse. Individual blood groups were not incriminated as a predisposing factor although the small numbers of negroes in this series fared badly. Although this investigation has excluded a range of potential risk factors which could contribute to the development of cold injury, the problem persists. Two areas of further study are needed: the first involves research into the production of better protective clothing in the form of effective cold weather boots and gloves and the second requires the delineation of those dietary and ethnic factors which allow certain communities to adapt successfully to the cold. A review of the literature in this latter area is presented.

  18. 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

  19. 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

  20. 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.

  1. A retrospective study on traumatic dental and soft-tissue injuries in preschool children in Zagreb, Croatia.

    PubMed

    Vuletić, Marko; Škaričić, Josip; Batinjan, Goran; Trampuš, Zdenko; Čuković Bagić, Ivana; Jurić, Hrvoje

    2014-02-01

    The purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, time elapsed before treatment and type of tooth from the records of traumatized children. A retrospective study was conducted in the Department of Paediatric Dentistry at the University Dental Clinic in Zagreb, Croatia using the documentation of 128 patients (61 males and 67 females) aged 1 month to 6 years with injuries of primary teeth between February 2009 and January 2013. Trauma was seen in 217 primary teeth, which implies that the number of injured primary teeth was 1.69 per child. The maxillary central incisors were the most frequently affected teeth (81.1%), they were followed by maxillary lateral incisors, while the least affected were mandibular central incisors. Traumatic dental injuries involved periodontal tissue 2.82 times more frequently than hard dental and pulp tissue. The main cause of teeth injury was fall (67.2%) and the majority of injuries occurred at home (51.6%) (p<0.05). Of 128 patients who received treatment 71 (55.5%) also had soft-tissue injuries. The distribution of soft-tissue injuries by gender (35 males, 36 females) was not statistically significant. Comparing children with soft-tissue injuries and those without them, a statistically significant difference was found in the time of arrival (p<0.01). The results of this study showed the need of informing about preventive measures against falls at home and the methods of providing first aid in dental trauma injuries.

  2. Management of the bladder in traumatic injuries of the spinal cord during the First World War and its implications for the current practice of urology.

    PubMed

    Silver, John R

    2011-08-01

    What's known on the subject? and What does the study add? Prior to the First World War, traumatic injuries to the spinal cord rapidly led to death from severe infections of the bladder. During the Second World War, Ludwig Guttmann resurrected the use of intermittent catheterisation at Stoke Mandeville Hospital, by meticulous attention to detail and was so successful, that this method was introduced into general urological practice. Historical review of the management of the bladder in patients with spinal injuries. Spinal injury patients--literature review--personal experience at Stoke Mandeville Hospital. Review of the different methods of catheterisation from the 19th century to today. Methods learned from the management of the bladder of spinal injuries patients were adopted into mainstream urology.

  3. 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.

  4. 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…

  5. 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

  6. Ocular diseases and nonbattle injuries seen at a tertiary care medical center during the Global War on Terrorism.

    PubMed

    Psolka, Maximilian; Bower, Kraig S; Brooks, Dain B; Donnelly, Steven J; Iglesias, Melissa; Rimm, William R; Ward, Thomas P

    2007-05-01

    We retrospectively reviewed the records of 107 U.S. military personnel referred to the Walter Reed Army Medical Center ophthalmology service with eye diseases and nonbattle injuries diagnosed during Operation Enduring Freedom and Operation Iraqi Freedom. Ocular diseases and nonbattle injuries ranged from minor to vision-threatening, represented a broad variety of conditions, and required the expertise of a number of ophthalmic subspecialists. The most common diagnoses were uveitis (13.1%), retinal detachment (11.2%), infectious keratitis (4.7%), and choroidal neovascularization (4.7%). Eighty-four patients (78.5%) met Army retention standards and were returned to duty. Twenty patients (18.7%) were referred to a medical evaluation board, seven (6.5%) of whom failed to meet retention standards for eye and vision; the retention status of three patients (2.8%) remains to be determined.

  7. 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

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. 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

  13. The pattern of homicidal slash/chop injuries: a 10 year retrospective study in University Hospital Kuala Lumpur.

    PubMed

    Ong, B B

    1999-03-01

    Homicides as a result of slash/chop injuries are not commonly reported in forensic literature. A 10 year retrospective study from 1987 to 1996 was performed on the pattern of homicidal slash/chop injuries in University Hospital, Kuala Lumpur. A total of 37 cases were analysed. The ages ranged from 17 to 85 years. The victims consisted of Indonesian (37.8%), Chinese (27.0%), Indian (24.3%) and Malay (8.1%) ethnic groups; 2.7% of the cases were not identified. Most of the cases were due to intentional violence (n = 27), while the rest consisted of domestic violence (n = 2), robbery (n = 2), psychiatric homicide (n = 1), accident (n = 2) and unclassified (n = 3). In the intentional violence group, the majority of the victims (n = 16) had more than five wounds. In contrast, the victims in other categories had less than five wounds each, with the exception of a single case in the psychiatric-homicide group. In homicide victims with a single wound, the most common site of injury was the neck. In those with multiple wounds, the common sites were the head and neck. Sixteen cases showed defence injuries, all of them belonging to the intentional-violence group. The reasons for the high incidence of homicidal slash/chop wounds are discussed, as well as the difficulties associated with interpretation of such wounds.

  14. Burden of musculoskeletal disease and nonbattle nontraumatic injury in both war and disaster zones.

    PubMed

    Waterman, Brian R; Schoenfeld, Andrew J; Holland, Courtney A; Goodman, Gens P; Belmont, Philip J

    2011-01-01

    Disasters, both man-made and natural, are a known cause of morbidity and mortality among vulnerable populations. The initial phase of public health response typically addresses immediate traumatic injury or death in the wake of a disaster. However, little is known about the magnitude and cost of subsequent nontraumatic injury and illness in disaster zones. Known as ``the hidden epidemic,'' the incidence and epidemiology of disease and nonbattle injuries among military service members in deployed settings has been more extensively investigated and may serve as a proxy for the evaluation of civilian populations following natural disaster. Further, prior reports from the military setting may serve to inform the broader population on the ultimate burden of nontraumatic injury and illness in recent disasters, particularly as they relate to musculoskeletal health.

  15. Work-related burn injuries in Ontario, Canada: A follow-up 10-year retrospective study.

    PubMed

    Clouatre, Elsa; Gomez, Manuel; Banfield, Joanne M; Jeschke, Marc G

    2013-09-01

    Work-related burn injuries contribute to a quarter of all burns in the USA. In 2009, the provincial Workplace Safety and Insurance Board reported 64,824 work-related injuries that resulted in time lost, 1188 injuries (2%) were a result of burns. There were two previous studies performed at a regional burn centre (1984-1990 and 1998-2000) that examined incidence and characteristics of work-related burns. There was no significant change between these two groups. The purpose of this study was to identify the recent pattern of work-related burns from 2001 to 2010 and to compare it to the previous studies. During the study period, 1427 patients were admitted for an acute injury to the regional burn centre. Of these, 330 were due to a work-related incident (23%). The mean age of patients was 40.5±11.9 years, 95% were male. The mean total body surface area burn was 11.9±16.2%. The most common mechanism of injury was flame (32.7%) followed by electrical (27%) and scald (19.7%), inhalation injury was present in 4.8% of patients and the mortality was 1.8%. Our study shows a significant decrease in the incidence in work-related burns treated at the regional burn centre (23.1% vs. 28.2% vs. 30.2%, p<0.01), flame burns have now become the leading cause of injury, there was a significant reduction in inhalation injury (4.8% vs. 23% vs. 14.8%, p<0.00001), and mortality over time (1.8% vs. 4% vs. 6.7% p=0.02). These findings strongly suggest a change in the cause of work-related burns, improvement in burn care, and that prevention strategies may have been more effective.

  16. 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

  17. 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

  18. 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%).

  19. 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

  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. 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.

  2. 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.

  3. 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.

  4. 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

  5. Injury of the mammillothalamic tract in patients with subarachnoid haemorrhage: a retrospective diffusion tensor imaging study

    PubMed Central

    Jang, Sung Ho; Choi, Byung Yeon; Kim, Seong Ho; Chang, Chul Hoon; Jung, Young Jin; Kwon, Hyeok Gyu

    2014-01-01

    Objective Few studies have reported on injury of the mammillothalamic tract (MTT) in patients with stroke. However, no study in patients with subarachnoid haemorrhage (SAH) has been reported. Using diffusion tensor tractography, we attempted to investigate injury of the MTT in patients with SAH. Methods We recruited 16 patients with SAH and 15 control participants. DTI was obtained at 5.7±1.5 weeks after onset and reconstruction of the MTT was performed using the probabilistic tractography method. The fractional anisotropy (FA) value and tract number of the MTT and the Mini-Mental State Examination (MMSE) score were determined. Values of FA and tract volume showing a decrement of more than two SDs that of normal control were defined as abnormal. Results The FA value and tract volume in the patient group were significantly lower than those in the control group (p<0.05). In addition, MMSE showed strong (r=0.67, p=0.005) positive correlation with tract volume without correlation with FA. In the individual analysis, 16 MTTs of 32 MTTs in 16 patients showed abnormalities of the MTT in terms of the FA value, the tract volume or the presence of a reconstructed MTT. As a result, 10 (62.5%) of 16 patients showed abnormality of the MTT in at least one hemisphere. Conclusions We found that patients with SAH showed injury of the MTT and this injury showed correlation with cognitive dysfunction. PMID:25052176

  6. Fatal firearm injuries in autopsy cases at central Bangkok, Thailand: a 10-year retrospective study.

    PubMed

    Myint, Sithu; Rerkamnuaychoke, Budsaba; Peonim, Vichan; Riengrojpitak, Suda; Worasuwannarak, Wisarn

    2014-11-01

    Even though there have been previously published reports on firearm injuries in various countries, the incidence and pattern of death from firearm injuries in Thailand have not been studied before. In present study, 149 fatal firearm injuries from 2002 to 2011 were reviewed. At total of 7126 autopsies, fatal firearm injuries comprised of 2.09% (n = 149) of total autopsies cases. Among those victims, 136 were male (91.3%), 13 (8.7%) were female. The youngest age of victim was 10 years and the oldest was 79 years. Mean age of the victims was 33.79 years and median age was 30 years. Outdoor incident was the most common scene of crime. Night time incident (18:00 PM-05:59 AM) was higher than day time one. Most of the cases occurred in week ends (n = 52). Homicide (77.2%) was the most frequent manner of death. Head/face and chest were the most common sites of entrance. The autopsy report also study on entrance wound, range and types of projectiles. Blood alcohol concentration was examined in 122 cases and 38 victims showed positive results, 11 cases revealed using of illegal substances in blood and urine analysis. This study also included the association between manner of death and other factors. Age group, time of incidence, place of incidence, number of entrance wound and range showed statistically significant association with manner of death.

  7. Fatal firearm injuries in autopsy cases at central Bangkok, Thailand: a 10-year retrospective study.

    PubMed

    Myint, Sithu; Rerkamnuaychoke, Budsaba; Peonim, Vichan; Riengrojpitak, Suda; Worasuwannarak, Wisarn

    2014-11-01

    Even though there have been previously published reports on firearm injuries in various countries, the incidence and pattern of death from firearm injuries in Thailand have not been studied before. In present study, 149 fatal firearm injuries from 2002 to 2011 were reviewed. At total of 7126 autopsies, fatal firearm injuries comprised of 2.09% (n = 149) of total autopsies cases. Among those victims, 136 were male (91.3%), 13 (8.7%) were female. The youngest age of victim was 10 years and the oldest was 79 years. Mean age of the victims was 33.79 years and median age was 30 years. Outdoor incident was the most common scene of crime. Night time incident (18:00 PM-05:59 AM) was higher than day time one. Most of the cases occurred in week ends (n = 52). Homicide (77.2%) was the most frequent manner of death. Head/face and chest were the most common sites of entrance. The autopsy report also study on entrance wound, range and types of projectiles. Blood alcohol concentration was examined in 122 cases and 38 victims showed positive results, 11 cases revealed using of illegal substances in blood and urine analysis. This study also included the association between manner of death and other factors. Age group, time of incidence, place of incidence, number of entrance wound and range showed statistically significant association with manner of death. PMID:25440139

  8. 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

  9. 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

  10. Retrospective study of 1000 deaths from injury in England and Wales

    PubMed Central

    Anderson, I D; Woodford, M; de Dombal, F T; Irving, Miles

    1988-01-01

    One thousand consecutive deaths from injury in 11 coroner's districts in England and Wales were reviewed by four independent assessors, who studied necropsy reports to identify deaths in hospital that might have been preventable. Of 514 patients admitted to hospital alive, 102 deaths (20%) were judged by all four assessors to have been potentially preventable. When those cases in which three out of four assessors considered that the death was preventable were added the total rose to 170 (33%). Nearly two thirds of all non-central nervous system deaths were judged to have been preventable. The median age of the 170 patients whose deaths were preventable was 41, and the mean Injury Severity Score was 29. Further analysis suggested that the preventable deaths were principally the result of failure to stop bleeding and prevent hypoxia and the absence of, or delay in, surgical treatment. The results closely parallel those from similar studies from the United States and suggest that there are serious deficiencies in the services for managing severe injury in England and Wales. Debate is needed now on how to correct these deficiencies. In particular, the place of trauma centres must be considered. PMID:3133060

  11. Resilience, Traumatic Brain Injury, Depression and Posttraumatic Stress among Iraq/Afghanistan War Veterans

    PubMed Central

    Elliott, Timothy R.; Hsiao, Yu-Yu; Kimbrel, Nathan A.; Meyer, Eric; DeBeer, Bryann B.; Gulliver, Suzy Bird; Kwok, Oi-Man; Morissette, Sandra B.

    2016-01-01

    Objective We examined the prospective influence of the resilient, undercontrolled, and overcontrolled personality prototypes on depression and posttraumatic stress disorder (PTSD) symptoms among Iraq/Afghanistan war veterans. After accounting for the possible influence of combat exposure, we expected that the resilient prototype would predict lower depression and PTSD over time and would be associated with adaptive coping strategies, higher social support, lower psychological inflexibility, and higher self-reported resilience relative to the overcontrolled and undercontrolled prototypes, independent of TBI status. Method One-hundred twenty-seven veterans (107 men, 20 women; average age = 37) participated in the study. Personality was assessed at baseline, and PTSD and depression symptoms were assessed eight months later. Path analysis was used to test the direct and indirect effects of personality on distress. Results No direct effects were observed from personality to distress. The resilient prototype did have significant indirect effects on PTSD and depression through its beneficial effects on social support, coping and psychological inflexibility. TBI also had direct effects on PTSD. Conclusions A resilient personality prototype appears to influence veteran adjustment through its positive associations with greater social support and psychological flexibility, and lower use of avoidant coping. Low social support, avoidant coping and psychological inflexibility are related to overcontrolled and undercontrolled personality prototypes, and these behaviors seem to characterize veterans who experience problems with depression and PTSD over time. A positive TBI status is directly and prospectively associated with PTSD symptomology independent of personality prototype. Implications for clinical interventions and future research are discussed. PMID:26214528

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. British dental surgery and the First World War: the treatment of facial and jaw injuries from the battlefield to the home front.

    PubMed

    Hussey, K D

    2014-11-01

    When Britain went to war in 1914, the British Expeditionary Force was deployed without a single dentist. Initially considered combatants, the only dental professionals who could serve at the Front were medically qualified dental surgeons in the Royal Army Medical Corps. In treating the traumatic facial and jaw injuries caused by trench warfare, the dental surgeons of this era earned their place on specialist surgical teams and established the principles of oral and maxillofacial surgery. This article will examine the contribution of specialist dental surgeons to the management of facial and jaw wounds in the First World War along the chain of evacuation from the battlefield to the home front, using illustrative examples from the Hunterian Museum at the Royal College of Surgeons of England.

  17. Effects of non contact low-frequency ultrasound on healing of suspected deep tissue injury: a retrospective analysis.

    PubMed

    Honaker, Jeremy S; Forston, Michael R; Davis, Emily A; Wiesner, Michelle M; Morgan, Jennifer A

    2013-02-01

    The purpose of this study was to assess the effectiveness of non contact low-frequency ultrasound on the healing of suspected deep tissue injury (SDTI). Participants were adults ranging in age from 28 to 93 years old, with multiple diagnoses including anaemia, diabetes mellitus and hypertension. Data were examined retrospectively on 85 patients (intervention group = 43 and non intervention group = 42) with 127 SDTI (intervention group = 64 and non intervention group = 63). Participants in both groups received standard of care for treating pressure ulcers. A severity score was used to assess SDTI severity before treatment and healing/progression after treatment. This scale measures surface area, wound colour/tissue assessment, and skin integrity with potential scores of 3 to 18 (higher scores indicate greater severity). A significant difference in changes in wound severity was found (t = 5·67, P < 0.000). Difference in mean change scores was 2·52 on the 3-18 severity scale. The decrease in wound severity for the intervention group was 1·45. Severity in the non intervention group increased by 1·06. This exploratory study of the effect of the non contact low-frequency ultrasound provides initial findings that support its use with SDTI.

  18. 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

  19. Injuries caused by antipersonnel mines in Croatian Army soldiers on the East Slavonia front during the 1991-1992 war in Croatia.

    PubMed

    Soldo, S; Puntarić, D; Petrovicki, Z; Prgomet, D

    1999-02-01

    During the war in Croatia, antipersonnel mines were mostly laid without plan by both sides, with no minefield layout, especially on the East Slavonia front. A group of Croatian disabled war veterans wounded by antipersonnel mines at the East Slavonia front from June 1, 1991, to September 1, 1992, were analyzed. The front line between the Croatian Army units and Serbian paramilitary units mostly ran along a lowland, partially swampy and wooded ground, convenient for large-scale laying of antipersonnel mines, especially so-called surprise mines. Fifty-seven soldiers suffered injuries caused by antipersonnel mines, 27 (47.4%) of them by pressure-activated mines and 30 (52.6%) by pull-action mines. The severity of wounds was assessed according to the Abbreviated Injury Scale (AIS). In the group of patients with wounds inflicted by pressure-activated mines, the mean AIS score was 4.0 +/- 0.7, with injuries to the lower extremities (mostly feet) ranging from foot-mutilating defects to partial lower-leg amputation. In the group of patients with injuries caused by pull-action mines, the mean AIS score was 3.0 +/- 0.9, indicating relatively minor injuries of different types according to the mechanism of wounding and localization. A failure to comply with minelaying regulations made protection impossible and resulted in a relatively high proportion of the wounded. The same problems are now encountered on mine removal. According to estimates, at least 10 years of intensive work of 2,000 to 3,000 trained experts will be required to clear some 2 million mines laid all over the area.

  20. 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.

  1. 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

  2. Does Helicobacter pylori Exacerbate Gastric Mucosal Injury in Users of Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control Study

    PubMed Central

    Kono, Yoshiyasu; Okada, Hiroyuki; Takenaka, Ryuta; Miura, Ko; Kanzaki, Hiromitsu; Hori, Keisuke; Kita, Masahide; Tsuzuki, Takao; Kawano, Seiji; Kawahara, Yoshiro; Yamamoto, Kazuhide

    2016-01-01

    Background/Aims The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori remains controversial. We retrospectively investigated whether H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users. Methods From January 2010 to December 2013, a total of 245 long-term NSAID (including low-dose aspirin) users who had undergone an esophagogastroduodenoscopy and had been evaluated for H. pylori infection were enrolled at Okayama University Hospital and Tsuyama Chuo Hospital. The degree of gastric mucosal injury was assessed according to the modified Lanza score (MLS). Severe gastric mucosal injury was defined as an MLS ≥4. Univariate and multivariate logistic regression analyses were performed. Results In the univariate analysis, age ≥75 years (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3 to 4.2), H. pylori-positivity (OR, 2.0; 95% CI, 1.2 to 3.5), and the concomitant use of proton pump inhibitors (PPIs) (OR, 0.48; 95% CI, 0.26 to 0.86) were significantly associated with severe gastric mucosal injury. The multivariate analysis was adjusted by age and sex and demonstrated that H. pylori-positivity (OR, 1.8; 95% CI, 1.0 to 3.3) and the concomitant use of PPIs (OR, 0.53; 95% CI, 0.28 to 0.99) significantly contributed to severe gastric mucosal injury. Conclusions H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users. PMID:26087789

  3. The Republic of Mexico and the United States of America: The Mexican-American War -- In Retrospect. Fulbright-Hays Summer Seminar Abroad 1996 (Mexico).

    ERIC Educational Resources Information Center

    Juarez, Pablo Hill

    The unit is intended as part of a world cultures curriculum taught at the 10th grade level. The lessons include: (1) "Mexico in Brief"; (2) "The Mexican American War 1846-1848"; and (3) "History and Educational Status of Americans of Mexican Descent (Chicanos) in the Southwest." Additional resources and a 32-item bibliography accompany the unit.…

  4. 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)

  5. 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

  6. 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

  7. 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

  8. Alcohol consumption and interpersonal injury in a pediatric oral and maxillofacial trauma population: a retrospective review of 1,192 trauma patients.

    PubMed

    McAllister, Peter; Laverick, Sean; Makubate, Boikanyo; Jones, David Carl

    2015-06-01

    The social, financial, and health implications of adult alcohol-related oral and maxillofacial trauma have been recognized for several years. Affordability and widespread accessibility of alcohol and issues of misuse in the pediatric trauma population have fostered concerns alcohol may be similarly implicated in young patients with orofacial trauma. The aim of this study was to review data of pediatric facial injuries at a regional maxillofacial unit, assess the prevalence of alcohol use, and review data of patients sustaining injury secondary to interpersonal violence. This study is a retrospective, 3-year review of a Regional Maxillofacial Unit (RMU) trauma database. Inclusion criterion was consecutive facial trauma patients under 16 years of age, referred to RMU for further assessment and/or management. Alcohol use and injuries sustained were reviewed. Of 1,192 pediatric facial trauma patients, 35 (2.9%) were associated with alcohol intake. A total of 145 (12.2%) alleged assault as the mechanism of injury, with older (12-15 years) (n = 129; 88.9%), male (n = 124; 85.5%) (p < 0.001) patients commonly involved and alcohol use implicated in 26 (17.9%) presentations. A proportion of vulnerable adolescents misuse alcohol to the risk of traumatic facial injury, and prospective research to accurately determine any role of alcohol in the pediatric trauma population is essential.

  9. Can pre-season fitness measures predict time to injury in varsity athletes?: a retrospective case control study

    PubMed Central

    2012-01-01

    Background The ability to determine athletic performance in varsity athletes using preseason measures has been established. The ability of pre-season performance measures and athlete’s exposure to predict the incidence of injuries is unclear. Thus our purpose was to determine the ability of pre-season measures of athletic performance to predict time to injury in varsity athletes. Methods Male and female varsity athletes competing in basketball, volleyball and ice hockey participated in this study. The main outcome measures were injury prevalence, time to injury (based on calculated exposure) and pre-season fitness measures as predictors of time to injury. Fitness measures were Apley’s range of motion, push-up, curl-ups, vertical jump, modified Illinois agility, and sit-and-reach. Cox regression models were used to identify which baseline fitness measures were predictors of time to injury. Results Seventy-six percent of the athletes reported 1 or more injuries. Mean times to initial injury were significantly different for females and males (40.6% and 66.1% of the total season (p < 0.05), respectively). A significant univariate correlation was observed between push-up performance and time to injury (Pearson’s r = 0.332, p < 0.01). No preseason fitness measure impacted the hazard of injury. Regardless of sport, female athletes had significantly shorter time to injury than males (Hazard Ratio = 2.2, p < 0.01). Athletes playing volleyball had significantly shorter time to injury (Hazard Ratio = 4.2, p < 0.01) compared to those playing hockey or basketball. Conclusions When accounting for exposure, gender, sport and fitness measures, prediction of time to injury was influenced most heavily by gender and sport. PMID:22824555

  10. The Risk of Suicide according to Drug Abuse and Nicotine Dependence in Patients with War Injuries and Chronic Traumatic Stress Disorder

    PubMed Central

    Ghaffari Nejad, Alireza; Kheradmand, Ali; Mirzaiee, Mahdieh

    2011-01-01

    Background The incidence of suicide is higher in individuals with post-traumatic stress disorder (PTSD) than the general population. This prevalence rate is related to many factors including drug dependence. This study was conducted in people wounded during the Iran-Iraq war with PTSD, in order to compare the risk of suicide in those with and without drug and nicotine dependence. Methods This cross-sectional study, conducted in 2007-2008, comprised 104 male individuals who had participated in the Iran-Iraq war and had a current diagnosis of PTSD. They had been referred to a psychiatry hospital and the psychiatrists' offices in Kerman, Iran. Three questionnaires were used including Davidson Trauma Scale, California Risk Estimator for Suicide and the Fagerstrom Test for Nicotine Dependence to assess the severity of PTSD, the risk of suicide, and nicotine dependence, respectively. Data were analyzed by descriptive and analytical statistics using chi-square, regression, analysis of variance (ANOVA), student-t and correlation tests. Findings The severity of PTSD was significantly different in individuals with low to moderate dependence on cigarette smoking than in those with heavy dependence on smoking (P = 0.002). However, the corresponding figures were not significantly different in individuals with and without substance abuse. Although the risk of suicide had no significant difference among individuals with low to moderate dependence on cigarettes compared to those with high nicotine dependence, it was higher in subjects with substance abuse than in those without it (P = 0.0001). Conclusion Our findings suggest that dependence on cigarettes may not play a role in increasing the risk of suicide, whereas the dependence on opium and its derivatives may increase this risk. Therefore, prevention and treatment of drug abuse may be effective on the incidence of suicide in patients with war injuries and PTSD. PMID:24494115

  11. 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

  12. 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

  13. 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.

  14. Acute Kidney Injury Treated with Dialysis outside the Intensive Care Unit: A Retrospective Observational Single-Center Study

    PubMed Central

    Sprenger-Mähr, Hannelore; Zitt, Emanuel; Lhotta, Karl

    2016-01-01

    Introduction The number of patients suffering from acute kidney injury requiring dialysis (AKI-D) is increasing. Whereas causes and outcome of AKI-D in the intensive care unit (ICU) are described extensively, few data exist about AKI-D patients treated outside the ICU. Aim of this study was to identify the causes of AKI-D, determine in-depth the comorbid conditions and outcome of this particular patient group and identify possibilities for its prevention. Methods We retrospectively studied all AKI-D patients treated outside the ICU in a single nephrology referral center between January 2010 and June 2015. Data on comorbid conditions, renal function and drug therapy prior to AKI-D, and possible causal events were collected. Patients were grouped into those with renal hypoperfusion as the predominant cause of AKI-D (hemodynamic group) and those with other causes (non-hemodynamic group). Results During 66 months 128 patients (57% male, mean age 69.3 years) were treated. AKI-D was community-acquired in 70.3%. The most frequent comorbidities were hypertension (62.5%), chronic kidney disease (CKD) (58.9%), coronary artery disease (CAD) (46.1%), diabetes (35.9%) and heart failure (34.1%). Most patients were prescribed diuretics (61.7%) and inhibitors of the renin-angiotensin-aldosterone system (RASI) (57.8%); 46.1% had a combination of both. In the 88 patients with hemodynamic AKI-D (68.8%) the most frequent initiating events were diarrhea (39.8%), infections (17.0%) and acute heart failure (13.6%). In the 40 patients with non-hemodynamic AKI-D (31.2%) interstitial nephritis (n = 15) was the prominent diagnosis. Patients with hemodynamic AKI-D were older (72.6 vs. 62.1 years, p = 0.001), suffered more often from CKD (68.2% vs. 33.3%, p = 0.003), CAD (54.5% vs. 27.5%, p = 0.004) and diabetes (42.0% vs. 22.5%, p = 0.033), and were more frequently on diuretics (75.0% vs. 32.5%, p<0.001), RASI (67.0% vs. 37.5%, p = 0.002) or their combination (58.0% vs. 20.0%, p<0

  15. 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

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

    PubMed Central

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

    1995-01-01

    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

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

    PubMed

    Baker, Edward James; Lee, Geraldine Ann

    2016-01-01

    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 analgesic modes

  18. 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

  19. 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

  20. Acute paediatric bite injuries treated on inpatient basis: a 10-year retrospective study and criteria for hospital admission.

    PubMed

    Shipkov, Hristo; Stefanova, Penka; Sirakov, Vladimir; Stefanov, Rumen; Dachev, Dimitar; Simeonov, Martin; Ivanov, Biser; Nenov, Momchil

    2013-12-01

    The aim of this study was to evaluate the acute bite wounds in children treated on an inpatient basis over a 10-year period and the criteria for inpatient treatment. This study comprised all acute mammalian bite injuries in relation to all paediatric bite injuries seen at the Emergency Surgical Department (ESD). Inclusion criteria were: aged between 0-18 years; acute human or animal bite injuries (presenting for the first time); and inpatient treatment. Exclusion criteria were: bite wounds treated elsewhere and referred for complications; bites treated on an outpatient basis referred for complications; and all insect bites. Over 10 years, 12,948 children were seen at the ESD. There were 167 children (0.77%) with mammalian bite wounds. Twelve of them responded to the inclusion criteria. They presented 7.18% of all mammalian bite injuries and 0.09% of all paediatric emergency visits at the ESD. The average age was 3.82 ± 1.63 years (from 1.3-7 years). The time elapsed between the accident to the wound debridement was 118.64 ± 101.39 minutes. There were 10 dogs, one horse, and one rabbit bite. Surgical treatment comprised debridement, saline irrigation, and primary closure or reconstruction. All patients received antibiotics in the postoperative period. The average hospital stay was 5.92 ± 2.39 days. In one case a partial distal flap necrosis occurred. Animal bite injuries treated on an inpatient basis are predominantly dog bites in young children under 10 years of age, with deep, extended, and commonly multiple injuries. Only 7% of paediatric bite injuries require inpatient treatment.

  1. Exposure to an organophosphate pesticide, individually or in combination with other Gulf War agents, impairs synaptic integrity and neuronal differentiation, and is accompanied by subtle microvascular injury in a mouse model of Gulf War agent exposure.

    PubMed

    Ojo, Joseph O; Abdullah, Laila; Evans, James; Reed, Jon Mike; Montague, Hannah; Mullan, Michael J; Crawford, Fiona C

    2014-04-01

    Gulf War illness (GWI) is a currently untreatable multi-symptom disorder experienced by 1990-1991 Persian Gulf War (GW) veterans. The characteristic hallmarks of GWI include cognitive dysfunction, tremors, migraine, and psychological disturbances such as depression and anxiety. Meta-analyses of epidemiological studies have consistently linked these symptomatic profiles to the combined exposure of GW agents such as organophosphate-based and pyrethroid-based pesticides (e.g. chlorpyrifos (CPF) and permethrin (PER) respectively) and the prophylactic use of pyridostigmine bromide (PB) as a treatment against neurotoxins. Due to the multi-symptomatic presentation of this illness and the lack of available autopsy tissue from GWI patients, very little is currently known about the distinct early pathological profile implicated in GWI (including its influence on synaptic function and aspects of neurogenesis). In this study, we used preclinical models of GW agent exposure to investigate whether 6-month-old mice exposed to CPF alone, or a combined dose of CPF, PB and PER daily for 10 days, demonstrate any notable pathological changes in hippocampal, cortical (motor, piriform) or amygdalar morphometry. We report that at an acute post-exposure time point (after 3 days), both exposures resulted in the impairment of synaptic integrity (reducing synaptophysin levels) in the CA3 hippocampal region and altered neuronal differentiation in the dentate gyrus (DG), demonstrated by a significant reduction in doublecortin positive cells. Both exposures also significantly increased astrocytic GFAP immunoreactivity in the piriform cortex, motor cortex and the basolateral amygdala and this was accompanied by an increase in (basal) brain acetylcholine (ACh) levels. There was no evidence of microglial activation or structural deterioration of principal neurons in these regions following exposure to CPF alone or in combination with PB and PER. Evidence of subtle microvascular injury was

  2. Occurrence and timing of complications following traumatic dental injuries: A retrospective study in a dental trauma department

    PubMed Central

    Lin, Shaul; Pilosof, Nir; Karawani, Munir; Wigler, Ronald; Kaufman, Arieh Y.; Teich, Sorin T.

    2016-01-01

    Background This study explores the pattern of complications occurrence resulting from traumatic dental injuries, the relation of this pattern to the number of years from the time of the injury to its first diagnosis, and other contributing characteristics such as root development and trauma characteristic. Material and Methods Patients’ data treated following dental trauma from 2002 to 2014 were classified and grouped according to age, gender, tooth type, injury type, diagnosis and the time that elapsed between the traumatic event and the diagnosis of complications (TIC). The distribution function of the quantitative parameters was determined with the Kolmogorov-Smirnov test. Fisher exact test was used to test differences between categorical parameters. Results The review identified 166 patients (114 male and 52 female), with a total of 287 traumatized teeth, and a mean of 1.8 injured teeth per incident. Maxillary teeth were involved significantly more often in traumatic dental injuries. The follow-up period range (TIC) had a mean of 2.99 years. The most frequent complication was pulp necrosis (34.2%). The most frequent complication related to avulsion was ankylotic root resorption (50%) diagnosed after a median TIC of 1.18 years. Open apices at the occurrence of trauma were observed in 52 teeth. Of these, 54.9% experienced pulp necrosis and 9.8% inflammatory root resorption with a median TIC of 1.63 years. Teeth that experienced multiple traumatic events showed significantly more late pulp necrosis compared to teeth that experienced a single traumatic injury (61.9% vs. 25.3%, respectively, p<0.0001). Conclusions Follow-up periods should be based on the type of traumatic dental injury and the severity of the potential complications for the tooth. Current recommendations for follow-up after traumatic dental injury should be revised to reflect the need for more frequent and overall prolonged follow-up. Key words:Dental trauma, avulsion, open apex, pulp necrosis

  3. Reconstructive challenges in war wounds

    PubMed Central

    Bhandari, Prem Singh; Maurya, Sanjay; Mukherjee, Mrinal Kanti

    2012-01-01

    War wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent military conflicts, hydrosurgery jet debridement and negative pressure wound therapy have been successfully used in the preparation of war wounds. In war injuries, due to a heavy casualty load, a faster and reliable method of reconstruction is aimed at. Pedicle flaps in extremities provide rapid and reliable cover in extremity wounds. Large complex defects can be reconstructed using microvascular free flaps in a single stage. This article highlights the peculiarities and the challenges encountered in the reconstruction of these ghastly wounds. PMID:23162233

  4. No benefit to surgical fixation of flail chest injuries compared with modern comprehensive management: results of a retrospective cohort study

    PubMed Central

    Farquhar, Jaclyn; Almahrabi, Yahya; Slobogean, Gerard; Slobogean, Bronwyn; Garraway, Naisan; Simons, Richard K.; Hameed, S. Morad

    2016-01-01

    Background Chest wall trauma is a common cause of morbidity and mortality. Recent technological advances and scientific publications have created a renewed interest in surgical fixation of flail chest. However, definitive data supporting surgical fixation are lacking, and its virtues have not been evaluated against modern, comprehensive management protocols. Methods Consecutive patients undergoing rib fracture fixation with rib-specific locking plates at 2 regional trauma centres between July 2010 and August 2012 were matched to historical controls with similar injury patterns and severity who were managed nonoperatively with modern, multidisciplinary protocols. We compared short- and long-term outcomes between these cohorts. Results Our patient cohorts were well matched for age, sex, injury severity scores and abbreviated injury scores. The nonoperatively managed group had significantly better outcomes than the surgical group in terms of ventilator days (3.1 v. 6.1, p = 0.012), length of stay in the intensive care unit (3.7 v. 7.4 d, p = 0.009), total hospital length of stay (16.0 v. 21.9 d, p = 0.044) and rates of pneumonia (22% v. 63%, p = 0.004). There were no significant differences in long-term outcomes, such as chest pain or dyspnea. Conclusion Although considerable enthusiasm surrounds surgical fixation of flail chest injuries, our analysis does not immediately validate its universal implementation, but rather encourages the use of modern, multidisciplinary, nonoperative strategies. The role of rib fracture fixation in the modern era of chest wall trauma management should ultimately be defined by prospective, randomized trials. PMID:27438051

  5. 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

  6. Neuroimaging, behavioral, and psychological sequelae of repetitive combined blast/impact mild traumatic brain injury in Iraq and Afghanistan war veterans.

    PubMed

    Petrie, Eric C; 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

    2014-03-01

    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; [(18)F]-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. Serotonergic antidepressant effects on aggressive, self-injurious and destructive/disruptive behaviours in intellectually disabled adults: a retrospective, open-label, naturalistic trial.

    PubMed

    Janowsky, David S; Shetty, Mahesh; Barnhill, Jarrett; Elamir, Belal; Davis, John M

    2005-03-01

    There is a growing body of evidence that serotonergic antidepressants are useful in the treatment of maladaptive behaviours in the intellectually disabled. However, not all studies have shown positive results due to lack of efficacy, tolerance development, and troublesome side-effects. The current study consisted of a review of the treatment response to a variety of serotonergic antidepressants, consisting of selective serotonin reuptake inhibitors (SSRIs ) (n = 36) and clomipramine (n = 2) in 38 institutionalized intellectually disabled adults (20 males, 18 females; mean age 45.6 yr, age range 18-74 yr). Those studied were treated for aggression, self-injurious behaviours, destructive/disruptive behaviours, depression/dysphoria, or a combination of these or other challenging behaviours. Most were receiving concurrent psychotropic and/or anticonvulsant medications. Effectiveness was determined by a retrospective review of the summaries of multidisciplinary Neuropsychiatric Behavioural Reviews (NBRs) in which global and specific maladaptive behaviours were rated on a 1- to 7-point scale, and by psychologists' ratings of target behaviours. Overall, statistically significant decreases in the ratings of global maladaptive behaviour and aggression, self-injurious behaviour, destruction/disruption and depression/dysphoria and in psychologists' ratings occurred in the subject group after the initiation of antidepressants. The results suggest that serotonergic antidepressants are useful in the treatment of challenging/maladaptive behaviours in the intellectually disabled. PMID:15482629

  9. Patterns and injuries associated with orbital wall fractures in elderly patients who visited the emergency room: a retrospective case–control study

    PubMed Central

    Kim, Youn-Jung; Ahn, Shin; Seo, Dong-Woo; Sohn, Chang Hwan; Lee, Hyung-Joo; Park, In-June; Yang, Dong-Jin; Ryoo, Seung Mok; Kim, Won Young; Lim, Kyung Soo

    2016-01-01

    Objectives This study aimed to determine orbital wall fracture (OWF) patterns and associated facial injuries in elderly patients and compare them with those in their younger adult counterparts. Design A retrospective case–control study. Setting An emergency department of a university-affiliated hospital located in an urban area. Participants A total of 1378 adult patients with OWF diagnosed by CT from 1 January 2004 through 31 March 2014 were enrolled. Patients were categorised into elderly (≥65 years) and non-elderly (<65 years) groups. Results The elderly group (n=146) had a mean age of 74.0 years compared with 37.5 years in the non-elderly group (n=1232). Slipping was the most common cause of OWF in the elderly group (43.8%, p<0.001), whereas violence was the most common cause in the non-elderly group (37.3%, p<0.001). The lateral orbital wall was the more common site of fracture in the elderly group, and their injuries were more often associated with concurrent facial bone fractures, including the mandible, maxilla and zygoma, compared with the non-elderly group. After adjusting for sex and the mechanism of injury, inclusion in the elderly group was a significant risk factor for fracture of the lateral wall (OR 1.658; 95% CI 1.074 to 2.560) and concomitant facial bone fractures of the maxilla (OR 1.625; 95% CI 1.111 to 2.377) and zygoma (OR 1.670; 95% CI 1.126 to 2.475). Conclusions Elderly patients were vulnerable to facial trauma, and concurrent facial bone fracture associated with OWF was more commonly observed in this age group. Therefore, a high index of suspicion and thorough investigation, including CT, for OWF-associated facial bone fractures are important. PMID:27645553

  10. Injury severity and serum amyloid A correlate with plasma oxidation-reduction potential in multi-trauma patients: a retrospective analysis

    PubMed Central

    2009-01-01

    Background In critical injury, the occurrence of increased oxidative stress or a reduced antioxidant status has been observed. The purpose of this study was to correlate the degree of oxidative stress, by measuring the oxidation-reduction potential (ORP) of plasma in the critically injured, with injury severity and serum amyloid A (SAA) levels. Methods A total of 140 subjects were included in this retrospective study comprising 3 groups: healthy volunteers (N = 21), mild to moderate trauma (ISS < 16, N = 41), and severe trauma (ISS ≥ 16, N = 78). For the trauma groups, plasma was collected on an almost daily basis during the course of hospitalization. ORP analysis was performed using a microelectrode, and ORP maxima were recorded for the trauma groups. SAA, a sensitive marker of inflammation in critical injury, was measured by liquid chromatography/mass spectrometry. Results ORP maxima were reached on day 3 (± 0.4 SEM) and day 5 (± 0.5 SEM) for the ISS < 16 and ISS ≥ 16 groups, respectively. ORP maxima were significantly higher in the ISS < 16 (-14.5 mV ± 2.5 SEM) and ISS ≥ 16 groups (-1.1 mV ± 2.3 SEM) compared to controls (-34.2 mV ± 2.6 SEM). Also, ORP maxima were significantly different between the trauma groups. SAA was significantly elevated in the ISS ≥ 16 group on the ORP maxima day compared to controls and the ISS < 16 group. Conclusion The results suggest the presence of an oxidative environment in the plasma of the critically injured as measured by ORP. More importantly, ORP can differentiate the degree of oxidative stress based on the severity of the trauma and degree of inflammation. PMID:19925664

  11. 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

  12. Patient and Community-Level Socio-Demographic Characteristics Associated with Emergency Department Visits for Childhood Injury; A Retrospective Analysis of Data from the Pediatric Emergency Care Applied Research Network (PECARN) Core Data Project 2004–2008

    PubMed Central

    Macy, Michelle L.; Zonfrillo, Mark R.; Cook, Lawrence J.; Funai, Tomohiko; Goldstick, Jason; Stanley, Rachel M.; Chamberlain, James M.; Cunningham, Rebecca M.; Lipton, Robert; Alpern, Elizabeth R.

    2015-01-01

    Objective To examine pediatric emergency department (ED) visits over 5 years, trends in injury severity, and associations between injury-related ED visit outcome and patient and community-level socio-demographic characteristics. Study design Retrospective analysis of administrative data provided to the Pediatric Emergency Care Applied Research Network Core Data Project, 2004–2008. Home addresses were geocoded to determine census block group and associated socio-demographic characteristics. Maximum Abbreviated Injury Scale severity and Severity Classification System scores were calculated. Generalized estimating equations were used to test for associations between socio-demographic characteristics and admission or transfer among injury-related ED visits. Results Overall ED visits and injury-related visits increased from 2004 to 2008 at study sites. Of 2,833,676 successfully geocoded visits, 700,821 (24.7%) were injury-related. The proportion of higher severity injury-related visits remained consistent. Nearly 10% of injury-related visits resulted in admission or transfer each year. After adjusting for age, sex, payer, and injury severity, odds of admission or transfer were lower among minority children and children from areas with moderate and high prevalence of poverty. Conclusions Pediatric injury-related ED visits to included sites increased over the study period while injury severity, anticipated resource utilization, and visit outcomes remained stable, with low rates of admission or transfer. Socio-demographic differences in injury-related visits and ED disposition were apparent. ED-based injury surveillance is essential to understand disparities, inform targets for prevention programs, and reduce the overall burden of childhood injuries. PMID:26141551

  13. Outcome of occupational electrical injuries among French electric company workers: a retrospective report of 311 cases, 1996-2005.

    PubMed

    Piotrowski, Aleksandra; Fillet, Anne-Marie; Perez, Philippe; Walkowiak, Philippe; Simon, Denis; Corniere, Marie-Jean; Cabanes, Pierre-André; Lambrozo, Jacques

    2014-05-01

    This study reviewed records of all electrical incidents involving work-related injury to employees Electricité de France (EDF) from 1996 through 2005 and analysed data for 311 incidents. The results are compared with 1231 electrical incidents that occurred during 1970-1979 and 996 incidents during 1980-1989. A total of 311 electrical incidents were observed. The medical consequences of electrical incident remain severe and particularly, the current fatality rate (3.2%) is similar to that recorded in the 1980s (2.7%) and 1970s (3.3%). Among individuals with non-fatal incidents, any change has occurred in the prevalence of permanent functional sequelae (23.6% in the 1970s vs. 27.6% in the 1980s and 32.5% currently). An increase in the incidence of neuropsychiatric sequelae (5.4% in the 1980s vs. 13% currently) has been observed and they are now the second most common type of sequelae after those directly related to burns. Among the neurological sequelae, peripheral nervous system disorders are the most common, as observed in the 1980s. Since the definition of post-traumatic stress disorder (PTSD) has changed between the two periods, we can only report that the current prevalence of PTSD is 7.6%. This study emphasises the need for specific management of neurological and psychological impairments after electrical injuries, including especially early recognition and initiation of effective treatment.

  14. 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

  15. Wars, disasters and kidneys.

    PubMed

    Lameire, N

    2014-12-01

    This paper summarizes the impact that wars had on the history of nephrology, both worldwide and in the Ghent Medical Faculty notably on the definition, research and clinical aspects of acute kidney injury. The paper briefly describes the role of 'trench nephritis' as observed both during World War I and II, supporting the hypothesis that many of the clinical cases could have been due to Hantavirus nephropathy. The lessons learned from the experience with crush syndrome first observed in World War II and subsequently investigated over many decades form the basis for the creation of the Renal Disaster Relief Task Force of the International Society of Nephrology. Over the last 15 years, this Task Force has successfully intervened both in the prevention and management of crush syndrome in numerous disaster situations like major earthquakes.

  16. Risk of Acute Kidney Injury and Long-Term Outcome in Patients With Acetaminophen Intoxication: A Nationwide Population-Based Retrospective Cohort Study.

    PubMed

    Chen, Yu-Guang; Lin, Cheng-Li; Dai, Ming-Shen; Chang, Ping-Ying; Chen, Jia-Hong; Huang, Tzu-Chuan; Wu, Yi-Ying; Kao, Chia-Hung

    2015-11-01

    Acetaminophen (APAP) intoxication is a common cause of hepatic toxicity and life-threatening hepatic failure. However, few studies have investigated the possible association between APAP intoxication and acute kidney injury (AKI). We constructed a retrospective cohort study to clarify the relationship between APAP intoxication and the risk of AKI.We identified patients with APAP intoxication and selected a comparison cohort that was 1:4 frequency matched according to age, sex, and year of APAP intoxication diagnosis from the Taiwan National Health Insurance Research Database from 1998 to 2010. We analyzed the risks of AKI for patients with APAP intoxication by using Cox proportional hazards regression models.In this study, 2914 patients with APAP intoxication and 11,656 controls were included. The overall risks of developing AKI were 2.41-fold in the patients with APAP intoxication compared with the comparison cohort. After we excluded APAP intoxication patients with coexisting AKI and hepatic failure/hepatitis, the overall risks of developing AKI were still 2.22-fold in the patients with APAP intoxication. There were 2 patients who had end-stage renal disease (ESRD) following APAP intoxication-related AKI. Limitations include retrospective review, selection bias, and absence of data on detail medications used, laboratory investigations and dosage of APAP intoxication.Our long-term cohort study results showed that AKI is a possible adverse effect among patients with APAP intoxication, regardless of whether patients have presented with hepatic toxicity. However, additional studies are necessary to clarify whether such patients can progress to ESRD. PMID:26579812

  17. 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.

  18. 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

  19. Proteinuria and hematuria are associated with acute kidney injury and mortality in critically ill patients: a retrospective observational study

    PubMed Central

    2014-01-01

    Background Proteinuria and hematuria are both important health issues; however, the nature of the association between these findings and acute kidney injury (AKI) or mortality remains unresolved in critically ill patients. Methods Proteinuria and hematuria were measured by a dipstick test and scored using a scale ranging from a negative result to 3+ in 1883 patients admitted to the intensive care unit. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The odds ratios (ORs) for AKI and 3-year mortality were calculated after adjustment for multiple covariates according to the degree of proteinuria or hematuria. For evaluating the synergistic effect on mortality among proteinuria, hematuria, and AKI, the relative excess risk due to interaction (RERI) was used. Results Proteinuria and hematuria increased the ORs for AKI: the ORs of proteinuria were 1.66 (+/−), 1.86 (1+), 2.18 (2+), and 4.74 (3+) compared with non-proteinuria; the ORs of hematuria were 1.31 (+/−), 1.58 (1+), 2.63 (2+), and 2.52 (3+) compared with non-hematuria. The correlations between the mortality risk and proteinuria or hematuria were all significant and graded (Ptrend < 0.001). There was a relative excess risk of mortality when both AKI and proteinuria or hematuria were considered together: the synergy indexes were 1.30 and 1.23 for proteinuria and hematuria, respectively. Conclusions Proteinuria and hematuria are associated with the risks of AKI and mortality in critically ill patients. Additionally, these findings had a synergistic effect with AKI on mortality. PMID:24942179

  20. 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

  1. 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.

  2. 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

  3. [Management of war injuries from the anesthesiologic point of view: a report of experiences from the IKRK hospital in Kabul, September 1990].

    PubMed

    Ursprung, T

    1991-01-01

    We report the medical experience during a 3 week stay in the ICRC hospital of Kabul as anaesthesist. 170 war wounded patients had been treated following clear and simple rools of war surgery. The anaesthetic management and the important role of Ketamin is explained.

  4. Assessment and Predicting Factors of Repeated Brain Computed Tomography in Traumatic Brain Injury Patients for Risk-Stratified Care Management: A 5-Year Retrospective Study

    PubMed Central

    Sumritpradit, Preeda; Setthalikhit, Thitipong

    2016-01-01

    Background and Objective. To determine the value of repeated brain CT in TBI cases for risk-stratified care management (RSCM) and to identify predicting factors which will change the neurosurgical management after repeated brain CTs. Methods. A 5-year retrospective study from January 2009 to August 2013 was conducted. The primary outcome was the value of repeated brain CT in TBI cases. The secondary outcome is to identify predicting factors which will change the neurosurgical management after repeated brain CTs. Results. There were 145 consecutive patients with TBI and repeated brain CT after initial abnormal brain CT. Forty-two percent of all cases (N = 61) revealed the progression of intracranial hemorrhage after repeated brain CT. In all 145 consecutive patients, 67.6% of cases (N = 98) were categorized as mild TBI. For mild head injury, 8.2% of cases (N = 8) had undergone neurosurgical management after repeated brain CT. Only 1 from 74 mild TBI patients with repeated brain CT had neurosurgical intervention. Clopidogrel and midline shift more than 2 mm on initial brain CT were significant predicting factors to indicate the neurosurgical management in mild TBI cases. Conclusion. Routine repeated brain CT for RSCM had no clinical benefit in mild TBI cases. PMID:27703812

  5. 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

  6. The Effects of Pre-Existing Hyponatremia and Subsequent-Developing Acute Kidney Injury on In-Hospital Mortality: A Retrospective Cohort Study

    PubMed Central

    Lee, Sung Woo; Baek, Seon Ha; Ahn, Shin Young; Na, Ki Young; Chae, Dong-Wan; Chin, Ho Jun; Kim, Sejoong

    2016-01-01

    Background and Objectives Both hyponatremia and acute kidney injury (AKI) are common and harmful in hospitalized patients. However, their combined effects on patient mortality have been little studied. Methods We retrospectively enrolled 19191 adult patients who were admitted for 1 year. Pre-existing hyponatremia was defined as a serum sodium level < 135 mmol/L on the first measurement of their admission. AKI was defined as a rise in serum creatinine by ≥ 26.5 μmol/L or ≥ 1.5 times of the baseline value of creatinine during the hospital stay. Results The prevalence of pre-existing hyponatremia was 8.2%. During a median 6.0 days of hospital stay, the incidence rates of AKI and in-hospital patient mortality were 5.1% and 0.9%, respectively. Pre-existing hyponatremia independently predicted AKI development and in-hospital mortality (adjusted hazard ratio [HR] 1.300, P = 0.004; HR 2.481, P = 0.002, respectively). Pre-existing hyponatremia and subsequent development of AKI increased in-hospital mortality by 85 times, compared to the patients with normonatremia and no AKI. In subgroup analysis, the AKI group showed higher rates of de novo hypernatremia than the non-AKI group during the admission. De novo hypernatremia, which might be associated with over-correction of hyponatremia, increased in-hospital mortality (HR 3.297, P <0.001), and patients with AKI showed significantly higher rates of de novo hypernatremia than patients without AKI (16.2% vs. 1.4%, P < 0.001, respectively). Conclusion Pre-existing hyponatremia may be associated with the development of AKI in hospitalized patients, and both hyponatremia and hospital-acquired AKI could have a detrimental effect on short term patient mortality, which might be related to the inappropriate correction of hyponatremia in AKI patients. PMID:27622451

  7. 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.

  8. 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

  9. Risk Factors for the Failure of Spinal Burst Fractures Treated Conservatively According to the Thoracolumbar Injury Classification and Severity Score (TLICS): A Retrospective Cohort Trial

    PubMed Central

    Shen, Jieliang; Xu, Linfei; Zhang, Baolong; Hu, Zhenming

    2015-01-01

    Background The management of thoracolumbar (TL) burst fractures is still controversial. The thoracolumbar injury classification and severity score (TLICS) algorithm is now widely used to guide clinical decision making, however, in clinical practice, we come to realize that TLICS also has its limitations for treating patients with total scores less than 4, for which conservative treatment may not be optimal in all cases. Purpose The aim of this study is to identify several risk factors for the failure of conservative treatment of TL burst fractures according to TLICS algorithm. Methods From June 2008 to December 2013, a cohort of 129 patients with T10-l2 TL burst fractures with a TLISC score ≤3 treated non-operatively were identified and included into this retrospective study. Age, sex, pain intensity, interpedicular distance (IPD), canal compromise, loss of vertebral body height and kyphotic angle (KA) were selected as potential risk factors and compared between the non-operative success group and the non-operative failure group. Results One hundred and four patients successfully completed non-operative treatment, the other 25 patients were converted to surgical treatment because of persistent local back pain or progressive neurological deficits during follow-up. Our results showed that age, visual analogue scale (VAS) score and IPD, KA were significantly different between the two groups. Furthermore, regression analysis indicated that VAS score and IPD could be considered as significant predictors for the failure of conservative treatment. Conclusion The recommendation of non-operative treatment for TLICS score ≤3 has limitations in some patients, and VAS score and IPD could be considered as risk factors for the failure of conservative treatment. Thus, conservative treatment should be decided with caution in patients with greater VAS scores or IPD. If non-operative management is decided, a close follow-up is necessary. PMID:26284373

  10. 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.

  11. 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

  12. Incidence and mortality of acute kidney injury in patients with acute coronary syndrome: A retrospective study from a single coronary care unit.

    PubMed

    Buargub, Mahdia; Elmokhtar, Zohra Omar

    2016-01-01

    Acute kidney injury (AKI) is associated with adverse short-and long-term outcomes. The aim of this study was to evaluate the incidence of AKI and the short-term mortality in patients admitted with acute coronary syndrome (ACS) to a single coronary care unit (CCU) in Tripoli, Libya. We retrospectively studied the medical records of ACS patients admitted to the CCU of a referral cardiology center, during the period from January 1, 2014, to December 31, 2014. AKI was defined according to the AKI network criteria. The incidence of AKI and short-term CCU mortality was compared between different types of ACS. Data of patients with and without AKI were compared using Student's t-test and Chi-squared statistic considering P <0.05 statistically significant. Eighty-four patients with ACS were included in the study; their mean age was 57.6 ± 14.4 years [standard deviation (SD)], 75% were males and their mean stay in the CCU was 4.3 ± 3 days (SD). Of them, 71.4% had ST-elevated myocardial infarction (STEMI), 22.6% had non-STEMI, and 6% had unstable angina. About 41.7% had AKI (19% had AKI Stage 1, 17.9% had AKI Stage 2, and 4.8% had AKI Stage 3). The total CCU mortality was 15.5%; mortality among AKI patients in the CCU was 25.7% compared with 6.12% in the non-AKI patients (P = 0.014). The mortality worsened with increasing severity of AKI. Patients with AKI were older (61.6 ± 15 years) than the non-AKI group (54.7 ± 13 years, P = 0.031), their mean blood pressure at admission was lower, their CCU stay was longer, and they more frequently had coexisting acute decompensated heart failure. In this study of ACS patients, the incidence of AKI was high, the CCU mortality among the AKI patients was 25.7% compared with 6.12% in the non-AKI patients, and the mortality worsened with increasing severity of AKI. PMID:27424693

  13. 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…

  14. 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.

  15. 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

  16. Snowboard injuries.

    PubMed

    Pino, E C; Colville, M R

    1989-01-01

    A retrospective survey of 267 snowboarders was undertaken to determine the population at risk and types and mechanisms of injuries sustained in this sport. Snowboarders are young (average age, 21 years), male (greater than 90%), view themselves in average or above average physical condition (96%), and have varied sports interests. One hundred ten injuries that resulted in a physician visit were reported. Ligament sprains, fractures, and contusions were the most frequent types of injury. Fifty percent of all injuries occurred in the lower extremities, with ankle injuries being the most common. Snowboard riders using equipment with increased ankle support seem to be more protected from lower extremity injuries. The lower extremity injuries were concentrated in the forward limb of the snowboarder, where the rider's weight is disproportionately distributed. Differences in the mechanism and spectrum of injury between snowboarding and skiing injuries were noted, including: impact rather than torsion as the major mechanism of injury, a significant lack of thumb injuries, comparative increase in ankle injuries, a decrease in knee injuries, and a higher percentage of upper extremity injuries.

  17. 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

  18. The disease profile of poverty: morbidity and mortality in northern Uganda in the context of war, population displacement and HIV/AIDS.

    PubMed

    Accorsi, S; Fabiani, M; Nattabi, B; Corrado, B; Iriso, R; Ayella, E O; Pido, B; Onek, P A; Ogwang, M; Declich, S

    2005-03-01

    The population of Gulu District (northern Uganda) has been severely incapacitated by war, epidemics and social disruption. This study is aimed at describing disease patterns and trends in this area through a retrospective analysis of discharge records for 155205 in-patients of Lacor Hospital in the period 1992-2002. The burden of infectious diseases in childhood is overwhelming, with malaria accounting for the steepest increase in admissions. Admissions for war-related injuries and malnutrition fluctuated with the intensity of the war and the severity of famine. Emerging and re-emerging infections, such as HIV/AIDS, tuberculosis and Ebola, accounted for a heavy disease burden; however, there has been a trend for admissions related to HIV/AIDS and tuberculosis to decrease since the implementation of community-based services. Vulnerable groups (infants, children and women) accounted for 79.8% of admissions. Long-term war, population displacement, the collapse of social structures and the breakdown of the health system place people at a much greater risk of persistent, emerging and re-emerging infectious diseases, malnutrition and war-related injuries, shaping the 'disease profile of poverty'. Most of the disease burden results from infectious diseases of childhood, whose occurrence could be dramatically reduced by low-cost and effective preventive and curative interventions. PMID:15653126

  19. Retrospective Evaluation of Canine and Feline Maxillomandibular Trauma Cases; A Comparison of Signalment with Non-Maxillomandibular Traumatic Injuries (2003-2012)

    PubMed Central

    Mulherin, Brenda L.; Snyder, Christopher J.; Soukup, Jason W.; Hetzel, Scott

    2014-01-01

    Summary Objectives To determine differences in signalment between maxillomandibular (MM) and non maxillomandibular (non-MM) trauma patients to help predict the type of injury sustained. Methods A medical records database was searched from December 2003-September 2012 to identify all MM trauma patients, and also a random sample of non-MM trauma patients was generated. Patient species, age, sex, weight, and injury aetiology were recorded for both populations. Results Sixty-seven MM trauma patients and 129 non-MM trauma patients were identified. Feline patients were almost twice as likely to be presented for MM trauma compared with non-MM trauma. The median weight of canine patients suffering MM injury was significantly less than that of non-MM patients (p=0.025). A significant association existed between the causes of injuries associated with MM and non-MM trauma populations (p=0.000023). The MM trauma patients were more likely to sustain injury as a result of an animal altercation (Bonferroni p=0.001) while non-MM injuries were more likely to result from motor vehicle accidents (Bonferroni p=0.001). Overall animals <1yr of age with traumatic injuries were overrepresented (65/196) in comparison to entire patient population. Clinical Significance The results of this study may help guide clinicians in the evaluation and screening of trauma patients that are presented as an emergency. Cats, small dogs and animals suffering from animal altercations should all be closely evaluated for maxillomandibular injury. PMID:24569903

  20. [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.

  1. [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

  2. 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.

  3. Water Wars

    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

  4. 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.

  5. 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

  6. 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)

  7. 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.

  8. 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.

  9. 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

  10. 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 ...

  11. 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,…

  12. 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…

  13. 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.

  14. 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

  15. 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...

  16. 48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...' 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...

  17. 48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...' 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...

  18. 48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...' 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...

  19. 48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...' 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...

  20. Delivering best care in war and peace.

    PubMed

    Moore, Alison

    2014-06-24

    Col Alan Finnegan, the fi rst Ministry of Defence professor of nursing, is driving forward research into preparing nurses for deployment and ensuring they deliver the best care possible in war and peace. Research topics range from the role of autonomous practitioners to the effects on soldiers of injuries to their genitalia.

  1. Medical responsibility and thermonuclear war.

    PubMed

    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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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)

  7. Environmental consequences of nuclear war

    SciTech Connect

    Harwell, M.A.; Hutchinson, T.C.; Cropper, W.P. Jr.; Harwell, C.C.; Grover, H.D.

    1989-01-01

    This book addresses the ecological, agricultural, and human effects of nuclear war. The topics covered include: Ecological principles relevant to nuclear war; Vulnerability of ecological systems to climatic effects on nuclear war; Additional potential effects of nuclear war on ecological systems; Potential effects of nuclear war on agricultural productivity; Food availability after nuclear war; and Experiences and extrapolations from Hiroshima and Nagasaki.

  8. Cold injuries.

    PubMed

    Kruse, R J

    1995-01-01

    There are two categories of cold injury. The first is hypothermia, which is a systemic injury to cold, and the second is frostbite, which is a local injury. Throughout history, entire armies, from George Washington to the Germans on the Russian Front in World War II, have fallen prey to prolonged cold exposure. Cold injury is common and can occur in all seasons if ambient temperature is lower than the core body temperature. In the 1985 Boston Marathon, even though it was 76 degrees and sunny, there were 75 runners treated for hypothermia. In general, humans adapt poorly to cold exposure. Children are at particular risk because of their relatively greater surface area/body mass ratio, causing them to cool even more rapidly than adults. Because of this, the human's best defense against cold injury is to limit his/her exposure to cold and to dress appropriately. If cold injury has occurred and is mild, often simple passive rewarming such as dry blankets and a warm room are sufficient treatment.

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

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

    PubMed

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

    2014-03-01

    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

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

    PubMed

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

    2014-03-01

    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.

  16. 'War surgery at sea': maritime trauma experience in the Gulf War 2003.

    PubMed

    Matthews, Jon J; Mercer, Stuart J

    2003-01-01

    During the second Gulf War in 2003, the Primary Casualty Receiving facility onboard R.F.A. Argus treated thirty six patients with injuries sustained in the conflict, including thirty Iraqi enemy prisoners of war and displaced persons. Their injuries and operative management are reported. Eighteen casualties sustained fragmentation injuries, six casualties sustained gunshot wounds and seven casualties suffered a combination of both. In addition to penetrating missile injuries five casualties from road traffic accidents were treated. All wounds were managed following the established principles of war surgery. The extremities were involved in twenty eight patients (78%) including nine open, multifragmented long bone fractures which were managed with external skeletal fixators. Two laparotomies and one thoracotomy were performed. The average duration of surgery was one hundred and thirty two minutes with the longest procedure lasting for six hours and ten minutes. This was the first time that the Primary Casualty Receiving Facility had been used to surgically manage war casualties and it fulfilled this role to good effect.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. Fingertip injuries

    PubMed Central

    Saraf, Sanjay; Tiwari, VK

    2007-01-01

    Background: Fingertip injuries are extremely common. Out of the various available reconstructive options, one needs to select an option which achieves a painless fingertip with durable and sensate skin cover. The present analysis was conducted to evaluate the management and outcome of fingertip injuries. Materials and Methods: This is a retrospective study of 150 cases of fingertip Injuries of patients aged six to 65 years managed over a period of two years. Various reconstructive options were considered for the fingertip lesions greater than or equal to 1 cm2. The total duration of treatment varied from two to six weeks with follow-up from two months to one year. Results: The results showed preservation of finger length and contour, retention of sensation and healing without significant complication. Conclusion: The treatment needs to be individualized and all possible techniques of reconstruction must be known to achieve optimal recovery. PMID:21139772

  3. 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.

  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. 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

  6. 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

  7. Nurses at war.

    PubMed

    Dean, Erin

    The first world war opened up nursing to a wider range of women and earned new status for the profession. Nursing service records from the conflict, available online for the first time at www.national archives.gov.uk, provide a detailed insight into the lives of nurses who were the first to handle war casualties on an industrial scale.

  8. Fighting the Drug War.

    ERIC Educational Resources Information Center

    The Journal of State Government, 1990

    1990-01-01

    All nine articles in this periodical issue focus on the theme of the war against illegal drug use, approaching the topic from a variety of perspectives. The articles are: "The Drug War: Meeting the Challenge" (Stanley E. Morris); "Ways to Fight Drug Abuse" (Bruce A. Feldman); "Treatment Key to Fighting Drugs" (Stan Lundine); "Patience and…

  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. 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…

  11. 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.)

  12. 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)

  13. 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)

  14. Caring for veterans returning home from Middle Eastern wars.

    PubMed

    Wands, Lisa Marie

    2011-04-01

    After serving at war, veterans work to resume a normal life at home. For some, the difficulties of reintegration are compounded by significant physical injury or psychological trauma, such as traumatic brain injury and post-traumatic stress disorder. It is equally important to attend to the all-encompassing experience of reintegration for any veteran. The transition is deeply embedded in the context of relationships and, as such, nurses can provide support. Nurses can find guidance on how to better connect with veterans returning home from war in Swanson's work on caring.

  15. Predictors of displacement behaviour during the 2006 Lebanon war.

    PubMed

    Khawaja, Marwan; Assaf, Shireen; Yamout, Rouham

    2011-01-01

    The July 2006 war in Lebanon was one of the country's shortest wars. Yet perhaps it was also the worst interstate war in the history of Lebanon. Over the course of 33 days, the war resulted in over 1000 deaths, thousands of injuries, large-scale destruction of infrastructure and properties, as well as massive population displacements. Approximately a third of the Lebanese population was displaced during the war. Population-based survey data collected in early 2007 and logistic regression models were used to examine the effects of some demographic and socio-economic factors on displacement, stratified by war-affected and non-affected areas. The sample was restricted to adults who were at least 18 years old. We found that the intensity of the conflict as captured by the region of residence was understandably the most important variable in predicting displacement. The odds of displacement were higher for those who were younger in age, married or who had obtained a higher education. Females and those of Lebanese nationality had higher odds of displacement than their male and non-Lebanese counterparts, but only in war-damaged areas. Interestingly, household composition and size, economic standing and car ownership were not related to the odds of displacement. Findings from the present study may help policy-makers and humanitarian agencies in their planning efforts during emergencies, including wars.

  16. Abnormal oral habits in the children of war veterans.

    PubMed

    Yassaei, S; Rafieian, M; Ghafari, R

    2005-01-01

    Any kind of stress has a negative effect on the mood of people and stress resulting from war is no exception. Stress from war has not only has effects on war veterans but also on the families. Children of these families have been more susceptible to abnormal oral habits. In this observational, analytical and historical research, attempts have been made to determine the prevalence of abnormal oral habits in the children of war veterans (martyrs, freed prisoners of war and war cripples) and compare them with a control group. In this study of 520 children aged between 7 and 11 years were (238 in the study group and 282 in the control group), information was gathered via a questionnaire completed by the mothers of the students. Analysis of the received information showed that the prevalence of para functional and abnormal oral habits was more in the study group (P = 0.005). The prevalence rate was highest in children, whose family members had been both crippled and freed prisoners of war, while the rate was lowest in children whose parents had been only prisoners of war without any lasting physical injury. Most of these children had acquired these habits at the age of seven and these abnormal habits were most prevalent in children aged eight and nine.

  17. Gastrointestinal problems in modern wars: clinical features and possible mechanisms.

    PubMed

    Wang, Wei-Feng; Guo, Xiao-Xu; Yang, Yun-Sheng

    2015-01-01

    Gastrointestinal problems are common during wars, and they have exerted significant adverse effects on the health of service members involved in warfare. The spectrum of digestive diseases has varied during wars of different eras. At the end of the 20th century, new frontiers of military medical research emerged due to the occurrence of high-tech wars such as the Gulf War and the Kosovo War, in which ground combat was no longer the primary method of field operations. The risk to the military personnel who face trauma has been greatly reduced, but disease and non-battle injuries (DNBIs) such as neuropsychological disorders and digestive diseases seemed to be increased. Data revealed that gastrointestinal symptoms such as constipation, diarrhea, dyspepsia, and noncardiac chest pain are common among military personnel during modern wars. In addition, a large number of deployed soldiers and veterans who participated in recent wars presented with chronic gastrointestinal complaints, which fulfilled with the Rome III criteria for functional gastrointestinal disorders (FGIDs). It was also noted that many veterans who returned from the Gulf War suffered not only from chronic digestive symptoms but also from neuropsychological dysfunction; however, they also showed symptoms of other systems. Presently, this broad range of unexplained symptoms is known as "Gulf War syndrome". The mechanism that underlies Gulf War syndrome remains unclear, but many factors have been associated with this syndrome such as war trauma, stress, infections, immune dysfunction, radiological factors, anthrax vaccination and so on. Some have questioned if the diagnosis of FGIDs can be reached given the complexity of the military situation. As a result, further studies are needed to elucidate the pathogenesis of gastrointestinal disease among military personnel.

  18. Pre- and/or Intra-Operative Prescription of Diuretics, but Not Renin-Angiotensin-System Inhibitors, Is Significantly Associated with Acute Kidney Injury after Non-Cardiac Surgery: A Retrospective Cohort Study

    PubMed Central

    Tagawa, Miho; Ogata, Ai; Hamano, Takayuki

    2015-01-01

    Background and Objectives Pre- and/or intra-operative use of diuretics, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARB) constitutes a potentially modifiable risk factor for postoperative acute kidney injury (AKI). It has been studied whether use of these drugs predicts AKI after cardiac surgery. The objective of this study was to examine whether administration of these agents was independently associated with AKI after non-cardiac surgery. Design, Setting, Participants, and Measurements This was a retrospective observational study. Inclusion criteria were adult patients (age ≥ 18) who underwent non-cardiac surgery under general anesthesia from 2007 to 2009 at Kyoto Katsura Hospital. Exclusion criteria were urological surgery, missing creatinine values, and preoperative dialysis. The exposures of interest were pre- and/or intra-operative use of diuretics or ACE-I/ARB. Outcome variables were postoperative AKI as defined by the AKI Network (increase in creatinine ≥ 0.3 mg/dL or 150% within 48 hours, or urine output < 0.5 ml/kg/hour for > 6 hours). Multivariable logistic regression analyses were conducted and adjusted for potential confounders. Propensity scores (PS) for receiving diuretics or ACE-I/ARB therapy were estimated and PS adjustment, PS matching, and inverse probability weighting were performed. Results There were 137 AKI cases (5.0%) among 2,725 subjects. After statistical adjustment for patient and surgical characteristics, odds (95% CI) of postoperative AKI were 2.07 (1.10-3.89) (p = 0.02) and 0.89 (0.56-1.42) (p = 0.63) in users of diuretics and ACE-I/ARB, respectively, compared with non-users. PS adjustment, PS matching, and inverse probability weighting yielded similar results. The effect size of diuretics was significantly greater in the patients with lower propensity for diuretic use (p for interaction < 0.1). Conclusions Prescription of diuretics, but not ACE-I/ARB, was independently associated with

  19. 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.

  20. 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 ...

  1. War Experiences and War-related Distress in Bosnia and Herzegovina Eight Years after War

    PubMed Central

    Ringdal, Gerd Inger; Ringdal, Kristen; Simkus, Albert

    2008-01-01

    Aim To examine the relationship between war experiences and war-related distress in Bosnia and Herzegovina. Methods The survey was performed in the late 2003 on a representative sample of 3313 respondents. The face-to-face interviews included 15 items on war-related distress and 24 items on war experiences. From these items we developed the War-related Distress Scale, the Direct War Experiences Scale, and the Indirect War Experiences Scale. Regression analysis was used to examine the relationship between war-related distress symptoms and war experiences variables, controlling for a range of other variables. Results Almost half of the respondents did not report any war-related distress symptoms, while about 13% reported 7 or more symptoms. Direct war experiences had a significant effect on war-related distress even eight years after the war, while indirect war experiences showed no significant effect on war-related distress. We found that marital status weakly decreased war-related distress, while household size increased it. Conclusion Direct war experiences seem to have a long-lasting traumatic effect on a substantial number of residents of Bosnia and Herzegovina. PMID:18293460

  2. 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)

  3. 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…

  4. The influence of war on the development of neurosurgery.

    PubMed

    Dowdy, Justin; Pait, T Glenn

    2014-01-01

    The treatment of craniospinal war wounds proved to be a significant driving force in the early growth of neurosurgery as a specialty. This publication explores the historical relationship between the evolution of combat methodology from antiquity through modern conflicts as it dovetails with and drives corresponding advancements in the field of neurosurgery. Whether it's the basic management principles for intracranial projectile wounds derived from World War I experiences, the drastic improvement in the outcomes and management of spinal cord injuries observed in World War II, or the fact that both of these wars played a crucial role in the development of a training system that is the origin of modern residency programs, the influence of wartime experiences is pervasive.

  5. 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

  6. 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.

  7. Triathlon related musculoskeletal injuries: the status of injury prevention knowledge.

    PubMed

    Gosling, Cameron McR; Gabbe, Belinda J; Forbes, Andrew B

    2008-07-01

    Triathlon is a popular participation sport that combines swimming, cycling and running into a single event. A number of studies have investigated the incidence of injury, profile of injuries sustained and factors contributing to triathlon injury. This paper summarises the published literature in the context of the evidence base for the prevention of triathlon related injuries. Relevant articles on triathlon injuries were sourced from peer-reviewed English language journals and assessed using the Translating Research into Injury Prevention Practice (TRIPP) framework. This review highlights the significant knowledge gap that exists in the published literature describing the incidence of injury, the profile of injuries sustained and evidence for the prevention of injury in triathlon. Despite the number of studies undertaken to address TRIPP Stages 1 and 2 (injury surveillance, aetiology and mechanism of injury), most triathlon studies have been limited by retrospective designs with substantial, and unvalidated, recall periods, inconsistency in the definitions used for a reportable injury and exposure to injury, or a failure to capture exposure data at all. Overall, the paucity of quality, prospective studies investigating the incidence of injury in triathlon and factors contributing to their occurrence has led to an inability to adequately inform the development of injury prevention strategies (TRIPP Stages 3-6) for this sport, a situation that must be rectified if gains are to be made in reducing the burden of triathlon related injury.

  8. Development of a comprehensive Blast-Related Auditory Injury Database (BRAID).

    PubMed

    Joseph, Antony R; Horton, Jaime L; Clouser, Mary C; MacGregor, Andrew J; Louie, Michelle; Galarneau, Michael R

    2016-01-01

    The Department of Defense Hearing Conservation Program provides specific guidance for service components to prevent occupational hearing loss; however, it does not specifically contend with the unique noise exposures observed in the theater of war, such as blasts and explosions. In order to examine the effects of blast injury on hearing sensitivity, we developed a large database composed of demographic, audiometric, point of injury, and medical outcome data, with the primary aim of developing a long-standing and integrated capability for the surveillance, assessment, and investigation of blast-related hearing outcomes. Methods used to develop the dataset are described. Encompassing more than 16,500 Navy and Marine Corps personnel, the Blast-Related Auditory Injury Database (BRAID) includes individuals with a blast-related injury and nonblast control subjects. Using baseline and postdeployment hearing threshold data, a retrospective analysis of the cohort revealed that the rate of hearing loss for the injured servicemembers was 39%. The BRAID will be useful for studies that assess hearing patterns following deployment-related injury, such as blast exposures, that facilitate exploration of health outcomes and whether they are predictive of audiometric disposition and that help establish hearing loss prevention strategies and program policies for affected military commands and servicemembers.

  9. Development of a comprehensive Blast-Related Auditory Injury Database (BRAID).

    PubMed

    Joseph, Antony R; Horton, Jaime L; Clouser, Mary C; MacGregor, Andrew J; Louie, Michelle; Galarneau, Michael R

    2016-01-01

    The Department of Defense Hearing Conservation Program provides specific guidance for service components to prevent occupational hearing loss; however, it does not specifically contend with the unique noise exposures observed in the theater of war, such as blasts and explosions. In order to examine the effects of blast injury on hearing sensitivity, we developed a large database composed of demographic, audiometric, point of injury, and medical outcome data, with the primary aim of developing a long-standing and integrated capability for the surveillance, assessment, and investigation of blast-related hearing outcomes. Methods used to develop the dataset are described. Encompassing more than 16,500 Navy and Marine Corps personnel, the Blast-Related Auditory Injury Database (BRAID) includes individuals with a blast-related injury and nonblast control subjects. Using baseline and postdeployment hearing threshold data, a retrospective analysis of the cohort revealed that the rate of hearing loss for the injured servicemembers was 39%. The BRAID will be useful for studies that assess hearing patterns following deployment-related injury, such as blast exposures, that facilitate exploration of health outcomes and whether they are predictive of audiometric disposition and that help establish hearing loss prevention strategies and program policies for affected military commands and servicemembers. PMID:27273241

  10. 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

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

    PubMed

    Edwards, Ryan D

    2014-05-01

    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

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

    PubMed

    Edwards, Ryan D

    2014-05-01

    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.

  13. 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)

  14. 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

  15. A Novel Method for Verifying War Mortality while Estimating Iraqi Deaths for the Iran-Iraq War through Operation Desert Storm (1980-1993)

    PubMed Central

    Li, Shang-Ju; Flaxman, Abraham; Lafta, Riyadh; Galway, Lindsay; Takaro, Tim K.; Burnham, Gilbert; Hagopian, Amy

    2016-01-01

    Objectives We estimated war-related Iraqi mortality for the period 1980 through 1993. Method To test our hypothesis that deaths reported by siblings (even dating back several decades) would correspond with war events, we compared sibling mortality reports with the frequency of independent news reports about violent historic events. We used data from a survey of 4,287 adults in 2000 Iraqi households conducted in 2011. Interviewees reported on the status of their 24,759 siblings. Death rates were applied to population estimates, 1980 to 1993. News report data came from the ProQuest New York Times database. Results About half of sibling-reported deaths across the study period were attributed to direct war-related injuries. The Iran-Iraq war led to nearly 200,000 adult deaths, and the 1990–1991 First Gulf War generated another approximately 40,000 deaths. Deaths during peace intervals before and after each war were significantly lower. We found a relationship between total sibling-reported deaths and the tally of war events across the period, p = 0.02. Conclusions We report a novel method to verify the reliability of epidemiological (household survey) estimates of direct war-related injury mortality dating back several decades. PMID:27768730

  16. 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.…

  17. 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.

  18. 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)

  19. The Great War. [Teaching Materials].

    ERIC Educational Resources Information Center

    Public Broadcasting Service, Washington, DC.

    This package of teaching materials is intended to accompany an eight-part film series entitled "The Great War" (i.e., World War I), produced for public television. The package consists of a "teacher's guide,""video segment index,""student resource" materials, and approximately 40 large photographs. The video series is not a war story of battles,…

  20. 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)

  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. 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…

  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. 'War neurosis' during the Spanish Civil War (1936-39).

    PubMed

    Villasante, Olga

    2010-12-01

    The aim of this contribution is to analyse the incidence and treatment of war neurosis in Madrid during the Spanish Civil War. First, the scientific papers published on war neurosis during and after the war are examined. Then the work of Gregorio Bermann (1894-1972), a member of the International Brigades who organized the frontline Neuropsychiatric Service at the Hospital de Chamartín de La Rosa (Madrid), is analysed. Las neurosis en la guerra, published in 1941, which recounts Bermann's personal experience in the care of war neurosis in Spain, is also discussed.

  5. 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)

  6. Medicalized weapons & modern war.

    PubMed

    Gross, Michael L

    2010-01-01

    "Medicalized" weapons--those that rely on advances in neuroscience, physiology, and pharmacology--offer the prospect of reducing casualties and protecting civilians. They could be especially useful in modern asymmetric wars in which conventional states are pitted against guerrilla or insurgent forces. But may physicians and other medical workers participate in their development?

  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. 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)

  9. 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…

  10. 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…

  11. 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)

  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. 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…

  14. 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…

  15. 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

  16. 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

  17. War, terrorism, and children.

    PubMed

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

    2004-04-01

    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 best approach, it is important to provide information that is developmentally appropriate. Providing education and guidance can reduce stress and enhance understanding of the chaotic events confronting our nation. It also provides a platform for communication and exploration should additional terrorist attacks or acts of war occur. It is important to examine how to approach children and adolescents to communicate with them about these sensitive issues.

  18. Australia and nuclear war

    SciTech Connect

    Denborough, M.A.

    1985-01-01

    This volume compiles the papers presented in the conference held in May 1983 under the auspices of the Center for Continuing Education at the Australian National University. It also includes some previously unpublished scientific research. The papers range from analyses of the atmospheric and medical consequences of nuclear war to summaries of the efforts of people in all walks of life to prevent a global catastrophe.

  19. 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

  20. 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

  1. Blast-related mild traumatic brain injury: mechanisms of injury and impact on clinical care.

    PubMed

    Elder, Gregory A; Cristian, Adrian

    2009-04-01

    Mild traumatic brain injury has been called the signature injury of the wars in Iraq and Afghanistan. In both theaters of operation, traumatic brain injury has been a significant cause of mortality and morbidity, with blast-related injury the most common cause. Improvised explosive devices have been the major cause of blast injuries. It is estimated that 10% to 20% of veterans returning from these operations have suffered a traumatic brain injury, and there is concern that blast-related injury may produce adverse long-term health affects and affect the resilience and in-theater performance of troops. Blast-related injury occurs through several mechanisms related to the nature of the blast overpressure wave itself as well as secondary and tertiary injuries. Animal studies clearly show that blast overpressure waves are transmitted to the brain and can cause changes that neuropathologically are most similar to diffuse axonal injury. One striking feature of the mild traumatic brain injury cases being seen in veterans of the wars in Iraq and Afghanistan is the high association of mild traumatic brain injury with posttraumatic stress disorder. The overlap in symptoms between the disorders has made distinguishing them clinically challenging. The high rates of mild traumatic brain injury and posttraumatic stress disorder in the current operations are of significant concern for the long-term health of US veterans with associated economic implications. PMID:19306373

  2. The Effect of War on Children.

    ERIC Educational Resources Information Center

    Goldson, Edward

    1996-01-01

    This paper discusses the effects of modern war on children in the 20th century, focusing on direct and indirect effects of World War II, Vietnam War, war in Afghanistan, conflicts in Africa and in Central America, and Persian Gulf War. The paper notes the devastating effects on children of disruption of education and other public services in…

  3. Baseball bat assault injuries.

    PubMed

    Groleau, G A; Tso, E L; Olshaker, J S; Barish, R A; Lyston, D J

    1993-03-01

    The baseball bat, according to Baltimore City police crime statistics, is a commonly used weapon. To assess the severity of injuries inflicted by this modern-day club, we retrospectively reviewed 75 charts of patients treated at the University of Maryland Medical Systems Hospital for baseball bat injuries from January 1990 through July 1991. Multisystem trauma was documented, with craniocerebral injury being the most frequent and the most frequent cause of death. Of the victims struck on the head, 26% sustained an intracranial hemorrhage. In our series, the history of loss of consciousness and the Glasgow Coma Scale score failed to reliably identify the patients with serious injuries. Seventeen percent of our patients with intracranial hemorrhages had both a negative or uncertain history of loss of consciousness and a normal Glasgow Coma Scale score on arrival.

  4. 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 ...

  5. 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 ...

  6. [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

  7. After more than 10 years of Gulf War veteran medical evaluations, what have we learned?

    PubMed

    Gray, Gregory C; Gackstetter, Gary D; Kang, Han K; Graham, John T; Scott, Ken C

    2004-06-01

    Since the 1991 Gulf War, more than 10 years and 1 billion dollars of health evaluations and research have been invested in understanding illnesses among Gulf War veterans. We examined the extensive published healthcare utilization data in an effort to summarize what has been learned. Using multiple search techniques, data as of June 2003 from four different national Gulf War health registries and numerous hospitalization and ambulatory care reports were reviewed. Thus far, published reports have not revealed a unique Gulf War syndrome nor identified specific exposures that might explain postwar morbidity. Instead, they have demonstrated that Gulf War veterans have had an increase in multi-symptom condition, injury, and mental health diagnoses. While these diagnoses are similar to those experienced by other comparable military populations, their explanation is not fully understood. New strategies to identify risk factors for, and to reduce, such postdeployment conditions are summarized.

  8. 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

  9. Factors Affecting Student Attitudes toward War.

    ERIC Educational Resources Information Center

    Lester, David

    1994-01-01

    Reviews previous research on attitudes toward war. Describes a study of undergraduate student attitudes toward war compared with personality traits. Finds that, although personality traits were only minimally associated with attitudes toward war, men were more prowar then women. (CFR)

  10. Whither the "signature wounds of the war" after the war: estimates of incidence rates and proportions of TBI and PTSD diagnoses attributable to background risk, enhanced ascertainment, and active war zone service, active component, U.S. Armed Forces, 2003-2014.

    PubMed

    Brundage, John F; Taubman, Stephen B; Hunt, Devin J; Clark, Leslie L

    2015-02-01

    Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are "signature wounds" of the Afghanistan/Iraq wars; however, many TBI/PTSD cases are not war related. During the wars, diagnoses of TBI/PTSD among military members increased because risks of TBI/PTSD, and capabilities to detect cases, increased. This report summarizes TBI/PTSD diagnosis experiences of three cohorts of overseas deployers in relation to the natures of their exposures to active war service and enhanced case ascertainment efforts. The findings suggest that, during the war, the proportions of PTSD diagnoses attributable to war zone service decreased from approximately 80% to less than 50%, while the proportions attributable to enhanced case ascertainment increased from less than 10% to nearly 50%. The proportions of TBI diagnoses attributable to war zone service more than tripled from 2003-2005 (13.1%) through 2007-2009 (44.8%); the proportions attributable to enhanced ascertainment also markedly increased, but not until after 2007. By the end of the war, war zone service and enhanced ascertainment accounted for similar proportions of all PTSD and TBI diagnoses. If programs and resources currently focused on TBI and PTSD continue, rates of diagnoses post-war will greatly exceed those pre-war. PMID:25734618

  11. 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

  12. 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.

  13. 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

  14. Children of War. [Lesson Plan].

    ERIC Educational Resources Information Center

    Discovery Communications, Inc., Bethesda, MD.

    This lesson plan presents activities in which students read, analyze, and discuss excerpts from children's war diaries; and create a storyboard for a public service announcement on children's rights in wartime. It includes objectives, materials, procedures, extension activities, excerpts of children's war diaries, suggested readings, and web…

  15. 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…

  16. 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…

  17. 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…

  18. 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.

  19. 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,…

  20. 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

  1. 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.”

  2. 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.

  3. 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

  4. Nuclear war: preventable or inevitable?

    PubMed

    Smith, Richard

    1984-06-23

    Smith reports at length on the fourth meeting of International Physicians for the Prevention of Nuclear War, held in Helsinki in 1984 and attended by 450 doctors from 53 countries. Among the topics addressed by the delegates were the preventability of nuclear war, the threat of nuclear winter, the expenditure on atomic weapons of funds that could be used for health programs, the effects on children of the threat of nuclear conflict, and the danger of accidental nuclear war. The meeting concluded with a letter sent from the conference to the leaders of the United States and the Soviet Union.

  5. Wars of the 1990s.

    PubMed

    Firket, H

    2001-01-01

    The 40 wars of the past decade, all 'minor', have resulted in a total of more than two million deaths and 20 million refugees or displaced persons. Few have been the international wars typical of previous periods. Nine out of ten began as internal or civil wars, foreign intervention--when it occurred--being always secondary. The weapons used, the effects on the civilian populations, the type and extension of damages are different but equally destructive. The main causes of these conflicts are cultural or religious, rather than economic. The best attitudes to attempt to prevent or stop them are surveyed.

  6. Literature of War and Peace. Section III: Why War?

    ERIC Educational Resources Information Center

    Bettendorf, Joline; And Others

    This 13-day curriculum unit is designed for use in English and language arts classrooms, grades 7-12 and junior college. While it is the third section in a series of five on the literature of war and peace, it can be used with or without the other four sections. Each section of the series focuses on a different genre of the literature of war and…

  7. World War I psychoneuroses: hysteria goes to war.

    PubMed

    Tatu, Laurent; Bogousslavsky, Julien

    2014-01-01

    During the First World War, military physicians from the belligerent countries were faced with soldiers suffering from psychotrauma with often unheard of clinical signs, such as camptocormia. These varied clinical presentations took the form of abnormal movements, deaf-mutism, mental confusion, and delusional disorders. In Anglo-Saxon countries, the term 'shell shock' was used to define these disorders. The debate on whether the war was responsible for these disorders divided mobilized neuropsychiatrists. In psychological theories, war is seen as the principal causal factor. In hystero-pithiatism, developed by Joseph Babinski (1857-1932), trauma was not directly caused by the war. It was rather due to the unwillingness of the soldier to take part in the war. Permanent suspicion of malingering resulted in the establishment of a wide range of medical experiments. Many doctors used aggressive treatment methods to force the soldiers exhibiting war neuroses to return to the front as quickly as possible. Medicomilitary collusion ensued. Electrotherapy became the basis of repressive psychotherapy, such as 'torpillage', which was developed by Clovis Vincent (1879-1947), or psychofaradism, which was established by Gustave Roussy (1874-1948). Some soldiers refused such treatments, considering them a form of torture, and were brought before courts-martial. Famous cases, such as that of Baptiste Deschamps (1881-1953), raised the question of the rights of the wounded. Soldiers suffering from psychotrauma, ignored and regarded as malingerers or deserters, were sentenced to death by the courts-martial. Trials of soldiers or doctors were also held in Germany and Austria. After the war, psychoneurotics long haunted asylums and rehabilitation centers. Abuses related to the treatment of the Great War psychoneuroses nevertheless significantly changed medical concepts, leading to the modern definition of 'posttraumatic stress disorder'.

  8. 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…

  9. 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)

  10. Reducing the risk of nuclear war

    SciTech Connect

    Einhorn, R.J.; Garrity

    1985-01-01

    This report seeks to outline a strategy for reducing the chances of nuclear war and to place arms control in proper perspective within it. Chapter titles include: The Risks of Nuclear War; The Fundamental and Proximate Causes of U.S.-Soviet Nuclear War; and Policies to Reduce the Risk of Nuclear War.

  11. 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…

  12. 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)

  13. [Incidence of sports-related eye injuries].

    PubMed

    Pikkel, J; Gelfand, Y; Miller, B

    1995-10-01

    The incidence of sports-related eye injuries was analyzed retrospectively for 1991-1993. It was fairly steady at about 2% of all eye casualties annually. 21% of those with sports-related eye injuries required hospitalization. The commonest pathological findings were corneal erosion (32%), eye lid injuries (27%), hyphema (19%) and macular edema (3%). Most eyes were injured during soccer (37%) and basketball (27%) games, the most popular sports in Israel.

  14. The "War Poets": Evolution of a Literary Conscience in World War I.

    ERIC Educational Resources Information Center

    Galambos, Ellen

    1983-01-01

    Pre-World War I poetry often used picturesque images which blinded people to the actual horrors of war. The war poets, who experienced the destruction of World War I, led the way in expressing new images of the devastation and death of war, rather than focusing on honor and glory. (IS)

  15. 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)

  16. Assessment and treatment of common persistent sequelae following blast induced mild traumatic brain injury.

    PubMed

    Schultz, Billie A; Cifu, David X; McNamee, Shane; Nichols, Michelle; Carne, William

    2011-01-01

    The ongoing wars in Iraq and Afghanistan and terrorist activity worldwide have been associated with an increased incidence of blast injuries. While blast injuries share similarities with blunt or penetrating traumatic injuries, there are unique mechanistic elements of blast injury that create increased vulnerability to damage of specific organs. This review highlights the mechanism of blast-related injury, describes the common sequelae of blast exposure that may impact rehabilitation care, and summarizes the intervention strategies for these blast-related sequelae.

  17. Observations of a pediatric surgeon in the Persian Gulf War.

    PubMed

    Reyna, T M

    1993-02-01

    In Third-World countries, infectious disease is the principal cause of childhood death and disability. During the Persian Gulf War trauma became the leading cause of death in children, prompting this review of experience with the delivery of pediatric trauma care to noncombatant children at a military hospital. Eight hundred seventy-seven patients were admitted to the 410th Evacuation Hospital from January to April 1991. Fifty of the patients (6%) were children, and 40 of the 50 were admitted for trauma. The mean age of the children was 9 years. Sixty-five percent of pediatric patients sustained penetrating injuries; mechanisms of injury included shrapnel wounds, gunshot wounds, burns, motor vehicle accidents, crush injuries, and falls. The overall mortality rate for children admitted to the hospital was 12%, but no injured child died as a result of trauma. Complications of dehydration or malnutrition in infants accounted for all the deaths.

  18. Slow-pitch softball injuries.

    PubMed

    Wheeler, B R

    1984-01-01

    A prospective investigation of slow-pitch softball injuries incurred in Hawaii was undertaken to study the nature of these injuries and analyze their causes. The injured players were involved in league softball with referees. There were 83 athletes and 93 injuries. A retrospective review of all Army softball-related admissions was also done. Thirty-five athletes or 42% were injured while sliding, 29 "foot first" and the remainder "hand first". Twenty-five of 27 ankle injuries caused by sliding included 20 fractures, 3 sprains, and 2 complete closed posterior dislocations. Analysis of these injuries suggests that the injury occurs when the individual uses the base to rapidly decelerate and avoid overrunning the base. Eighty-four percent of the athletes were injured from three mechanisms; 42% from sliding, 25% from "jamming" injuries, and 17% from falls. The only preventable group of injuries appears to be the sliding injuries. Recessing the bases, using "quick release" rather than anchored bases, teaching safer sliding techniques, or eliminating the slide are suggested as means of preventing these injuries.

  19. 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 ...

  20. 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 ...

  1. 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 ...

  2. 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 ...

  3. Women, Gender, and the War.

    ERIC Educational Resources Information Center

    Jeffords, Susan

    1989-01-01

    Examines the representation of women in Vietnam War literature and films within a context of changing gender relationships in American society. Argues that critical attention needs to be given to the structure of masculinity and its relationship to warfare. (MS)

  4. 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.

  5. 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.

  6. 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.

  7. Hamstring injuries.

    PubMed

    Ropiak, Christopher R; Bosco, Joseph A

    2012-01-01

    Hamstring injuries are a frequent injury in athletes. Proximal injuries are common, ranging from strain to complete tear. Strains are managed nonoperatively, with rest followed by progressive stretching and strengthening. Reinjury is a concern. High grade complete tears are better managed surgically, with reattachment to the injured tendon or ischial tuberosity. Distal hamstring injury is usually associated with other knee injuries, and isolated injury is rare.

  8. Psychological aspects of nuclear war

    SciTech Connect

    Thompson, J.

    1985-01-01

    Exploring the nature of nuclear war, this treatise examines human reaction to nuclear disaster and accidental explosions. The discussion is based on evidence of human fallibility that has emerged from the psychology of accidents and from research into decision-making in military and political contexts. The book draws on the psychology of negotiation and conflict resolution to suggest ways in which the threat of nuclear war might be reduced.

  9. 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.

  10. 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)

  11. 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.

  12. 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

  13. 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.

  14. Quality of life in families of Croatian veterans 15 years after the war.

    PubMed

    Zdjelarević, Ana; Komar, Zoran; Loncar, Mladen; Plasć, Ivana Dijanić; Hrabac, Pero; Groznica, Ivana; Marcinko, Darko

    2011-01-01

    Exposure to war trauma with its consequences such as post traumatic stress disorder (PTSD) and disability due to combat injuries poses a significant problem for modern Croatian society. However, this is also a public health problem requiring continuous study of effective treatment strategies to achieve an increase in quality of life of most war-affected groups. Aim of this study was to examine the quality of life of population most affected by war - families of Croatian veterans. Present study included 126 female participants, who agreed to complete physical and psychiatric examination organized by the Ministry of Family, War Veterans and Intergenerational Solidarity. Included were participants with status of either wife of war veteran suffering from PTSD, wife who lost her husband in war circumstances or wife of war veteran with physical disabilities resulting from war activities. All three groups were asked to fill out the World Health Organization Quality of Life Questionnaire - short form (WHOQOL-BREF). Results indicate that assumed intensity of secondary trauma is not associated with quality of life. Namely, the highest level of satisfaction was found in wives of the most seriously affected invalids of war (M=3.77; sd=0.741), folowed by the wives of deceased soldiers (M=3.5; sd= 0.697), while the lowest quality of life results were found in wives of veterans suffering from PTSD (M=3.12; sd=0.608). Our results confirm that, nearly 15 years after the war, wives of disabled or killed Croatian soldiers have a (comparatively) satisfactory quality of their everyday lives, compared to the wives of veterans suffering from PTSD.

  15. 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.

  16. 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 Central

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

    2015-01-01

    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 cm3; sensitivity, 60.7%; specificity, 70.4%). The incidence of Grade ≥2 RILI was significantly lower with AVS5 of the ipsilateral lung ≥564.9 cm3 than with AVS5 < 564.9 cm3 (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

  17. [Organization of stomatological care in Russian army during first World War 1914-1917 y].

    PubMed

    Pavlovskiĭ, L N

    2006-01-01

    The article presents issues on organization of stomatological care in Russian army during First World War. The author showed reasons of low efficiency of the treatment of soldiers with maxillofacial region. Injuries beginning of a new stage in the treatment of maxillofacial region fire wounds and origin of a new specialty developed a military maxillofacial surgery.

  18. The Colyer Collection of First World War dental radiographs and casts at the Hunterian Museum.

    PubMed

    Hussey, Kristin

    2014-07-01

    The Colyer Collection of First World War dental radiographs and casts is a unique teaching resource with a fascinating history. The story of the radiographs illuminates the role of dental surgery and Sir J. Frank Colyer (1866-1954) in the treatment of maxillofacial injuries during this period.

  19. 76 FR 2447 - Gulf War and Health, Volume 6, Physiologic, Psychologic, and Psychosocial Effects of Deployment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-13

    ... disease, injury, or illness for which service connection can be granted (e.g. suicide or marital conflict.... Consistent with VA's past interpretation of section 1118, see 72 FR 48734, 48739-41 (Aug. 24, 2007), we... service in the Gulf War. 75 FR 59968 (September 29, 2010). As explained above, however, there is...

  20. 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.

  1. 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.

  2. Gunshot and Explosion Injuries

    PubMed Central

    Peleg, Kobi; Aharonson-Daniel, Limor; Stein, Michael; Michaelson, Moshe; Kluger, Yoram; Simon, Daniel; Noji, Eric K.

    2004-01-01

    Context: An increase of terror-related activities may necessitate treatment of mass casualty incidents, requiring a broadening of existing skills and knowledge of various injury mechanisms. Objective: To characterize and compare injuries from gunshot and explosion caused by terrorist acts. Methods: A retrospective cohort study of patients recorded in the Israeli National Trauma Registry (ITR), all due to terror-related injuries, between October 1, 2000, to June 30, 2002. The ITR records all casualty admissions to hospitals, in-hospital deaths, and transfers at 9 of the 23 trauma centers in Israel. All 6 level I trauma centers and 3 of the largest regional trauma centers in the country are included. The registry includes the majority of severe terror-related injuries. Injury diagnoses, severity scores, hospital resource utilization parameters, length of stay (LOS), survival, and disposition. Results: A total of 1155 terror-related injuries: 54% by explosion, 36% gunshot wounds (GSW), and 10% by other means. This paper focused on the 2 larger patient subsets: 1033 patients injured by terror-related explosion or GSW. Seventy-one percent of the patients were male, 84% in the GSW group and 63% in the explosion group. More than half (53%) of the patients were 15 to 29 years old, 59% in the GSW group and 48% in the explosion group. GSW patients suffered higher proportions of open wounds (63% versus 53%) and fractures (42% versus 31%). Multiple body-regions injured in a single patient occurred in 62% of explosion victims versus 47% in GSW patients. GSW patients had double the proportion of moderate injuries than explosion victims. Explosion victims have a larger proportion of minor injuries on one hand and critical to fatal injuries on the other. LOS was longer than 2 weeks for 20% (22% in explosion, 18% in GSW). Fifty-one percent of the patients underwent a surgical procedure, 58% in the GSW group and 46% in explosion group. Inpatient death rate was 6.3% (65 patients), 7

  3. [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

  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. Cardiac injuries caused by blunt trauma: an autopsy based assessment of the injury pattern.

    PubMed

    Turan, Arzu Akcay; Karayel, Ferah Anik; Akyildiz, Elif; Pakis, Isil; Uzun, Ibrahim; Gurpinar, Kagan; Atilmis, Umit; Kir, Ziya

    2010-01-01

    Nonpenetrating chest trauma with injury to the heart and aorta has become increasingly common, particularly as a result of rapid deceleration in high-speed vehicular accidents, over the past 2-3 decades. The high mortality rate of cardiac injuries and possible late onset complications make blunt cardiac injuries an important challenging point for legal medicine. One hundred and ninety cases with blunt cardiac injuries in a period of 3 years were analyzed retrospectively in terms of patterns of cardiac injury, survival times, and demographic profiles of the cases in this study.

  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.

  7. 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.

  8. 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.

  9. Student injuries in the dissecting room.

    PubMed

    Cornwall, Jon; Davies, Tilman M; Lees, David

    2013-01-01

    Cadaver dissection is the first opportunity for many students to practice handling human tissue and is their first exposure to the occupational hazards involved with this task. Few studies examine dissection room injuries to ascertain the dangers associated with dissecting. We performed a retrospective cohort analysis of dissection room injuries from four student cohorts over an eleven-year period (2001-2011), including second-year medical students, third-year medical students, second-year dental students, and third-year science students. Injury data included activity causing injury, object responsible, and injury site. A total of 163 injuries during 70,039 hours of dissection were recorded, with 66 in third-year medical students, 42 in second-year medical students, 36 in third-year science students, and 16 in second-year dental students. The overall rate was 2.87 injuries per 1,000 dissection hours, with second-year medical students most frequently injured (5.5 injuries per 1,000 hours); third-year medical students were least frequently injured (1.3 injuries per 1,000 hours). A significant difference in injury rates between student groups indicated a higher than expected injury rate to second-year medical students and lower than expected rates to third-year medical students. Injury rates increased for most groups between 2001-2006 and 2007-2011 periods. Most injuries (79%) were from scalpel cuts to the finger or thumb. This study provides injury rates for dissection room injuries to students, indicating differences in injury frequency between cohorts and an increase in injury rate over time. As scalpel cuts were the most likely injury mechanism, targeting scalpel handling with preventative strategies may reduce future injury risk.

  10. Neurologic injury in snowmobiling

    PubMed Central

    Plog, Benjamin A.; Pierre, Clifford A.; Srinivasan, Vasisht; Srinivasan, Kaushik; Petraglia, Anthony L.; Huang, Jason H.

    2014-01-01

    Background: Snowmobiles are increasingly popular recreational, all-terrain utility vehicles that require skill and physical strength to operate given their inherent maneuverability, acceleration, and top speed capabilities. These same characteristics increase the risk of injury with the operation of these vehicles, particularly neurological injury. We characterize our series of 107 patients involved in snowmobiling accidents. Methods: From January 2004 to January 2012, all snowmobiling-related injuries referred to our regional trauma center were reviewed. Information had been recorded in the hospital's trauma registry and medical records were retrospectively reviewed for data pertaining to the injuries, with particular emphasis on neurological injuries and any associated details. Results: A total of 107 patients were identified. Ninety percent of injured riders were male. The mean age was 34.4 years (range 10-70), with 7% younger than age 16. The mean Injury Severity Score was 12.0 ± 0.69 (range 1-34). Although not documented in all patients, alcohol use was found in 7.5% of the patients and drug use found in one patient. Documentation of helmet use was available for only 31 of the patients; of which 13% were not helmeted. Causes included being thrown, flipped, or roll-over (33%), striking a stationary object (27%), being struck by a snowmobile (9%), striking another snowmobile (5.5%) or a car, train, or truck (5.5%), being injured by the machine itself (9%), other (2%) or unspecified (18%). Head injuries occurred in 35% patients, including concussion, subarachnoid hemorrhage, subdural hematoma, contusion, and facial/skull fracture. Spinal fractures occurred in 21% of the patients. Fractures to the thoracic spine were the most common (50%), followed by the cervical (41%) and lumbar (36%) spine. There were also three brachial plexus injuries, one tibial nerve injury, and one internal carotid artery dissection. Average length of stay was 4.98 ± 0.56 days

  11. 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.

  12. 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

  13. 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

  14. Plastic Surgery Challenges in War Wounded I: Flap-Based Extremity Reconstruction

    PubMed Central

    Sabino, Jennifer M.; Slater, Julia; Valerio, Ian L.

    2016-01-01

    Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases. Advanced reconstructive techniques coupled with regenerative medicine applications have played a critical role in the restoration, recovery, and rehabilitation of functional limb salvage. Translational Relevance: The past 14 years of war trauma have increased our understanding of tissue transfer for extremity reconstruction in the treatment of combat casualties. Injury patterns, flap choice, and reconstruction timing are critical variables to consider for optimal outcomes. Clinical Relevance: Subacute reconstruction with specifically chosen flap tissue and donor site location based on individual injuries result in successful tissue transfer, even in critically injured patients. These considerations can be combined with regenerative therapies to optimize massive wound coverage and limb salvage form and function in previously active patients. Summary: Traditional soft tissue reconstruction is integral in the treatment of war extremity trauma. Pedicle and free flaps are a critically important part of the reconstructive ladder for salvaging extreme extremity injuries that are seen as a result of the current practice of war. PMID:27679751

  15. Plastic Surgery Challenges in War Wounded I: Flap-Based Extremity Reconstruction

    PubMed Central

    Sabino, Jennifer M.; Slater, Julia; Valerio, Ian L.

    2016-01-01

    Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases. Advanced reconstructive techniques coupled with regenerative medicine applications have played a critical role in the restoration, recovery, and rehabilitation of functional limb salvage. Translational Relevance: The past 14 years of war trauma have increased our understanding of tissue transfer for extremity reconstruction in the treatment of combat casualties. Injury patterns, flap choice, and reconstruction timing are critical variables to consider for optimal outcomes. Clinical Relevance: Subacute reconstruction with specifically chosen flap tissue and donor site location based on individual injuries result in successful tissue transfer, even in critically injured patients. These considerations can be combined with regenerative therapies to optimize massive wound coverage and limb salvage form and function in previously active patients. Summary: Traditional soft tissue reconstruction is integral in the treatment of war extremity trauma. Pedicle and free flaps are a critically important part of the reconstructive ladder for salvaging extreme extremity injuries that are seen as a result of the current practice of war.

  16. 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.

  17. 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

  18. 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.

  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.

  20. 10-year experience of injuries sustained during clearance of anti-personnel mines.

    PubMed

    Brown, R; Chaloner, E; Mannion, S; Cheatle, T

    2001-12-15

    Clearance of anti-personnel mines and unexploded ordnance in countries recovering from war usually continues long after conflict has ceased. We prospectively recorded 92 traumatic injuries sustained by 73 mineclearers working in seven countries over a period of 10 years. 15% of injuries were fatal, with an incidence of 116 injuries per 100000 workers per year. Limb injury occurred in 59% of cases, with an overall amputation rate of 30%. 44% of injuries were sustained by workers handling a mine, resulting in severe upper limb and facial injuries. The incidence of facial injuries fell after the introduction of visors.

  1. 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…

  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. 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

  4. 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.

  5. 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.

  6. 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…

  7. 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...

  8. 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…

  9. United States Historians, Cold War Rhetoric, and The Finnish Winter War.

    ERIC Educational Resources Information Center

    Olson, Keith W.

    The U.S. attitude toward Finland during the Cold War years reveals much about U.S. society and politics. In particular, the war between Finland and the Soviet Union during 1939 and 1940 (Finnish Winter War) and the way in which the United States reacted to it at the time and in the years following World War II has relevance for better…

  10. Suicide Prevention in the Pacific War (WWII).

    ERIC Educational Resources Information Center

    Suzuki, Peter T.

    1991-01-01

    During war against Japan, there were two facets of U.S. program to prevent suicide among the Japanese: research component in Foreign Morale Analysis Division of Office of War Information and a suicide prevention program itself put into effect toward the end of the war in battles of Saipan and Okinawa and undertaken by U.S. GIs. (Author/NB)

  11. World War II Memorial Learning Activities.

    ERIC Educational Resources Information Center

    Tennessee State Dept. of Education, Nashville.

    These learning activities can help students get the most out of a visit to the Tennessee World War II Memorial, a group of ten pylons located in Nashville (Tennessee). Each pylon contains informational text about the events of World War II. The ten pylons are listed as: (1) "Pylon E-1--Terror: America Enters the War against Fascism, June 1940";…

  12. An Anthropology of Violence and War.

    ERIC Educational Resources Information Center

    Balandier, Georges

    1986-01-01

    Describes anthropological thinking about primeval violence; how it originated, was manifested, and controlled. Discusses the role of war in Mawri of Niger society as an example of a society which preferred war to peace. Concludes with reflections on present 'secondary or induced wars,' and the need to understand these conflicts in terms of an…

  13. 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)

  14. 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…

  15. 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)

  16. Skateboard injuries.

    PubMed

    Cass, D T; Ross, F

    1990-08-01

    The recent increase in skateboard injuries is causing concern. Over a 30-month period there were 80 admissions (69 children) to Westmead Hospital because of skateboard injuries. Among children most injuries were minor, involving fractures to the upper limbs (47) or minor head injuries (8). The only serious injuries were a ruptured urethra and a closed head injury. Over the same time period skateboard riding caused five deaths in New South Wales. These all involved head injuries and in four instances collisions with cars. The data strongly support other studies that show skateboard riding is particularly dangerous near traffic and should be proscribed. However, in parkland and around the home the skateboard is an enjoyable toy with an acceptable risk of minor injury. Helmets should be worn and would have prevented all the head injury admissions in this series. Children under 10 have a higher risk of fractures and head injuries due to insufficient motor development to control the boards and the resultant falls. Skateboard injuries are an example of injuries caused by a "fad epidemic". To cope with these types of periodic events up-to-date data collection is needed, followed rapidly by an intervention programme so that serious injuries can be kept to a minimum.

  17. The Persian Gulf War: civilian war-related stress and the influence of age, religious faith, and war attitudes.

    PubMed

    Plante, T G; Manuel, G M

    1992-03-01

    This study examined the stress response of 86 civilian subjects at the onset of the Persian Gulf War. The Impact of Events Scale (IES) and the Symptom Checklist-90-Revised (SCL-90-R) were used to measure participants' subjective stress response and symptoms of psychological distress. Subjects also completed a demographic questionnaire that included questions that ranged from religious affiliation to approval of the war effort. The study describes war-related stress and the influence of age, religious faith, and attitudes about war on reported levels of stress. Results indicate measurable levels of war-related stress in this civilian population.

  18. 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…

  19. 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)

  20. 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…

  1. 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)

  2. 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…

  3. The past and present of blast injury research in China.

    PubMed

    Zhao, Yan; Zhou, Yuan-Guo

    2015-01-01

    With the increasing incidence of blast injury, the research on its mechanisms and protective measures draws more and more attention. Blast injury has many characteristics different from general war injuries or trauma. For example, soldiers often have various degrees of visceral injury without significant surface damage, combined injuries and arterial air embolism. Researchers in China began to investigate blast injury later than the United States and Sweden, but the development is so fast that lots of achievements have been gained, including the development of biological shock tube, the mechanisms and characteristics of blast injury in various organs, as well as protective measures under special environments. This article reviews the past and current situation of blast injury research in China.

  4. 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

  5. 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 ...

  6. 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 ...

  7. 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 - ...

  8. [Muscle crush injury and crush syndrome].

    PubMed

    Reingardienė, Dagmara; Jodžiūnienė, Liucija; Lažauskas, Robertas

    2010-01-01

    Crush injury is defined as compression of extremities or other parts of the body that causes muscle breakdown (traumatic rhabdomyolysis). Systemic consequences of crush injuries are as follows: rhabdomyolysis, electrolyte and acid-base abnormalities, hypovolemia, and acute renal failure. Crush injuries are important injuries in disaster situations: earthquakes, hurricanes, mining and road traffic accidents, war, collapse of buildings, etc. In this review article, there are discussed about epidemiology of crush syndrome, risk factors, pathophysiology (mechanisms of muscle cell injury, release of substances from injured muscles, other consequences of reperfusion), clinical features, differential diagnosis, investigations, complications (acute renal failure, hypovolemic shock, hyperkalemia, infection, compartment syndrome), approach to treatment (adequate rehydration, a forced mannitol-alkaline diuresis, intravenous fluids, management of hyperkalemia, wound care, hyperbaric oxygen, etc.), prognosis, the mortality rate and prevention (timely support may reduce morbidity and mortality).

  9. An epidemiologic study of squash injuries.

    PubMed

    Berson, B L; Rolnick, A M; Ramos, C G; Thornton, J

    1981-01-01

    A retrospective investigation of squash-related injuries incurred at a private and a public club in New York was undertaken to gain insight into the incidence and nature of such injuries. Telephone interviews were conducted with 200 randomly selected individuals to obtain their entire injury history. Sixty-nine of the 155 squash players contacted sustained injuries during their participation. Some had multiple injuries. This resulted in an overall injury rate of 44.5%. Strains and sprains accounted for over one-third of the injuries. Nearly one-half of the injuries involved the lower extremity, with the ankle and lower leg being injured most often. Forty-seven percent of the injuries seen were considered disabling because the patients were out of action for more than two weeks after injury. Players over the age of 40 are at increased risk for injury, as are newcomers to the game. Increased injury rates were also associated with an increased frequency of play among females. Only rarely will an injured squash player become permanently impaired.

  10. Speed and spinal injuries.

    PubMed

    Healy, D G; Connolly, P; Stephens, M M; O'Byrne, J M; McManus, F; McCormack, D

    2004-09-01

    Road traffic accidents (RTA) are a significant cause of spinal trauma. On the 31st of October 2002 a new penalty system for speed related driving offences was introduced in Ireland. Our intention was to assess the effects of the introduction of this system on the activity of the National Spinal Injuries Centre (NSIC) with a retrospective review of all admissions from November 1998 until October 2003. The number of new acute admissions to the spinal injury unit during the study period was 831. In the first 6 months of the new system the number of RTA related admissions fell significantly to 17 compared to an average of 33 in the preceding 4 years. However, this effect was not maintained in the second 6 months. The fall in spinal injuries following RTA in the first 6 months of the new system parallels the pattern of road death reduction in this period. This suggests that driving behaviour can be modified with direct benefits in reducing spinal injuries. However, this effect has not persisted in the second 6 months of the new system suggesting that to maintain this change the perception and familiarity of a penalty are important factors in its impact.

  11. Battlefield euthanasia - courageous compassion or war crime?

    PubMed

    Neuhaus, Susan J

    2011-03-21

    Issues relating to voluntary euthanasia that are currently being debated by Australian society are distinctly different from those encountered by battlefield doctors. Doctors in war undertake to treat those affected by conflict; their participation in euthanasia challenges the profession's definition of "duty of care". Euthanasia must be distinguished from "triage" and medical withdrawal of care (which are decided within a medical facility where, although resources may be limited, comfort care can be provided in the face of treatment futility). Battlefield euthanasia is a decision made, often immediately after hostile action, in the face of apparently overwhelming injuries; there is often limited availability of pain relief, support systems or palliation that would be available in a civilian environment. The battlefield situation is further complicated by issues of personal danger, the immediacy of decision making and difficulties with distinguishing civilians from combatants. Regardless of the circumstances on a battlefield, doctors, whether they are civilians or members of a defence force, are subject to the laws of armed conflict, the special provisions of the Geneva Conventions and the ethical codes of the medical profession.

  12. 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

  13. 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.

  14. 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

  15. [War casualty triage during the First World War].

    PubMed

    Ferrandis, Jean-Jacques; Lefort, Hugues; Tabbagh, Xavier; Pons, François

    2014-06-01

    Along with the front hospitals (HOE), the action of sorting out the injured was one of the most important innovations of the Great War. Progressively, it was implemented and codified on each level of the evacuating chain, with variations due to the different phases of the conflict, such as in Verdun or in the Somme. From 1917 onwards, specific sorting centers, managed by experimented soldiers, were set up in the evacuating hospitals.

  16. [Rendering surgical care for the wounded presenting with injuries to limb vessels].

    PubMed

    Efimenko, N A; Kokhan, E P; Galik, N I

    2008-01-01

    The proffered paper provides the information about rendering surgical care for the wounded presenting with vascular injuries inflicted and sustained during wars Russia was engaged in, to be followed by a detailed description of the haemorrhage-arresting methods and techniques used in N. I. Pirogov's time, during World War I, the Great Patriotic War, as well as in local military conflicts and combat operations. Also depicted herein is the role surgeons of Russia have played in the development of vascular surgery, and, finally, due coverage is given to the statistical data concerning the methods of rendering care for those having suffered firearm wounds and injuries involving vascular lesions.

  17. Bicycling injuries.

    PubMed

    Silberman, Marc R

    2013-01-01

    Bicycling injuries can be classified into bicycle contact, traumatic, and overuse injuries. Despite the popularity of cycling, there are few scientific studies regarding injuries. Epidemiological studies are difficult to compare due to different methodologies and the diverse population of cyclists studied. There are only three studies conducted on top level professionals. Ninety-four percent of professionals in 1 year have experienced at least one overuse injury. Most overuse injuries are mild with limited time off the bike. The most common site of overuse injury is the knee, and the most common site of traumatic injury is the shoulder, with the clavicle having the most common fracture. Many overuse and bicycle contact ailments are relieved with simple bike adjustments.

  18. Racquet sports--patterns of injury presenting to a sports injury clinic.

    PubMed

    Chard, M D; Lachmann, S M

    1987-12-01

    In an 8-year retrospective study, 631 injuries due to the racquet sports of squash (59%), tennis (21%) and badminton (20%) were seen in a sports injury clinic, males predominating (58 to 66%). The proportion of squash injuries was higher than expected and probably relates to higher physical stress and risk of contact in this sport. Also they occurred mainly in persons over 25 years (59%) i.e. the reverse for sport in general. Acute traumatic injuries were seen especially in squash players, a majority affecting the knee, lumbar region, muscles and ankle. Tennis injuries differed most with lateral epicondylitis, patello-femoral pain and lumbar disc prolapse being relatively common. The badminton injury pattern overlapped the others. Lower limb injuries predominated in all three. Detailed assessment of 106 cases showed many to be new, infrequent, social players. Poor warm-up was a common factor in new and established players. The importance of these findings is discussed.

  19. War, peace and professional responsibility.

    PubMed

    Cassel, C K

    1983-01-01

    The technology of modern weapons, especially nuclear weapons, poses a critical threat to the health of all people. In addition to the unprecedented risk of massive destruction to living things and to the ecosphere, the resources used in production of these arsenals cause an economic threat to the health of populations even if the weapons are never used. Medical and social scientists have a responsibility to work for the prevention of nuclear war and the reversal of the arms race. This may imply an obligation to work towards the prevention of war in general. Professional responsibility in this regard is based on (1) special expertise, (2) influence in society and (3) the symbolic power of the values of life, health and human dignity.

  20. Neurosurgical notes: World War II.

    PubMed

    Pool, J L

    2000-03-01

    This concerns my activities as a neurosurgeon in the European Theater of Operations and the North African, Tunisian campaign, during World War II. Action during the Battle of the Bulge came later. Our mobile tent hospital, the 9th Evacuation Hospital, was similar to that depicted in the television show M*A*S*H. To lend flavor to these comments, I have referred to medical and surgical matters in other units as well as our own, mentioned global aspects of the war, and included vignettes of life off-duty. The story begins after induction into the Army Medical Corps as a volunteer in July 1942 and ends with honorable discharge in April 1946. PMID:10719869

  1. Head injuries in helmeted child bicyclists.

    PubMed Central

    Grimard, G.; Nolan, T.; Carlin, J. B.

    1995-01-01

    OBJECTIVE: To determine the characteristics and the severity of head and facial injuries to helmeted child bicyclists, and whether the helmet contributed to the injury, and to study factors related to bicycle accidents. DESIGN: Retrospective review of two case series. Children sustaining head injury while not wearing helmets were studied as a form of reference group. SETTING: Large paediatric teaching hospital. SUBJECTS: 34 helmeted child bicyclists and 155 non-helmeted bicyclists, aged 5-14 years. MAIN OUTCOME MEASURES: Number of injuries, type of injuries, injury severity score, deaths, and accident circumstances. RESULTS: 79% of the head injuries of the helmeted child group were mild and two thirds of these had facial injuries. Children in the helmet group were in a greater proportion of bike-car collisions than the no helmet group and at least 15% of the helmets were lost on impact. There were no injuries secondary to the helmet. CONCLUSIONS: Most of the head injuries sustained by the helmeted children were of mild severity and there was no evidence to suggest that the helmet contributed to injury. Nevertheless, consideration should be given to designing a facial protector for the bicycle helmet and to improvement of the fastening device. PMID:9345988

  2. 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.

  3. Climatic effects of nuclear war

    SciTech Connect

    Turco, R.P.; Toon, O.B.; Ackerman, T.P.; Pollack, J.B.; Sagan, C.

    1984-08-01

    Recent findings by this group confirmed by workers in Europe, the US and the USSR, suggest that the long-term climatic effects of a major nuclear war are likely to be much severer and farther-reaching than had been supposed. In the aftermath of such a war vast areas of the earth could be subjected to prolonged darkness, abnormally low temperatures, violent windstorms, toxic smog and persistent radioactive fallout - in short, the combination of conditions that has come to be known as nuclear winter. In brief, the authors' initial results, published in Science in December, 1983, showed that the potential global atmospheric and climatic consequences of nuclear war...are serious. Significant hemispherical attenuation of the solar radiation flux and subfreezing land temperatures may be caused by fine dust raised in high-yield nuclear surface bursts and by smoke from city and forest fires ignited by airbursts of all yields. Subsequent studies, based on more powerful models of the general circulation of the earth's atmosphere, have tended to confirm both the validity of the authors' investgative approach and the main thrust of their findings. Most of this article is devoted to reviewing the current state of knowledge on this vital issue.

  4. [The characteristics of blast traumatic brain injury].

    PubMed

    Matsumoto, Yoshihisa; Hatano, Ben; Matsushita, Yoshitaro; Nawashiro, Hiroshi; Shima, Katsuji

    2010-08-01

    With the increase in terrorist activity in recent times, the number of blast injuries has also increased in civilian and military settings. In a recent war, the number of patients who suffered blast traumatic brain injury (bTBI) increased, so treatment of bTBI is currently a very important issue. Blast injury is complicated and can be divided into 4 categories: primary, secondary, tertiary, and quaternary. Primary blast injury results from exposure to blast waves; secondary blast injury is trauma caused by fragments of explosive devices; tertiary blast injury is the result of collision with objects; and quaternary blast injury is the result of exposure to toxic and other substances. Blast waves mainly injure air-containing organs such as the lung, bowel, and ear. The brain may also be affected by blast waves. From the clinical perspective, hyperemia and severe cerebral edema occur frequently in patients who sustain significant bTBI. Penetrating or closed head injury caused by the explosion may be associated with vasospasm and pseudoaneurysm formation. Mild traumatic brain injury during war can be associated with posttraumatic stress disorder. To elucidate the mechanism of bTBI, many research works using animal models and computer analysis are underway. Such studies have so far shown that blast waves can cause damage to the brain tissue and cognitive deficits; however, detailed investigations on this topic are still required. Treatment of bTBI patients may require clinical knowledge and skills related to intensive care, neurology, and neurosurgery. Moreover, further research is required in this field. PMID:20697143

  5. 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…

  6. 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

  7. Diving injuries.

    PubMed

    Dickey, L S

    1984-01-01

    This is a collective review about the pathophysiology, diagnosis, and management of SCUBA and diving injuries by the emergency physician. These injuries can be classified into those resulting from the toxic effects of the inhaled gas, from the pressure changes in the water and gas mixture while diving, and from decompression sickness. With the increasing popularity of SCUBA diving, it is hoped that this discussion will enable a recognition of these injuries and therefore minimize the morbidity and mortality from them.

  8. Medical costs of war in 2035: long-term care challenges for veterans of Iraq and Afghanistan.

    PubMed

    Geiling, James; Rosen, Joseph M; Edwards, Ryan D

    2012-11-01

    War-related medical costs for U.S. veterans of Iraq and Afghanistan may be enormous because of differences between these wars and previous conflicts: (1) Many veterans survive injuries that would have killed them in past wars, and (2) improvised explosive device attacks have caused "polytraumatic" injuries (multiple amputations; brain injury; severe facial trauma or blindness) that require decades of costly rehabilitation. In 2035, today's veterans will be middle-aged, with health issues like those seen in aging Vietnam veterans, complicated by comorbidities of posttraumatic stress disorder, traumatic brain injury, and polytrauma. This article cites emerging knowledge about best practices that have demonstrated cost-effectiveness in mitigating the medical costs of war. We propose that clinicians employ early interventions (trauma care, physical therapy, early post-traumatic stress disorder diagnosis) and preventive health programs (smoking cessation, alcohol-abuse counseling, weight control, stress reduction) to treat primary medical conditions now so that we can avoid treating costly secondary and tertiary complications in 2035. (We should help an amputee reduce his cholesterol and maintain his weight at age 30, rather than treating his heart disease or diabetes at age 50.) Appropriate early interventions for primary illness should preserve veterans' functional status, ensure quality clinical care, and reduce the potentially enormous cost burden of their future health care.

  9. Medical costs of war in 2035: long-term care challenges for veterans of Iraq and Afghanistan.

    PubMed

    Geiling, James; Rosen, Joseph M; Edwards, Ryan D

    2012-11-01

    War-related medical costs for U.S. veterans of Iraq and Afghanistan may be enormous because of differences between these wars and previous conflicts: (1) Many veterans survive injuries that would have killed them in past wars, and (2) improvised explosive device attacks have caused "polytraumatic" injuries (multiple amputations; brain injury; severe facial trauma or blindness) that require decades of costly rehabilitation. In 2035, today's veterans will be middle-aged, with health issues like those seen in aging Vietnam veterans, complicated by comorbidities of posttraumatic stress disorder, traumatic brain injury, and polytrauma. This article cites emerging knowledge about best practices that have demonstrated cost-effectiveness in mitigating the medical costs of war. We propose that clinicians employ early interventions (trauma care, physical therapy, early post-traumatic stress disorder diagnosis) and preventive health programs (smoking cessation, alcohol-abuse counseling, weight control, stress reduction) to treat primary medical conditions now so that we can avoid treating costly secondary and tertiary complications in 2035. (We should help an amputee reduce his cholesterol and maintain his weight at age 30, rather than treating his heart disease or diabetes at age 50.) Appropriate early interventions for primary illness should preserve veterans' functional status, ensure quality clinical care, and reduce the potentially enormous cost burden of their future health care. PMID:23198496

  10. Plastic Surgery Challenges in War Wounded II: Regenerative Medicine

    PubMed Central

    Valerio, Ian L.; Sabino, Jennifer M.; Dearth, Christopher L.

    2016-01-01

    Background: A large volume of service members have sustained complex injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). These injuries are complicated by contamination with particulate and foreign materials, have high rates of bacterial and/or fungal infections, are often composite-type defects with massive soft tissue wounds, and usually have multisystem involvement. While traditional treatment modalities remain a mainstay for optimal wound care, traditional reconstruction approaches alone may be inadequate to fully address the scope and magnitude of such massive complex wounds. As a result of these difficult clinical problems, the use of regenerative medicine therapies, such as autologous adipose tissue grafting, stem cell therapies, nerve allografts, and dermal regenerate templates/extracellular matrix scaffolds, is increased as adjuncts to traditional reconstructive measures. Basic and Clinical Science Advances: The beneficial applications of regenerative medicine therapies have been well characterized in both in vitro studies and in vivo animal studies. The use of these regenerative medicine techniques in the treatment of combat casualty injuries has been increasing throughout the recent war conflicts. Clinical Care Relevance: Military medicine has shown positive results when utilizing certain regenerative medicine modalities in treating complex war wounds. As a result, multi-institution clinical trials are underway to further evaluate these observations and reconstruction measures. Conclusion: Successful combat casualty wound care often requires a combination of traditional aspects of the reconstructive ladder/elevator with adoption of various regenerative medicine therapies. Due to the recent OIF/OEF conflicts, a high volume of combat casualties have benefited from adoption of regenerative medicine therapies and increased access to innovative clinical trials. Furthermore, many of these patients have had long-term follow-up to report

  11. Plastic Surgery Challenges in War Wounded II: Regenerative Medicine

    PubMed Central

    Valerio, Ian L.; Sabino, Jennifer M.; Dearth, Christopher L.

    2016-01-01

    Background: A large volume of service members have sustained complex injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). These injuries are complicated by contamination with particulate and foreign materials, have high rates of bacterial and/or fungal infections, are often composite-type defects with massive soft tissue wounds, and usually have multisystem involvement. While traditional treatment modalities remain a mainstay for optimal wound care, traditional reconstruction approaches alone may be inadequate to fully address the scope and magnitude of such massive complex wounds. As a result of these difficult clinical problems, the use of regenerative medicine therapies, such as autologous adipose tissue grafting, stem cell therapies, nerve allografts, and dermal regenerate templates/extracellular matrix scaffolds, is increased as adjuncts to traditional reconstructive measures. Basic and Clinical Science Advances: The beneficial applications of regenerative medicine therapies have been well characterized in both in vitro studies and in vivo animal studies. The use of these regenerative medicine techniques in the treatment of combat casualty injuries has been increasing throughout the recent war conflicts. Clinical Care Relevance: Military medicine has shown positive results when utilizing certain regenerative medicine modalities in treating complex war wounds. As a result, multi-institution clinical trials are underway to further evaluate these observations and reconstruction measures. Conclusion: Successful combat casualty wound care often requires a combination of traditional aspects of the reconstructive ladder/elevator with adoption of various regenerative medicine therapies. Due to the recent OIF/OEF conflicts, a high volume of combat casualties have benefited from adoption of regenerative medicine therapies and increased access to innovative clinical trials. Furthermore, many of these patients have had long-term follow-up to report

  12. Firecracker eye injuries during Deepavali festival: a case series.

    PubMed

    Kumar, Ravi; Puttanna, Manohar; Sriprakash, K S; Sujatha Rathod, B L; Prabhakaran, Venkatesh C

    2010-01-01

    We report a large series of ocular injuries caused by fire-crackers. This study was a hospital-based, singlecenter, retrospective case series in which the records of 51 patients with ocular injuries were analyzed. Injuries were classified according to Birmingham eye trauma terminology system (BETTS). Visual outcomes before and after the intervention were recorded. Ten patients were admitted for further management. As ocular firecracker injuries result in significant morbidity, public education regarding proper use of firecrackers may help in reducing the incidence of ocular injuries.

  13. Firecracker eye injuries during Deepavali festival: A case series

    PubMed Central

    Kumar, Ravi; Puttanna, Manohar; Sriprakash, K S; Sujatha Rathod, B L; Prabhakaran, Venkatesh C

    2010-01-01

    We report a large series of ocular injuries caused by fire-crackers. This study was a hospital-based, singlecenter, retrospective case series in which the records of 51 patients with ocular injuries were analyzed. Injuries were classified according to Birmingham eye trauma terminology system (BETTS). Visual outcomes before and after the intervention were recorded. Ten patients were admitted for further management. As ocular firecracker injuries result in significant morbidity, public education regarding proper use of firecrackers may help in reducing the incidence of ocular injuries. PMID:20195044

  14. Firecracker eye injuries during Deepavali festival: a case series.

    PubMed

    Kumar, Ravi; Puttanna, Manohar; Sriprakash, K S; Sujatha Rathod, B L; Prabhakaran, Venkatesh C

    2010-01-01

    We report a large series of ocular injuries caused by fire-crackers. This study was a hospital-based, singlecenter, retrospective case series in which the records of 51 patients with ocular injuries were analyzed. Injuries were classified according to Birmingham eye trauma terminology system (BETTS). Visual outcomes before and after the intervention were recorded. Ten patients were admitted for further management. As ocular firecracker injuries result in significant morbidity, public education regarding proper use of firecrackers may help in reducing the incidence of ocular injuries. PMID:20195044

  15. Science, ethics and war: a pacifist's perspective.

    PubMed

    Kovac, Jeffrey

    2013-06-01

    This article considers the ethical aspects of the question: should a scientist engage in war-related research, particularly use-inspired or applied research directed at the development of the means for the better waging of war? Because scientists are simultaneously professionals, citizens of a particular country, and human beings, they are subject to conflicting moral and practical demands. There are three major philosophical views concerning the morality of war that are relevant to this discussion: realism, just war theory and pacifism. In addition, the requirements of professional codes of ethics and common morality contribute to an ethical analysis of the involvement of scientists and engineers in war-related research and technology. Because modern total warfare, which is facilitated by the work of scientists and engineers, results in the inevitable killing of innocents, it follows that most, if not all, war-related research should be considered at least as morally suspect and probably as morally prohibited.

  16. Social science in the Cold War.

    PubMed

    Engerman, David C

    2010-06-01

    This essay examines ways in which American social science in the late twentieth century was--and was not--a creature of the Cold War. It identifies important work by historians that calls into question the assumption that all social science during the Cold War amounts to "Cold War social science." These historians attribute significant agency to social scientists, showing how they were enmeshed in both long-running disciplinary discussions and new institutional environments. Key trends in this scholarship include a broadening historical perspective to see social scientists in the Cold War as responding to the ideas of their scholarly predecessors; identifying the institutional legacies of World War II; and examining in close detail the products of extramural--especially governmental--funding. The result is a view of social science in the Cold War in which national security concerns are relevant, but with varied and often unexpected impacts on intellectual life.

  17. Children exposed to war/terrorism.

    PubMed

    Shaw, Jon A

    2003-12-01

    This paper reviews the prevalence of psychological morbidities in children who have been exposed to war-related traumas or terrorism as well as the diversity of war-related casualties and their associated psychological responses. The psychological responses to war-related stressors are categorized as (1) little or no reaction, (2) acute emotional and behavioral effects, and (3) long-term effects. Specific categories of war-related casualties discussed include refugee status, traumatic bereavement, effects of parental absence, and child soldiers. Psychological responses associated with terrorism and bioterrorism are presented. Lastly, mediators of the psychological response to war-related stressors are discussed, to include exposure effects, gender effects, parental, family and social factors, and child-specific factors. Children exposed to war-related stressors experience a spectrum of psychological morbidities including posttraumatic stress symptomatology, mood disorders, externalizing and disruptive behaviors, and somatic symptoms determined by exposure dose effect. Specific questions for future research are identified.

  18. Social science in the Cold War.

    PubMed

    Engerman, David C

    2010-06-01

    This essay examines ways in which American social science in the late twentieth century was--and was not--a creature of the Cold War. It identifies important work by historians that calls into question the assumption that all social science during the Cold War amounts to "Cold War social science." These historians attribute significant agency to social scientists, showing how they were enmeshed in both long-running disciplinary discussions and new institutional environments. Key trends in this scholarship include a broadening historical perspective to see social scientists in the Cold War as responding to the ideas of their scholarly predecessors; identifying the institutional legacies of World War II; and examining in close detail the products of extramural--especially governmental--funding. The result is a view of social science in the Cold War in which national security concerns are relevant, but with varied and often unexpected impacts on intellectual life. PMID:20718280

  19. Nature and results of treatment of war wounds caused by cluster bombs.

    PubMed

    Mitković, Milorad; Bumbasirević, Marko; Grubor, Predrag; Milenković, Sasa; Micić, Ivan; Stojiljković, Predrag; Kostić, Igor; Karaleić, Sasa; Stamenić, Sonja; Pavlović, Predrag; Stanojlović, Milos; Jovanović, Vladimir; Radovanović, Zoran; Cirić, Tamara; Kutlesić-Stojanović, Katarina; Mitković, Milan

    2013-01-01

    The aim of this study is to describe the nature of war wounds with fracture caused by cluster bombs and to suggest treatment options for such injuries. The nature of wounds caused by cluster bombs differs from those caused by conventional arms (they are more severe). The sides of the wounds are represented by conquasated soft tissues (such as fat and muscle) with thick dead tissues, ordinarily with a thickness of 0.5-4.5 cm. Another main characteristic of such injuries is the high percentage of amputations needed due to the high rate of neurovascular damage. This paper investigates the cases of 81 patients who sustained a total of 99 war wounds with fractures. The average age of the patients was 32.7 years while the youngest was 20 and the oldest, 77. According to The International Committee of the Red Cross (ICRC) classification of war wounds, 14 patients had grade I injuries, 48 patients grade II, and 29 patients, grade III. Mitkovic external fixation system, known also as the "War Fixator" was used for all fractures fixation. One protocol, which was a modification of the ICRC's protocol adapted to our specific conditions, was used throughout the study. For solving soft tissue defects, a rotator fasciocutan flap was the most frequently used. For solving of bones defect Mitkovic reconstructive external fixation device was used. All fractures we treated healed. We concluded that shortening the procedural time and being a very simple, immediate using of Mitkovic versatile external fixator ("War Fixator") is, leads to desirable results.

  20. If war is "just," so is abortion.

    PubMed

    Kissling, F

    1991-01-01

    Currently Catholic bishops are applying an inconsistent ethical paradigm to the issues of war and abortion. Based on the seamless garment theory war, abortion and capital punishment are all immoral acts because they are of the same garment. They are all "killing acts" and as such they are immoral. However there is within the Catholic paradigm the idea of a just war. The just war theory states that the destruction of human life in war is justified if it is for a greater good. However abortion has no exceptions, there is no just abortion in the rules of the Catholic Church. The author takes the just war doctrine as presented by the Catholic Church and shows how it could easily apply to abortion. Both war and abortion involve the taking of a human life, but in the case of war the taking of a life is justified if it is done to protect your own life. The same exception in abortion would be to allow abortion when the mother's life is in danger. yet no such exception exists. The just war theory further states that was is necessary to protect national integrity, particularly if the violation erodes the quality of life for its citizens. The same exception for abortion would include allowing abortions for women who already have more children then they can care for or if having the child would erode the quality of life for the woman. Other aspects of the just war theory include the competence and goals of the national leaders. Women must also be allowed to be competent moral agents. Proponents of the seamless garment theory will bring up the fact that in a just war only combatants die yet the fetus is innocent. But no war has ever been fought without the loss of innocent civilians.

  1. 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.

  2. 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…

  3. Relationship of sharp force injuries to motivation.

    PubMed

    Kitulwatte, Idg; Edirisinghe, Pas

    2015-09-01

    Forensic pathologists are often expected to provide an opinion on the intention of the assailant in sharp force fatalities. A retrospective study was carried out on reports of post-mortems of victims of sharp force trauma over five years. The position and type of injuries were recorded and related to the known motivation for murder. Victims of different motives of killing had an almost similar injury pattern. There is no significant association of the pathology of sharp force injuries with the motive of killing. PMID:25926324

  4. Management of extraperitoneal rectal injuries.

    PubMed

    Bostick, P J; Johnson, D A; Heard, J F; Islas, J T; Sims, E H; Fleming, A W; Sterling-Scott, R P

    1993-06-01

    Twenty-eight consecutive extraperitoneal rectal injuries for a period of 34 months ending in May 1990 were reviewed retrospectively. All injuries were due to penetrating gunshot wounds. The rectal exam was positive in 75% of patients versus 80.8% with proctosigmoidoscopy. All 28 patients had diversion of the fecal stream. Diverting colostomies were performed in 17 patients, Hartmann's colostomies in 7 patients, and proximal loop colostomies in 4 patients. Presacral drainage was used in 25 patients (89.3%). Distal irrigation was performed in 13 patients (46.4%) and primary repair in 9 patients (32.1%). There was one infectious complication (3.6%) and no deaths (0%). Fecal diversion and presacral drainage are the mainstay of therapy for civilian rectal injuries. The importance of distal irrigation of the rectum has not been established. Primary repair of the rectum has no effect on morbidity and mortality.

  5. The neurological manifestations of trauma: lessons from World War I.

    PubMed

    Linden, Stefanie C; Hess, Volker; Jones, Edgar

    2012-04-01

    Changes in the clinical presentation of functional disorders and the influence of social and cultural factors can be investigated through the historical case notes from mental hospitals. World War I (WWI) was a potent trigger of functional disorders with neurological or psychiatric symptoms. We analysed 100 randomly selected case files of German servicemen admitted to the Department of Psychiatry of the Charité Medical School of Berlin University during WWI and classified them according to contemporaneous and retrospective modern diagnoses. We compared the clinical presentations with accounts in the German and British medical literature of the time. Most patients obtained the contemporaneous diagnosis of 'psychopathic constitution' or hysteria reflecting the general view of German psychiatrists that not the war but an individual predisposition was the basis for the development of symptoms. The clinical picture was dominated by pseudoneurological motor or sensory symptoms as well as pseudoseizures. Some soldiers relived combat experiences in dream-like dissociative states that partly resemble modern-day post-traumatic stress disorder. Most servicemen were classified as unfit for military service but very few of them were granted compensation. Severe functional disorders of a neurological character could develop even without traumatic exposure in combat, which is of interest for the current debate on triggers of stress disorders. The high incidence of pseudoseizures accords with the psychiatric literature of the time and contrasts with accounts of war-related disorders in Britain. The tendency of German psychiatrists not to send traumatised servicemen back to active duty also distinguished between German and British practice. Our data contribute to the debate on the changing patterns of human responses to traumatic experience and their historical and social context.

  6. 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…

  7. 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…

  8. Children's Attitudes to War and Peace: When a Peace Agreement Means War

    ERIC Educational Resources Information Center

    McLernon, Frances; Cairns, Ed

    2006-01-01

    Previous research into children's concepts of peace, war and strategies to attain peace suggests that peace and war are developmentally constructed concepts. In order to examine the impact of the immediate sociocultural context, 343 adolescents in Northern Ireland in 2002 were questioned about their concepts of war and peace, and their strategies…

  9. 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…

  10. A Survey of Injuries Affecting Pre-Professional Ballet Dancers.

    PubMed

    Caine, Dennis; Bergeron, Glen; Goodwin, Brett J; Thomas, Jessica; Caine, Caroline G; Steinfeld, Sam; Dyck, Kevin; André, Suzanne

    2016-01-01

    A cross-sectional design was employed retrospectively to evaluate injuries self-reported by 71 pre-professional ballet dancers over one season. Some of the descriptive findings of this survey were consistent with those of previous research and suggest particular demographic and injury trends in pre-professional ballet. These results include gender distribution, mean age and age range of participants, training hours, injury location, acute versus overuse injuries, as well as average number of physiotherapy treatments per dancer. Other results provide information that was heretofore unreported or inconsistent with previous investigations. These findings involved proportion of dancers injured, average number of injuries per dancer, overall injury incidence during an 8.5 month period, incidence rate by technique level, mean time loss per injury, proportion of recurrent injury, and activity practiced at time of injury. The results of univariate analyses revealed several significant findings, including a decrease in incidence rate of injury with increased months of experience in the pre-professional program, dancers having lower injury risk in rehearsal and performance than in class, and a reduced risk of injury for dancers at certain technique levels. However, only this latter finding remained significant in multivariate analysis. The results of this study underscore the importance of determining injury rates by gender, technique level, and activity setting in addition to overall injury rates. They also point to the necessity of looking at both overall and individual dancer-based injury risks.

  11. A Survey of Injuries Affecting Pre-Professional Ballet Dancers.

    PubMed

    Caine, Dennis; Bergeron, Glen; Goodwin, Brett J; Thomas, Jessica; Caine, Caroline G; Steinfeld, Sam; Dyck, Kevin; André, Suzanne

    2016-01-01

    A cross-sectional design was employed retrospectively to evaluate injuries self-reported by 71 pre-professional ballet dancers over one season. Some of the descriptive findings of this survey were consistent with those of previous research and suggest particular demographic and injury trends in pre-professional ballet. These results include gender distribution, mean age and age range of participants, training hours, injury location, acute versus overuse injuries, as well as average number of physiotherapy treatments per dancer. Other results provide information that was heretofore unreported or inconsistent with previous investigations. These findings involved proportion of dancers injured, average number of injuries per dancer, overall injury incidence during an 8.5 month period, incidence rate by technique level, mean time loss per injury, proportion of recurrent injury, and activity practiced at time of injury. The results of univariate analyses revealed several significant findings, including a decrease in incidence rate of injury with increased months of experience in the pre-professional program, dancers having lower injury risk in rehearsal and performance than in class, and a reduced risk of injury for dancers at certain technique levels. However, only this latter finding remained significant in multivariate analysis. The results of this study underscore the importance of determining injury rates by gender, technique level, and activity setting in addition to overall injury rates. They also point to the necessity of looking at both overall and individual dancer-based injury risks. PMID:27661624

  12. 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.

  13. 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

  14. Why are Iraq and Afghanistan War veterans seeking PTSD disability compensation at unprecedented rates?

    PubMed

    McNally, Richard J; Frueh, B Christopher

    2013-06-01

    The wars in Iraq and Afghanistan have produced historically low rates of fatalities, injuries, and posttraumatic stress disorder (PTSD) among U.S. combatants. Yet they have also produced historically unprecedented rates of PTSD disability compensation seeking from the U.S. Department of Veterans Affairs. The purpose of this article is to consider hypotheses that might potentially resolve this paradox, including high rates of PTSD, delayed onset PTSD, malingered PTSD, and economic variables.

  15. Why are Iraq and Afghanistan War veterans seeking PTSD disability compensation at unprecedented rates?

    PubMed

    McNally, Richard J; Frueh, B Christopher

    2013-06-01

    The wars in Iraq and Afghanistan have produced historically low rates of fatalities, injuries, and posttraumatic stress disorder (PTSD) among U.S. combatants. Yet they have also produced historically unprecedented rates of PTSD disability compensation seeking from the U.S. Department of Veterans Affairs. The purpose of this article is to consider hypotheses that might potentially resolve this paradox, including high rates of PTSD, delayed onset PTSD, malingered PTSD, and economic variables. PMID:23954726

  16. 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

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. Gulf war depleted uranium risks.

    PubMed

    Marshall, Albert C

    2008-01-01

    US and British forces used depleted uranium (DU) in armor-piercing rounds to disable enemy tanks during the Gulf and Balkan Wars. Uranium particulate is generated by DU shell impact and particulate entrained in air may be inhaled or ingested by troops and nearby civilian populations. As uranium is slightly radioactive and chemically toxic, a number of critics have asserted that DU exposure has resulted in a variety of adverse health effects for exposed veterans and nearby civilian populations. The study described in this paper used mathematical modeling to estimate health risks from exposure to DU during the 1991 Gulf War for both US troops and nearby Iraqi civilians. The analysis found that the risks of DU-induced leukemia or birth defects are far too small to result in an observable increase in these health effects among exposed veterans or Iraqi civilians. The analysis indicated that only a few ( approximately 5) US veterans in vehicles accidentally targeted by US tanks received significant exposure levels, resulting in about a 1.4% lifetime risk of DU radiation-induced fatal cancer (compared with about a 24% risk of a fatal cancer from all other causes). These veterans may have also experienced temporary kidney damage. Iraqi children playing for 500 h in DU-destroyed vehicles are predicted to incur a cancer risk of about 0.4%. In vitro and animal tests suggest the possibility of chemically induced health effects from DU internalization, such as immune system impairment. Further study is needed to determine the applicability of these findings for Gulf War exposure to DU. Veterans and civilians who did not occupy DU-contaminated vehicles are unlikely to have internalized quantities of DU significantly in excess of normal internalization of natural uranium from the environment.

  3. Injury Control.

    ERIC Educational Resources Information Center

    Christophersen, Edward R.

    1989-01-01

    Injuries are now the cause of more deaths to children than the next six most frequent causes combined. Reviews the research evidence on the effectiveness of approaches to injury control such as legislation, health education, and behavioral strategies. Suggests avenues of further research. (Author/BJV)

  4. 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

  5. Injuries to the cervix in sexual assault victims.

    PubMed

    Keller, Patricia; Lechner, Megan

    2010-01-01

    Little research has addressed the types and meaning of genital injury in sexual assault victims. An even smaller amount of research exists documenting injury to the cervix in sexual assault victims. The purpose of this study was to examine the frequency of cervical injuries in women following sexual assault, the types of injuries seen, the mechanisms that are related to the injuries, and the types of injuries related to each mechanism. A retrospective chart review was conducted. A total of 538 charts were examined, with a final sample size of 114. Within this sample, 87.8% (n= 100) presented with no injury to the cervix, and 12.3% (n= 14) had documented injury. All statistical analyses were nonsignificant; however, clinical implications are noted. Recommendations for future research are made.

  6. 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.

  7. From Combat to Legacies: Novels of the Vietnam War.

    ERIC Educational Resources Information Center

    Johannessen, Larry R.

    1995-01-01

    Discusses novels of the Vietnam War, their usefulness, and the interest they hold for students. Considers four categories of Vietnam novels: the Vietnam experience, the war at home, the refugee experience, and the war's effect on the next generation. (SR)

  8. 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…

  9. 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.

  10. 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

  11. The Star Wars Scroll Illusion.

    PubMed

    Shapiro, Arthur G

    2015-10-01

    The Star Wars Scroll Illusion is a dynamic version of the Leaning Tower Illusion. When two copies of a Star-Wars-like scrolling text are placed side by side (with separate vanishing points), the two scrolls appear to head in different directions even though they are physically parallel in the picture plane. Variations of the illusion are shown with one vanishing point, as well as from an inverted perspective where the scrolls appear to originate in the distance. The demos highlight the conflict between the physical lines in the picture plane and perspective interpretation: With two perspective points, the scrolling texts are parallel to each other in the picture plane but not in perspective interpretation; with one perspective point, the texts are not parallel to each other in the picture plane but are parallel to each other in perspective interpretation. The size of the effect is linearly related to the angle of rotation of the scrolls into the third dimension; the Scroll Illusion is stronger than the Leaning Tower Illusion for rotation angles between 35° and 90°. There is no effect of motion per se on the strength of the illusion.

  12. 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

  13. The Star Wars Scroll Illusion

    PubMed Central

    2015-01-01

    The Star Wars Scroll Illusion is a dynamic version of the Leaning Tower Illusion. When two copies of a Star-Wars-like scrolling text are placed side by side (with separate vanishing points), the two scrolls appear to head in different directions even though they are physically parallel in the picture plane. Variations of the illusion are shown with one vanishing point, as well as from an inverted perspective where the scrolls appear to originate in the distance. The demos highlight the conflict between the physical lines in the picture plane and perspective interpretation: With two perspective points, the scrolling texts are parallel to each other in the picture plane but not in perspective interpretation; with one perspective point, the texts are not parallel to each other in the picture plane but are parallel to each other in perspective interpretation. The size of the effect is linearly related to the angle of rotation of the scrolls into the third dimension; the Scroll Illusion is stronger than the Leaning Tower Illusion for rotation angles between 35° and 90°. There is no effect of motion per se on the strength of the illusion.

  14. The Star Wars Scroll Illusion

    PubMed Central

    2015-01-01

    The Star Wars Scroll Illusion is a dynamic version of the Leaning Tower Illusion. When two copies of a Star-Wars-like scrolling text are placed side by side (with separate vanishing points), the two scrolls appear to head in different directions even though they are physically parallel in the picture plane. Variations of the illusion are shown with one vanishing point, as well as from an inverted perspective where the scrolls appear to originate in the distance. The demos highlight the conflict between the physical lines in the picture plane and perspective interpretation: With two perspective points, the scrolling texts are parallel to each other in the picture plane but not in perspective interpretation; with one perspective point, the texts are not parallel to each other in the picture plane but are parallel to each other in perspective interpretation. The size of the effect is linearly related to the angle of rotation of the scrolls into the third dimension; the Scroll Illusion is stronger than the Leaning Tower Illusion for rotation angles between 35° and 90°. There is no effect of motion per se on the strength of the illusion. PMID:27648216

  15. The Star Wars Scroll Illusion.

    PubMed

    Shapiro, Arthur G

    2015-10-01

    The Star Wars Scroll Illusion is a dynamic version of the Leaning Tower Illusion. When two copies of a Star-Wars-like scrolling text are placed side by side (with separate vanishing points), the two scrolls appear to head in different directions even though they are physically parallel in the picture plane. Variations of the illusion are shown with one vanishing point, as well as from an inverted perspective where the scrolls appear to originate in the distance. The demos highlight the conflict between the physical lines in the picture plane and perspective interpretation: With two perspective points, the scrolling texts are parallel to each other in the picture plane but not in perspective interpretation; with one perspective point, the texts are not parallel to each other in the picture plane but are parallel to each other in perspective interpretation. The size of the effect is linearly related to the angle of rotation of the scrolls into the third dimension; the Scroll Illusion is stronger than the Leaning Tower Illusion for rotation angles between 35° and 90°. There is no effect of motion per se on the strength of the illusion. PMID:27648216

  16. 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.

  17. 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

  18. 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…

  19. 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)

  20. 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)

  1. 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…

  2. 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…

  3. 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)

  4. 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…

  5. 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…

  6. 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)

  7. 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.

  8. 76 FR 21223 - Civil War Sesquicentennial

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... States of America the two hundred and thirty-fifth. (Presidential Sig.) [FR Doc. 2011-9368 Filed 4-14-11...#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...

  9. Badminton injuries.

    PubMed Central

    Krøner, K; Schmidt, S A; Nielsen, A B; Yde, J; Jakobsen, B W; Møller-Madsen, B; Jensen, J

    1990-01-01

    In a one year period, from 1 January 1986 to 31 December 1986, 4303 patients with sports injuries were treated at Aarhus Amtssygehus and Aarhus Kommunehospital. The mean age was 21.6 years (range 7-72 years) and 2830 were men. Two hundred and seventeen badminton injuries occurred in 208 patients (136 men) with a mean age of 29.6 years (range 7-57 years), constituting 4.1 percent of all sport injuries in Aarhus. Joints and ligaments were injured in 58.5 percent of the patients, most frequently located in the lower limb and significantly more often among patients younger than 30 years of age. Muscle injury occurred in 19.8 percent of the patients. This type of injury was significantly more frequent among patients older than 30 years of age. Most injuries were minor. However, 6.8 percent of the patients were hospitalized and 30.9 percent received additional treatment by a physician. As the risk of injury varies with age, attempts to plan training individually and to institute prophylactic measures should be made. PMID:2078802

  10. 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.

  11. The long-term consequences of war: the experience of World War II.

    PubMed

    Hunt, N; Robbins, I

    2001-05-01

    Seven hundred and thirty-one World War II and Korean War veterans completed a questionnaire about their experiences and their current psychological reactions to the war. Nineteen percent scored above the cut-off points for both the General Health Questionnaire and the (war-related) Impact of Event Scale, demonstrating that, even over 50 years after the event, many veterans still experience problems relating to their war experiences. Psychological distress was in part directly related to particular experiences, but intrusion and avoidance both played an important role as mediating variables. Other factors, such as prisoner of war (POW) status, type of service, rank, and illness were also considered. The findings indicate that the effects of a traumatic experience such as war can persist into later life.

  12. Hospital nurses' occupational exposure to blood: prospective, retrospective, and institutional reports.

    PubMed Central

    Aiken, L H; Sloane, D M; Klocinski, J L

    1997-01-01

    OBJECTIVES: This study examined nurses risk of exposure to blood resulting from injuries with needles and sharps, the methods of estimating those risks, and the factors affecting risks. METHODS: Nurses on 40 medical units in 20 hospitals in cities with a high incidence of AIDS were studied. Percutaneous injuries were documented for every shift during a 30-day period. These prospective reports were compared with retrospective and institutional reports. Factors affecting the likelihood of injuries were explored. RESULTS: Based on the prospective reports, the rate of injuries to staff nurses was 0.8 per nurse-year. Prospective and retrospective rates were similar, while institutional rates were significantly lower. Factors associated with increased injuries included recapping needles and temporary work assignments. Working in hospitals characterized by professional nurse practice models and taking precautions to avoid blood contact were associated with fewer injuries. CONCLUSIONS: Injuries from needlesticks are more common than institutional reports suggest and do not occur at random. Diminishing the frequency with which nurses recap needles, increasing precautions they take, reducing use of temporary nursing personnel, and implementing organizational changes may lower the odds of nurses being injured. PMID:9065213

  13. 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.

  14. 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

  15. 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.

  16. Mothering during war and postwar in Bosnia.

    PubMed

    Robertson, Cheryl Lee; Duckett, Laura

    2007-11-01

    The study aim was to describe displaced Bosnian mothers' experiences caring for their children during and immediately after the war (1992-1995). Mothers described their progression into war, through war, and into vastly changed lives. Using ethnographic methods, narrative data were collected near Sarajevo, Bosnia, from 14 displaced women who participated in one to three interviews each between 1996 and 1999. Data from the semistructured interviews were analyzed to determine patterns in participants' descriptions of mothering during war. Four common themes of mothering were identified in the data: "on the move," "I have to feed them," "living somewhere in between," and "still living the war inside." As care providers and policy makers develop initiatives to improve the health of women and children during complex humanitarian emergencies, there is much to learn from the narratives of Bosnian women about their extraordinary struggle to protect the lives of their children amid violence and loss.

  17. 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.

  18. Boarding injuries: the long and the short of it.

    PubMed

    Fabian, Leslie A; Thygerson, Steven M; Merrill, Ray M

    2014-01-01

    As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU) length of stay (LOS), Injury Severity Score (ISS), patient treatment options, disposition, and outcome) were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI), and intracranial hemorrhage (ICH) were significantly more common among longboard patients than skateboarders (P < 0.0001). All patients with an ISS above 15 were longboarders. Hospital and ICU LOS in days was also significantly greater for longboarders compared with skateboarders (P < 0.0001). Of the three patients that died, each was a longboarder and each experienced a head injury. Longboard injuries account for a higher incidence rate of severe head injuries compared to skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population.

  19. Boarding Injuries: The Long and the Short of It

    PubMed Central

    Fabian, Leslie A.; Thygerson, Steven M.; Merrill, Ray M.

    2014-01-01

    As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU) length of stay (LOS), Injury Severity Score (ISS), patient treatment options, disposition, and outcome) were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI), and intracranial hemorrhage (ICH) were significantly more common among longboard patients than skateboarders (P < 0.0001). All patients with an ISS above 15 were longboarders. Hospital and ICU LOS in days was also significantly greater for longboarders compared with skateboarders (P < 0.0001). Of the three patients that died, each was a longboarder and each experienced a head injury. Longboard injuries account for a higher incidence rate of severe head injuries compared to skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population. PMID:24660063

  20. Propeller injuries.

    PubMed

    Mann, R J

    1976-05-01

    Water skiing, boat racing, skin and scuba diving, and pleasure boat cruising are increasing in popularity. As a result the incidence of injuries secondary to motor propellers is becoming more frequent. In a ten-year period from 1963 to 1973, I collected a total of nine cases. In some amputations were necessary, and in other cases amputations occurred at the time of injury. Problems with bacterial flora occurring in open sea water versus salt water enclosed near docks and fresh lake water are discussed. A review of the orthopedic literature revealed sparse information regarding propeller injuries.

  1. 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

  2. Predictors of genital injury after nonconsensual intercourse.

    PubMed

    Anderson, Sarah L; Parker, Barbara J; Bourguignon, Cheryl M

    2009-01-01

    Understanding differences in genital injuries after nonconsensual and consensual intercourse is an important element of prosecuting sexual assault cases. In order to determine if the injury patterns and total surface area of genital injuries can differentiate between the types of intercourse (consensual or non-consensual), eighty women were examined after non-consensual (retrospective chart review, n = 40) and consensual (recruited, n = 40) intercourse within 48 hours using colposcopy, toluidine blue dye, and digital photography to document genital injuries. Differences between types of injuries found in the nonconsensual and consensual groups, based on the univariate analysis, were found with the number of sites (NoS) with ecchymosis (p < 0.01) and NoS with redness (p < 0.01). Based on the logistic hierarchical regression model, 85% of the nonconsensual group and 90% of the consensual group were classified correctly by using the NoS with tears, ecchymosis, abrasions, and redness and SA of injury when controlling for time from intercourse to examination. The NoS with redness (p = 0.017), NoS with ecchymosis, and SA of injury (p = 0.039) were individually predictive. The NoS with ecchymosis were also a significant finding when addressed as an individual block (p < 0.001). In this small sample, exploratory study, while controlling for time, the injury patterns and total SA of genital injuries were able to correctly classify the nonconsensual group 85% of the time. Replication of this study with a larger sample is essential.

  3. 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.

  4. 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

  5. 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.

  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.

  7. 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

  8. 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 ...

  9. 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)

  10. 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

  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.

  12. 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

  13. 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.

  14. Compensating for cold war cancers.

    PubMed

    Parascandola, Mark J

    2002-07-01

    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.

  15. [Penetrating head and brain injuries with nonmetal foreign bodies].

    PubMed

    Potapov, A A; Okhlopkov, V A; Latyshev, Ya A; Serova, N K; Eolchiyan, S A

    2014-01-01

    Penetrating brain injuries (PBI) are common in neurosurgical practice. Most of them are civil or war-time missile and blast injuries. This type of trauma is widely presented in neurosurgical publication, textbooks and clinical evidence-based guidelines. At the same time, PBI by non-metallic foreign bodies are very rare. All the data are limited to case reports and small series of cases. Moreover, there are no clinical consideration on diagnosis, treatment, complication, outcome and prognosis of PBI by non-metallic penetrating brain injuries. In this review all the data are summarized to provide recommendations on the diagnosis and treatment of PBI by non-metallic foreign bodies.

  16. 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.

  17. 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

  18. "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

  19. "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.

  20. 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