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Sample records for war injuries retrospective

  1. Retrospective analysis of patients with burn injury treated in a burn center in Turkey during the Syrian civil war

    PubMed Central

    Yuce, Yucel; Acar, Hakan A.; Erkal, Kutlu H.; Arditi, Nur B.

    2017-01-01

    Objectives: To report the management of burn injuries that occured in the Syria civil war, which were referred to our burn center. Methods: Forty-three patients with burns, injured in the civil war in Syria and whom were referred to Dr. Lütfi Kırdar Kartal Educating and Training Hospital Burn Centre of İstanbul, Turkey between 2011-2015 were analyzed in a retrospective study. Results: Most of our patients were in major burn classification (93%; 40/43) and most of them had burns >15% total on body surface area. Most of them were admitted to our center late after first management at centers with improper conditions and in cultures of these patients unusual and resistant strains specific to the battlefield were produced. Conclusion: Immediate transfer of the patients from the scene of incidence to burn centers ensures early treatment, this factor may be effective on the outcome of these patients. PMID:28042637

  2. Civil War vascular injuries.

    PubMed

    Blaisdell, F William

    2005-01-01

    As the result of the insistence of the Surgeon General during the United States Civil War, there was extensive documentation of injuries to major blood vessels and their resulting complications. The specific treatment of vascular injuries during the Civil War was ligation of the injured vessel or amputation. This was before there was any knowledge of the cause and prevention of infection. Overall, the results were dismal, with a mortality rate of nearly 60% for the more than 1000 soldiers treated by arterial ligation. The most important contribution of these medical reports was to define how the injuries should be diagnosed and managed. Many of the principles that developed as the result of this post-war review are as valid today as they were then. Unfortunately, it seems that many of these lessons have had to be relearned by the surgeons who have participated in each of our subsequent military conflicts.

  3. 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.

  4. Musculoskeletal injuries in the Afghan war.

    PubMed

    Bhatnagar, M K; Curtis, M J; Smith, G S

    1992-01-01

    Among the 1274 patients admitted to a Pakistan border hospital from 1985 to 1987, the distribution and outcome of musculoskeletal war injuries differed from those seen in other conflicts. Serious complications from injuries were found in approximately 50 per cent of patients, of which most were wound infections, chronic osteomyelitis, and restriction of joint motion. Guerrillas in the Afghan war had no access to acute medical treatment in the field. Many patients died before reaching the hospital, as reflected in the low proportion of paraxial injuries; very high complication rates were noted for all injuries. Although some complications, such as soft tissue infection and foreign body retention are not site specific, other complications such as contracture, non-union, loss of range of motion, and chronic osteomyelitis are highly related to the region injured. Early surgical management and evacuation of those with musculoskeletal war injuries can greatly improve the outcome from war trauma and reduce the subsequent disability. However, the increasing use of hand-held anti-aircraft missiles may prevent the rapid evacuation of the wounded in future conflicts, and may make the situation seen in Afghanistan more common.

  5. Eye injuries associated with 'war games'.

    PubMed

    Welsh, N H; Howes, F; Lever, J

    1989-09-16

    Eye injuries sustained by 4 patients who took part in 'war games' (in which young men shoot at each other with pistols powered by compressed carbon dioxide and firing latex rubber bullets filled with non-toxic paint) are described. In 3 cases the injuries were severe, including traumatic cataract, and 1 of these patients has a permanent macula scar with vision reduced to 6/36. Although eye protection is recommended, it was found that in the 'battle situation' combatants did not always follow regulations. Attention is drawn to the seriousness of disregarding the need for correct protective glasses.

  6. Sympathetic ophthalmia after injury in the iraq war.

    PubMed

    Freidlin, Julie; Pak, John; Tessler, Howard H; Putterman, Allen M; Goldstein, Debra A

    2006-01-01

    A 21-year-old US soldier received a penetrating eye injury while fighting in Iraq and was treated with evisceration. Sympathetic ophthalmia developed, which responded well to steroid treatment. This is the first case of sympathetic ophthalmia after a war injury reported since World War II.

  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. [Frequency, etiology, localization and surgical treatment of war injuries with tissue defects].

    PubMed

    Jevtović, D; Pantelić, B; Kozarski, J; Novaković, M; Piscević, B; Milović, B; Gacević, M

    2000-01-01

    The retrospective analysis of 1,514 cases treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy in the period between 1991 and 1995, established that the percentage of the injuries caused by gunshots and those caused by explosives during the conflict in former Yugoslavia, was more or less the same. The injuries caused by gunshot more often occurred on the head, neck, arms and trunk. The injuries of the legs caused by the explosives were more frequent, and they occurred in 83% of the cases. All the plastic surgeons who took part in the treatment of patients and in preparing the surgeons of other specialties for the treatment applied the original classification of the war injuries according to the structure of the defects that had occurred, to standardize the approach to the planning of treatment and the treatment itself of the wounded. In the delayed primary or secondary treatment of the injuries with the tissue defects all known plastic and reconstructive methods were applied. In the cases requiring the covering of the the tissue defect with the full thickness skin, local skin, fasciocutaneous, fascioadipose or muscle flap was chosen. Distant pedicled direct flaps were used in cases when it was not possible to use a more suitable reconstructive method. Free skin, myocutaneous or complex microvascular flaps were applied in cases of more extensive defects or if a more suitable solution could not be found. Our experience in surgical treatment of war injuries with skin defects during the civil war in former Yugoslavia has shown that over 50% of all the injured patients required the treatment of a plastic surgeon in a definite surgical treatment of a war injury. A multidisciplinary approach is necessary in the majority of the injured, and the surgical team is composed according to the affected area and the extent of the injury.

  10. 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).

  11. Nine year longitudinal retrospective study of Taekwondo injuries.

    PubMed

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

    2009-12-01

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

  12. 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.

  13. [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.

  14. Management of extravasation injuries: a retrospective study.

    PubMed

    Fırat, Cemal; Erbatur, Serkan; Aytekin, Ahmet Hamdi

    2013-02-01

    The extravasation of many agents during administration by way of the peripheral veins can produce severe necrosis of the skin and subcutaneous tissue. The incidence of an extravasation injury is elevated in the populations prone to complications, including the younger age groups. The severity of the necrosis depends on properties of the extravasated agent (vinca alkaloids, antracyclines, catecholamines, cationic solutions, osmotically active chemicals) including the type, concentration, and the quantity injected. In general, the primary diseases were chronic diseases such as hepatic or ischaemic encephalopathies, cardiac or pulmonary diseases, diabetes mellitus, and oncological diseases. The aim of this article was to explore the prevention, diagnosis, and treatment of extravasation injuries with a review of the literature. From January 2009 to August 2011, 22 patients were reviewed. Ten patients were children, and the others were adults. The surgical interventions were delayed until the development of the necrosis. A topical boric acid 3% solution was applied to all wounds with repetitive debridement. Debridement was performed once every 2 days and was continued until healthy tissue was obtained. The wounds of eight patients were repaired with split-thickness skin grafts, the wounds of six patients were reconstructed with randomised fasciocutaneous flaps, and the wounds of five patients healed by secondary intention. The wounds of three patients with massive swelling of the forearms were treated with only conservative modalities and limb elevation for 24-48 hours. Boric acid was found to promote granulation tissue in the wounds. The extravasation injuries can be prevented by using appropriate measures, such as the avoidance of perfusion under pressure, patient participation in pain follow-up, wound management by experienced health professionals, and preference for large and suitable veins.

  15. 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.

  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. 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.

  18. [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.

  19. The Importance of Human Needs during Retrospective Peacetime and the Persian Gulf War: University Students in the United States.

    ERIC Educational Resources Information Center

    Tang, Thomas Li-Ping; Tang, Theresa Li-Na

    The importance of human needs during the retrospective peacetime in 1990 and the Persian Gulf War in 1991 was examined among 564 college students in the United States. Results of factor analyses showed that during peacetime, two factors (higher-order and lower-order needs) were identified. During the war, all needs were rated as more important and…

  20. Bacteriology of war wounds at the time of injury.

    PubMed

    Murray, Clinton K; Roop, Stuart A; Hospenthal, Duane R; Dooley, David P; Wenner, Kimberly; Hammock, John; Taufen, Neil; Gourdine, Emmett

    2006-09-01

    Bacterial contamination of war wounds occurs either at the time of injury or during the course of therapy. Characterization of the bacteria recovered at the time of initial trauma could influence the selection of empiric antimicrobial agents used to prevent infection. In the spring of 2004, U.S. military casualties who presented to the 31st Combat Support Hospital in Baghdad, Iraq, with acute traumatic injuries resulting in open wounds underwent aerobic culture of their wounds to identify the bacteria colonizing the wounds. Forty-nine casualties with 61 separate wounds were evaluated. Wounds were located predominantly in the upper and lower extremities and were primarily from improvised explosive devices or mortars. Thirty wounds (49%) had bacteria recovered on culture, with 40 bacteria identified. Eighteen casualties (20 wounds) had undergone field medical therapy (irrigation and/or antimicrobial treatment); six of these had nine bacterial isolates on culture. Of the 41 wounds from 31 patients who had received no previous therapy, 24 grew 31 bacteria. Gram-positive bacteria (93%), mostly skin-commensal bacteria, were the predominant organisms identified. Only three Gram-negative bacteria were detected, none of which were characterized as broadly resistant to antimicrobial agents. The only resistant bacteria recovered were two isolates of methicillin-resistant Staphylococcus aureus (MRSA). Our assessment of war wound bacterioly soon after injury reveals a predominance of Gram-positive organisms of low virulence and pathogenicity. The presence of MRSA in wounds likely reflects the increasing incidence of community-acquired MRSA bacteria. These data suggest that the use of broad-spectrum antibiotics with efficacy against more resistant, Gram-negative bacteria, such as Pseudomonas aeruginosa and Acinetobacter spp., is unnecessary in early wound management.

  1. Self-reported ill health in male UK Gulf War veterans: a retrospective cohort study

    PubMed Central

    Simmons, Rebecca; Maconochie, Noreen; Doyle, Pat

    2004-01-01

    Background Forces deployed to the first Gulf War report more ill health than veterans who did not serve there. Many studies of post-Gulf morbidity are based on relatively small sample sizes and selection bias is often a concern. In a setting where selection bias relating to the ill health of veterans may be reduced, we: i) examined self-reported adult ill health in a large sample of male UK Gulf War veterans and a demographically similar non-deployed comparison group; and ii) explored self-reported ill health among veterans who believed that they had Gulf War syndrome. Methods This study uses data from a retrospective cohort study of reproduction and child health in which a validated postal questionnaire was sent to all UK Gulf War veterans (GWV) and a comparison cohort of Armed Service personnel who were not deployed to the Gulf (NGWV). The cohort for analysis comprises 42,818 males who responded to the questionnaire. Results We confirmed that GWV report higher rates of general ill health. GWV were significantly more likely to have reported at least one new medical symptom or disease since 1990 than NGWV (61% versus 37%, OR 2.7, 95% CI 2.5–2.8). They were also more likely to report higher numbers of symptoms. The strongest associations were for mood swings (OR 20.9, 95%CI 16.2–27.0), memory loss/lack of concentration (OR 19.6, 95% CI 15.5–24.8), night sweats (OR 9.9, 95% CI 6.5–15.2), general fatigue (OR 9.6, 95% CI 8.3–11.1) and sexual dysfunction (OR 4.6, 95%CI 3.2–6.6). 6% of GWV believed they had Gulf War syndrome (GWS), and this was associated with the highest symptom reporting. Conclusions Increased levels of reported ill health among GWV were confirmed. This study was the first to use a questionnaire which did not focus specifically on the veterans' symptoms themselves. Nevertheless, the results are consistent with those of other studies of post-Gulf war illness and thus strengthen overall findings in this area of research. Further examination

  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. Motor vehicle driver injury and marital status: a cohort study with prospective and retrospective driver injuries

    PubMed Central

    Whitlock, G; Norton, R; Clark, T; Jackson, R; MacMahon, S

    2004-01-01

    Objective: To investigate the association of marital status with risk of motor vehicle driver injury. Design: A cohort study with prospective and retrospective outcomes. Setting: New Zealand. Participants: A total of 10 525 adults (a volunteer sample of a multi-industry workforce, n = 8008; and a random sample of urban electoral rolls, n = 2517). Exposure variable: Self reported marital status, assessed from a questionnaire administered in 1992–93 (baseline). Main outcome measure: Motor vehicle driver injury resulting in admission of the driver to hospital and/or the driver's death, during the period 1988–98; hospitalisation and mortality data were obtained by record linkage to national health databases. Results: During 108 741 person-years of follow up, 139 driver injury cases occurred (85 before baseline, 54 after). After adjustment for age, sex, and study cohort, never married participants had twice the risk of driver injury (hazard ratio [HR] 2.06, 95% confidence interval [CI] 1.35 to 3.16) as married participants (HR 1.00). The relative risk for never married participants was slightly higher (HR 2.29), though less precise (95% CI 1.39 to 3.76), after further adjustment for alcohol intake, driving exposure, area of residence, body mass index, and occupational status. Conclusions: After taking age, sex, and other variables into account, never married people had a substantially higher risk of driver injury than married people. While requiring corroboration, these findings imply that it may be appropriate for driver injury countermeasures to be targeted to never married people. PMID:14760024

  5. Bacteriology of War Wounds at the Time of Injury

    DTIC Science & Technology

    2006-09-01

    Staphylococcus aureus isolates were methi- cillin-resistant S. aureus (MRSA). Conspicuously absent were streptococci (especially Streptococcus ...gangrene between World War I and the Korean War. Implementation of penicillin use after wounding during World War II probably led to the diminution of S...obtained 5 days after surgical therapy and implementation of antimicrobial treatment (typi- cally penicillin with streptomycin sulfate, chloramphenicol so

  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.

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

    PubMed Central

    Chotai, Pranit N.; Abdelgawad, Amr A.

    2014-01-01

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

  8. 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…

  9. [The construction and significance of the Chinese Museum of War Injuries].

    PubMed

    Wang, Xiao-min; Peng, Rui-yun; Wang, De-wen

    2010-03-01

    The Chinese Museum of War Injuries is the only military medical museum in China which collects special weapons, conventional weapons, high-tech weapons and pathological specimens, materials and documents of human and animal injuries caused by military environments and military operations, amounting to 4,350 objects. The construction of the Chinese Museum of War Injuries played an important role in the aspects of military medical education and training, popularization of public health knowledge, preservation of military medical historical materials and opening up to the outside world etc, to which should priority attention should be paid to by the Chinese government and relevant military departments.

  10. Effect of type and transfer of conventional weapons on civilian injuries: retrospective analysis of prospective data from Red Cross hospitals

    PubMed Central

    Coupland, Robin M; Samnegaard, Hans O

    1999-01-01

    Objective To examine the link between different weapons used in modern wars and their potential to injury civilians. Design Retrospective analysis of prospectively collected data about hospital admissions. Setting Hospitals of the International Committee of the Red Cross. Subjects 18 877 people wounded by bullets, fragmentation munitions, or mines. Of these, 2012 had been admitted to the hospital in Kabul within six hours of injury. Main outcome measures Age and sex of wounded people according to cause of injury and whether they were civilians (women and girls, boys under 16 years old, or men of 50 or more). Results 18.7% of those injured by bullets, 34.1% of those injured by fragments, and 30.8% of those injured by mines were civilians. Of those admitted to the Red Cross hospital in Kabul within six hours of injury, 39.1% of those injured by bullets, 60.6% of those injured by fragments, and 55.0% of those injured by mines were civilians. Conclusions The proportion of civilians injured differs between weapon systems. The higher proportion injured by fragments and mines is explicable in terms of the military efficiency of weapons, the distance between user and victim, and the effect that the kind of weapon has on the psychology of the user. Key messagesDuring war, mines and fragmenting munitions (mortars, bombs, and shells) are more likely than bullets to injure civiliansCivilians in a city under siege are particularly at risk of being injured by weapons whose users are not able to see the victimThe inherent nature of weapons may be a factor in determining whether civilians are killed or injuredThere is a need for greater respect for the Fourth Geneva Convention and for greater controls on weapons being transferred to untrained and undisciplined forces PMID:10445921

  11. A retrospective case-control analysis of 2002 running injuries

    PubMed Central

    Taunton, J; Ryan, M; Clement, D; McKenzie, D; Lloyd-Smith, D; Zumbo, B

    2002-01-01

    Objective: To provide an extensive and up to date database for specific running related injuries, across the sexes, as seen at a primary care sports medicine facility, and to assess the relative risk for individual injuries based on investigation of selected risk factors. Methods: Patient data were recorded by doctors at the Allan McGavin Sports Medicine Centre over a two year period. They included assessment of anthropometric, training, and biomechanical information. A model was constructed (with odds ratios and their 95% confidence intervals) of possible contributing factors using a dependent variable of runners with a specific injury and comparing them with a control group of runners who experienced a different injury. Variables included in the model were: height, weight, body mass index, age, activity history, weekly activity, history of injury, and calibre of runner. Results: Most of the study group were women (54%). Some injuries occurred with a significantly higher frequency in one sex. Being less than 34 years old was reported as a risk factor across the sexes for patellofemoral pain syndrome, and in men for iliotibial band friction syndrome, patellar tendinopathy, and tibial stress syndrome. Being active for less than 8.5 years was positively associated with injury in both sexes for tibial stress syndrome; and women with a body mass index less than 21 kg/m2 were at a significantly higher risk for tibial stress fractures and spinal injuries. Patellofemoral pain syndrome was the most common injury, followed by iliotibial band friction syndrome, plantar fasciitis, meniscal injuries of the knee, and tibial stress syndrome. Conclusions: Although various risk factors were shown to be positively associated with a risk for, or protection from, specific injuries, future research should include a non-injured control group and a more precise measure of weekly running distance and running experience to validate these results. PMID:11916889

  12. 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

  13. Can multidetector CT detect the site of gastrointestinal tract injury in trauma? – A retrospective study

    PubMed Central

    Panda, Ananya; Kumar, Atin; Gamanagatti, Shivanand; Das, Ranjita; Paliwal, Swati; Gupta, Amit; Kumar, Subodh

    2017-01-01

    PURPOSE We aimed to assess the performance of computed tomography (CT) in localizing site of traumatic gastrointestinal tract (GIT) injury and determine the diagnostic value of CT signs in site localization. METHODS CT scans of 97 patients with surgically proven GIT or mesenteric injuries were retrospectively reviewed by radiologists blinded to surgical findings. Diagnosis of either GIT or mesenteric injuries was made. In patients with GIT injuries, site of injury and presence of CT signs such as focal bowel wall hyperenhancement, hypoenhancement, wall discontinuity, wall thickening, extramural air, intramural air, perivisceral infiltration, and active vascular contrast leak were evaluated. RESULTS Out of 97 patients, 90 had GIT injuries (70 single site injuries and 20 multiple site injuries) and seven had isolated mesenteric injury. The overall concordance between CT and operative findings for exact site localization was 67.8% (61/90), partial concordance rate was 11.1% (10/90), and discordance rate was 21.1% (19/90). For single site localization, concordance rate was 77.1% (54/70), discordance rate was 21.4% (15/70), and partial concordance rate was 1.4% (1/70). In multiple site injury, concordance rate for all sites of injury was 35% (7/20), partial concordance rate was 45% (9/20), and discordance rate was 20% (4/20). For upper GIT injuries, wall discontinuity was the most accurate sign for localization. For small bowel injury, intramural air and hyperenhancement were the most specific signs for site localization, while for large bowel injury, wall discontinuity and hypoenhancement were the most specific signs. CONCLUSION CT performs better in diagnosing small bowel injury compared with large bowel injury. CT can well predict the presence of multiple site injury but has limited performance in exact localization of all injury sites. PMID:27924777

  14. 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.

  15. 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.

  16. Unintentional Injuries and Violence among Adults in Northern Jordan: A Hospital-Based Retrospective Study.

    PubMed

    Alzghoul, Manal M; Shakhatreh, Mohammed K; Al-Sheyab, Nihaya

    2017-03-24

    Injuries (unintentional and intentional) are the main cause of death and disability worldwide, including Jordan. The main purpose of this hospital-based retrospective study was to identify characteristics, causes, and risk factors of unintentional injuries and violence among all adult patients who approached the Accidents and Emergency department because of injury in Northern Jordan. Data were collected retrospectively from four major hospitals from January 2008 to January 2013. A total of 2425 Jordanian individuals who accessed and were treated by the four hospitals were included in this study. The findings show that the majority of patients who approached the Accidents and Emergency departments in the four hospitals were males (n = 2044, 87.16%) versus females (n = 301, 12.8%). Violence was the most common reason of injury (70.66%), followed by road traffic crashes (23.21%). The most common anatomical locations of reported injuries were the head (38.74%), followed by abdomen/pelvis and lower back, among males and females (9.93%). Violence had a high significant effect on the site of injuries. Patients who had been injured to the head because of a stab wound or fighting were substantially over-involved in head injuries, with injury rates 3.88 and 7.51 times higher than those who had been injured to the head due to gunshot, respectively. Even patients who had been injured to the head because of assault show much higher involvement in injury risk than non-assault patients (Odds Ratio = 8.46). These findings highlight the need for a large national study to confirm the findings. It also draws attention to the importance of public awareness and to special injury prevention programs that not only focus on saving lives and lessening the number of injuries, illnesses, and fatalities, but also to limit the social and economic burden of injury among adults in Northern Jordan.

  17. Combination Therapies for Traumatic Brain Injury: Retrospective Considerations

    PubMed Central

    Anderson, Gail; Atif, Fahim; Badaut, Jerome; Clark, Robert; Empey, Philip; Guseva, Maria; Hoane, Michael; Huh, Jimmy; Pauly, Jim; Raghupathi, Ramesh; Scheff, Stephen; Stein, Donald; Tang, Huiling; Hicks, Mona

    2016-01-01

    Abstract Patients enrolled in clinical trials for traumatic brain injury (TBI) may present with heterogeneous features over a range of injury severity, such as diffuse axonal injury, ischemia, edema, hemorrhage, oxidative damage, mitochondrial and metabolic dysfunction, excitotoxicity, inflammation, and other pathophysiological processes. To determine whether combination therapies might be more effective than monotherapy at attenuating moderate TBI or promoting recovery, the National Institutes of Health funded six preclinical studies in adult and immature male rats to evaluate promising acute treatments alone and in combination. Each of the studies had a solid rationale for its approach based on previous research, but only one reported significant improvements in long-term outcomes across a battery of behavioral tests. Four studies had equivocal results because of a lack of sensitivity of the outcome assessments. One study demonstrated worse results with the combination in comparison with monotherapies. While specific research findings are reported elsewhere, this article provides an overview of the study designs, insights, and recommendations for future research aimed at therapy development for TBI. PMID:25970337

  18. 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

  19. Joint Global War on Terror (GWOT) Vascular Injury Study 2

    DTIC Science & Technology

    2015-02-01

    underway and we have developed the surveillance program design and identified Service Members who incurred vascular injury. To date, four research nurse ...Current study staff consists of a program manager and four research nurses . The GWOT 2 Wartime Vascular Injury Study is an ongoing effort; therefore, the... Nurse , 2-4 April 2014, poster presentation o Vascular discharge education and follow-up care subsequent to wartime vascular trauma; Presented in San

  20. 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

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

    PubMed

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

    2016-03-01

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

  2. 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

  3. 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.

  4. 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

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

    PubMed Central

    2011-01-01

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

  6. Traumatic Brain Injury in Domestic Violence Victims: A Retrospective Study at the Barrow Neurological Institute.

    PubMed

    Zieman, Glynnis; Bridwell, Ashley; Cárdenas, Javier F

    2017-02-15

    Domestic violence is a national health crisis, which affects people of all ages, races, and socioeconomic classes. Traumatic brain injury is common in victims because of the high frequency of head and neck injuries inflicted through abuse. These recurrent injuries can lead to chronic symptoms with high morbidity. We conducted a retrospective chart review of 115 patients with a history of head trauma as a result of domestic violence. All patients were seen in a subspecialty traumatic brain injury clinic, at which time information regarding their histories and self-reported symptoms were recorded. In total, 109 females and 6 males were included in our study, with an age range of 4-68 years. Overall, 88% reported more than one injury and 81% reported a history of loss of consciousness associated with their injuries. Only 21% sought medical help at the time of injury. Whereas 85% had a history of abuse in adulthood, 22% had experienced abuse in both childhood and adulthood, and 60% of the patients abused as children went on to be abused as adults. Headache was the most common chief complaint, but on a self-reported symptom severity scale, behavioral symptoms were the most severe. Psychiatric disease was present in 84% of patients. Traumatic brain injury is a frequent sequela of domestic violence, from which many victims sustain multiple injuries without seeking medical care. Brain injuries are often sustained over many years and lead to lasting physical, behavioral, and cognitive consequences. Better understanding of these injuries will lead to improved care for this population.

  7. Defining an adequate sample of earlywood vessels for retrospective injury detection in diffuse-porous species.

    PubMed

    Arbellay, Estelle; Corona, Christophe; Stoffel, Markus; Fonti, Patrick; Decaulne, Armelle

    2012-01-01

    Vessels of broad-leaved trees have been analyzed to study how trees deal with various environmental factors. Cambial injury, in particular, has been reported to induce the formation of narrower conduits. Yet, little or no effort has been devoted to the elaboration of vessel sampling strategies for retrospective injury detection based on vessel lumen size reduction. To fill this methodological gap, four wounded individuals each of grey alder (Alnus incana (L.) Moench) and downy birch (Betula pubescens Ehrh.) were harvested in an avalanche path. Earlywood vessel lumina were measured and compared for each tree between the injury ring built during the growing season following wounding and the control ring laid down the previous year. Measurements were performed along a 10 mm wide radial strip, located directly next to the injury. Specifically, this study aimed at (i) investigating the intra-annual duration and local extension of vessel narrowing close to the wound margin and (ii) identifying an adequate sample of earlywood vessels (number and intra-ring location of cells) attesting to cambial injury. Based on the results of this study, we recommend analyzing at least 30 vessels in each ring. Within the 10 mm wide segment of the injury ring, wound-induced reduction in vessel lumen size did not fade with increasing radial and tangential distances, but we nevertheless advise favoring early earlywood vessels located closest to the injury. These findings, derived from two species widespread across subarctic, mountainous, and temperate regions, will assist retrospective injury detection in Alnus, Betula, and other diffuse-porous species as well as future related research on hydraulic implications after wounding.

  8. Defining an Adequate Sample of Earlywood Vessels for Retrospective Injury Detection in Diffuse-Porous Species

    PubMed Central

    Arbellay, Estelle; Corona, Christophe; Stoffel, Markus; Fonti, Patrick; Decaulne, Armelle

    2012-01-01

    Vessels of broad-leaved trees have been analyzed to study how trees deal with various environmental factors. Cambial injury, in particular, has been reported to induce the formation of narrower conduits. Yet, little or no effort has been devoted to the elaboration of vessel sampling strategies for retrospective injury detection based on vessel lumen size reduction. To fill this methodological gap, four wounded individuals each of grey alder (Alnus incana (L.) Moench) and downy birch (Betula pubescens Ehrh.) were harvested in an avalanche path. Earlywood vessel lumina were measured and compared for each tree between the injury ring built during the growing season following wounding and the control ring laid down the previous year. Measurements were performed along a 10 mm wide radial strip, located directly next to the injury. Specifically, this study aimed at (i) investigating the intra-annual duration and local extension of vessel narrowing close to the wound margin and (ii) identifying an adequate sample of earlywood vessels (number and intra-ring location of cells) attesting to cambial injury. Based on the results of this study, we recommend analyzing at least 30 vessels in each ring. Within the 10 mm wide segment of the injury ring, wound-induced reduction in vessel lumen size did not fade with increasing radial and tangential distances, but we nevertheless advise favoring early earlywood vessels located closest to the injury. These findings, derived from two species widespread across subarctic, mountainous, and temperate regions, will assist retrospective injury detection in Alnus, Betula, and other diffuse-porous species as well as future related research on hydraulic implications after wounding. PMID:22761707

  9. 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.

  10. The UK Military Experience of Thoracic Injury in the Wars in Iraq and Afghanistan

    DTIC Science & Technology

    2013-01-01

    advances in surgical technique.4 Haemorrhage and sepsis have remained the main causes of mortality throughout twentieth century warfare.1,6 In the...World War I, chest injuries were 6% of all combat wounds,1 with a mortality of 24– 27%2; haemorrhage and empyema were the leading causes of death...such as endotracheal intubation , mechanical ventilation, the use of antimicrobial agents and improved pulmonary toilet techniques removing retained

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

    PubMed

    Nash, William P; Litz, Brett T

    2013-12-01

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

  12. Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit.

    PubMed

    Montalvo, Alicia M; Shaefer, Hilary; Rodriguez, Belinda; Li, Tan; Epnere, Katrina; Myer, Gregory D

    2017-03-01

    The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002) and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p < 0.001) than non-competitors. Athletes who reported injury also reported significantly higher values for the following risk factors: years of participation (2.7 ± 1.8 v 1.8 ± 1.5, p = 0.001), weekly athlete training hours (7.3 ± 3.8 v 4.9 ± 2.1, p = 0.020), weekly athlete-exposures (6.4 ± 3.8 v 4.7 ± 2.1, p = 0.003), height (1.72 ± 0.09 m v 1.68 ± 0.01 m, p = 0.011), and body mass (78.24 ± 16.86 kg v 72.91 ± 14.77 kg, p = 0.037). Injury rates during CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce the increase

  13. [Characteristics of the clinical picture of combined injuries of the organ of vision and eye appendages under conditions of peace-time and war injuries].

    PubMed

    Kugoeva, E E; Aslanova, A F; Kulieva, Z T

    2002-01-01

    A total of 100 patients with combined injuries of the organ of vision and eye appendages, inflicted in peacetime and under war conditions, were examined. The clinical picture of combined injuries in the wounds inflicted at the battlefield (gunshot and resultant from mine explosions) and of traffic, communal, criminal, and occupational injuries was studied using traditional ophthalmological and common clinical instrumental methods of examination. Common regularities of the traumatic process were revealed in combined injuries: mutual aggravation of injuries to the eye and its appendages, a considerable incidence of bilateral injuries, and simultaneous impacts of several damaging factors. The most unfavorable prognosis as regards visual functions in the group observed was for patients with war injuries, particularly those caused by mine explosions.

  14. Airway complications in traumatic lower cervical spinal cord injury: A retrospective study

    PubMed Central

    Niedeggen, Andreas; Estel, Barbara; Seidl, Rainer O.

    2015-01-01

    Objective To investigate risk factors for pneumonia in patients with traumatic lower cervical spinal cord injury. Design Observational study, retrospective study. Setting Spinal cord unit in a maximum care hospital. Methods Thirty-seven patients with acute isolated traumatic spinal cord injury at levels C4–C8 and complete motor function injury (AIS A, B) treated from 2004 to 2010 met the criteria for inclusion in our retrospective analysis. The following parameters were considered: ventilation-specific parameters, re-intubation, creation of a tracheostomy, pneumonia, antibiotic treatment, and length of intensive care unit (ICU) stay and total hospitalization. Results Among the patients, 81% had primary invasive ventilation. In 78% of cases a tracheostomy was created; 3% of these cases were discharged with invasive ventilation and 28% with a tracheostomy without ventilation. Pneumonia according to Centers for Disease Control criteria occurred in 51% of cases within 21 ± 32 days of injury, and in 3% at a later date. The number of pre-existing conditions was significantly associated with pneumonia. Length of ICU stay was 25 ± 34 days, and average total hospital duration was 230 ± 144 days. Significant factors affecting the duration of ventilation were the number of pre-existing conditions and tetraplegia-specific complications. Conclusions Our results confirm that patients with traumatic lower cervical spinal cord injuries defined by lesion level and AIS constitute a homogeneous group. This group is characterized by a high rate of pneumonia during the first 4 weeks after injury. The number of pre-existing general conditions and spinal injury-specific comorbidities are the only risk factors identified for the development of pneumonia and/or duration of ventilation. PMID:25117865

  15. Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit

    PubMed Central

    Montalvo, Alicia M.; Shaefer, Hilary; Rodriguez, Belinda; Li, Tan; Epnere, Katrina; Myer, Gregory D.

    2017-01-01

    The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002) and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p < 0.001) than non-competitors. Athletes who reported injury also reported significantly higher values for the following risk factors: years of participation (2.7 ± 1.8 v 1.8 ± 1.5, p = 0.001), weekly athlete training hours (7.3 ± 3.8 v 4.9 ± 2.1, p = 0.020), weekly athlete-exposures (6.4 ± 3.8 v 4.7 ± 2.1, p = 0.003), height (1.72 ± 0.09 m v 1.68 ± 0.01 m, p = 0.011), and body mass (78.24 ± 16.86 kg v 72.91 ± 14.77 kg, p = 0.037). Injury rates during CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce the increase

  16. 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.

  17. Etiology and severity of various forms of ocular war injuries in patients presenting at an Army Hospital in Pakistan

    PubMed Central

    Hassan Naqvi, Syed Abid; Malik, Sidra; Zulfiqaruddin, Syed; Anwar, Syeda Birjees; Nayyar, Shahzad

    2016-01-01

    Objective: To determine the etiology and severity of various forms of ocular war injuries in patients presenting at an Army Hospital in Pakistan. Methods: This cross sectional study was conducted at the Department of Ophthalmology, Combined Military Hospital, Peshawar over four years period from June 2012 through March 2016, Two hundred ten consecutive soldiers who presented with ocular war injuries were included for analysis after taking written informed consent. A predesigned proforma was used to record patient’s demographic details along with the cause, side, type and severity of injury, ocular trauma score was also recorded at presentation. Results: The mean age of the patients was 29.34±5.35 years. All of them were males. Left side was more frequently involved (n=126, 60.0%) and the most frequent underlying cause was IED blast injury (n=114, 54.3%). Closed globe injuries were more frequent and were recorded in 120 (57.1%) patients. Upon assigning Ocular Trauma Score, Grade-V (28.6%) injuries were the most frequent followed by Grade-I (25.7%), Grade III (25.7%), Grade II (11.4%) and Grade IV (8.6%). When stratified for the type of injury, OTS Grade I injuries were highest (60.0%) among patients with open globe injuries, hence poorer prognosis, while OTS Grade V injuries were highest (50.0%) among patients with closed globe injuries (p=0.000). Conclusion: IED blast injuries are most frequently encountered ocular war injuries often involving soldiers in the age group 20-30 years. These open globe injuries had worst clinical presentation to begin with and poorer prognosis than closed globe injuries. PMID:28083061

  18. Heterogeneity of Posttraumatic Stress Disorder Symptoms in Croatian War Veterans: Retrospective Study

    PubMed Central

    Begić, Dražen; Jokić-Begić, Nataša

    2007-01-01

    Aim To determine the relationship between the intensity of combat-related posttraumatic stress disorder (PTSD) and the intensity of predominating symptoms. Method The study included 151 veterans from 1992-1995 war in Croatia with PTSD, aged 38.3 ± 7.3 years (mean ± standard deviation). The veterans were psychologically tested with the Mississippi Scale for Combat-related PTSD (M-PTSD), Questionnaire on Traumatic Combat and War Experiences (USTBI-M), and Minnesota Multiphasic Personality Inventory-version 201 (MMPI-201). Results The discriminative analysis of the data revealed that the group with lower PTSD intensity had the highest scores on MMPI scales D (depression, T-score 95.7 ± 5.6), Hs (hypochondriasis, 87.6 ± 5.1), and Hy (hysteria, 85.6 ± 4.9), whereas the group with higher PTSD intensity, besides these three scales (D = 98.3 ± 5.3; Hs = 90.1 ± 4.3; Hy = 89.5 ± 4.7), also had clinically significantly elevated Pt (psychastenia, 80.6 ± 5.6), Sc (schizophrenia, 79.6 ± 4.8), and Pa (paranoia, 85.6 ± 5.4) scales, with the highest Pa scale. Conclusion It was possible to differentiate study participants with different PTSD intensity on the basis of their MMPI profile. More intense PTSD was associated with externalized symptoms, such as aggression, acting-out, hostility, and mistrust, whereas less intensive PTSD was associated with mostly depressive symptoms. Our study showed that different intensity of PTSD has different symptom patterns. PMID:17436377

  19. 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

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

    PubMed

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

    2014-03-01

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

  1. 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.

  2. Tau and Beta-Amyloid Deposition, Microhemorrhage and Brain Function after Traumatic Brain Injury in War Veterans

    DTIC Science & Technology

    2015-10-01

    AWARD NUMBER: W81XWH-14-1-0418 TITLE: Tau and Beta-Amyloid Deposition, Microhemorrhage and Brain Function after Traumatic Brain Injury in War...COVERED 25 Sep 2014 - 24 Sep 2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Tau and Beta-Amyloid Deposition, Microhemorrhage and Brain Function after...Traumatic Brain Injury in War Veterans 5b. GRANT NUMBER W81XWH-14-1-0418 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Christopher Rowe 5d. PROJECT

  3. Extremity war injuries: collaborative efforts in research, host nation care, and disaster preparedness.

    PubMed

    Pollak, Andrew N; Ficke, Col James R

    2010-01-01

    The fourth annual Extremity War Injuries (EWI) Symposium addressed ongoing challenges and opportunities in the management of combat-related musculoskeletal injury. The symposium, which also examined host-nation care and disaster preparedness and response, defined opportunities for synergy between several organizations with similar missions and goals. Within the Department of Defense, the Orthopaedic Extremity Trauma Research Program (OETRP) has funded basic research related to a series of protocols first identified and validated at prior EWI symposia. A well-funded clinical research arm of OETRP has been developed to help translate and validate research advances from each of the protocols. The Armed Forces Institute for Regenerative Medicine, a consortium of academic research institutions, employs a tissue-engineering approach to EWI challenges, particularly with regard to tissue loss. Programs within the National Institute of Arthritis and Musculoskeletal and Skin Diseases and throughout the National Institutes of Health have also expanded tissue-engineering efforts by emphasizing robust mechanistic basic science programs. Much of the clinical care delivered by US military medical personnel and nongovernmental agencies has been to host-nation populations; coordinating delivery to maximize the number of injured who receive care requires understanding of the breadth and scope of resources available within the war zone. Similarly, providing the most comprehensive care to the greatest number of injured in the context of domestic mass casualty requires discussion and planning by all groups involved.

  4. Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction

    PubMed Central

    Esteves, Luiz Adriano; Joaquim, Andrei Fernandes; Tedeschi, Helder

    2016-01-01

    ABSTRACT Objective To evaluate the correlation between the treatment, the characteristics of the lesions and the clinical outcome of patients with traumatic injuries to the craniocervical junction. Methods This was a retrospective study of patients treated conservatively or surgically between 2010 and 2013 with complete data sets. Results We analyzed 37 patients, 73% were men with mean age of 41.7 years. Of these, 32% were submitted to initial surgical treatment and 68% received conservative treatment. Seven (29%) underwent surgery subsequently. In the surgical group, there were seven cases of odontoid type II fractures, two cases of fracture of posterior elements of the axis, one case of C1-C2 dislocation with associated fractured C2, one case of occipitocervical dislocation, and one case of combined C1 and C2 fractures, and facet dislocation. Only one patient had neurological déficit that improved after treatment. Two surgical complications were seen: a liquoric fistula and one surgical wound infection (reaproached). In the group treated conservatively, odontoid fractures (eight cases) and fractures of the posterior elements of C2 (five cases) were more frequent. In two cases, in addition to the injuries of the craniocervical junction, there were fractures in other segments of the spine. None of the patients who underwent conservative treatment presented neurological deterioration. Conclusion Although injuries of craniocervical junction are relatively rare, they usually involve fractures of the odontoid and the posterior elements of the axis. Our results recommend early surgical treatment for type II odontoid fractures and ligament injuries, the conservative treatment for other injuries. PMID:28076601

  5. 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.

  6. Sharp force injury fatalities: a retrospective study (1982-2012) in Brescia (Italy).

    PubMed

    Vassalini, Marzia; Verzeletti, Andrea; De Ferrari, Francesco

    2014-11-01

    A retrospective study was carried out on postmortem examination data of 131 sharp force-related casualties recorded by the Brescia Institute of Forensic Medicine between 1982 and 2012. The objective was to identify relevant parameters that may be used to distinguish the manner of deaths between homicide, suicide, and accident. The following variables were considered: manner of death; demographic data; scene; type of sharp object; location and numbers of wounds; the presence of hesitation marks/defense wounds; toxicological findings; psychiatric history. There were 92 homicides, 28 suicides, and 11 accidents. Most victims were male, with an average age of 43. Injuries in isolation were present in 9.8% of homicides, in 35.7% of suicides, and in 54.5% of accidents. Most injuries involved the left anterior chest in homicides and the forearms in suicides. This study underlines the importance of a meticulous postmortem examination of injuries on the body and their relationship with other results from the death scene investigation.

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

    PubMed Central

    Stevanović, Aleksandra; Frančišković, Tanja; Vermetten, Eric

    2016-01-01

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

  8. 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

  9. 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

  10. Exploration of Pedestrian Head Injuries-Collision Parameter Relationships through a Combination of Retrospective Analysis and Finite Element Method.

    PubMed

    Liu, Wenjun; Su, Sen; Qiu, Jinlong; Zhang, Yongyong; Yin, Zhiyong

    2016-12-16

    There are a very limited number of reports concerning the relationship between pedestrian head injuries and collision parameters through a combination of statistical analysis methods and finite element method (FEM). This study aims to explore the characteristics of pedestrian head injuries in car-pedestrian collisions at different parameters by using the two means above. A retrospective analysis of pedestrian head injuries was performed based on detailed investigation data of 61 car-pedestrian collision cases. The head damage assessment parameters (head injury criterion (HIC), peak stress on the skull, maximal principal strain for the brain) in car-pedestrian simulation experiments with four contact angles and three impact velocities were obtained by FEM. The characteristics of the pedestrian head injuries were discussed by comparing and analyzing the statistical analysis results and finite element analysis results. The statistical analysis results demonstrated a significant difference in skull fractures, contusion and laceration of brain and head injuries on the abbreviated injury scale (AIS)3+ was found at different velocities (p < 0.05) and angles (p < 0.05). The simulation results showed that, in pedestrian head-to-hood impacts, the values of head damage assessment parameters increased with impact velocities. At the same velocity, these values from the impact on the pedestrian's back were successively greater than on the front or the side. Furthermore, head injury reconstruction and prediction results of two selected cases were consistent with the real injuries. Overall, it was further spelled out that, for shorter stature pedestrians, increased head impact velocity results in greater head injury severity in car-pedestrian collision, especially in pedestrian head-to-hood impacts. Under a back impact, the head has also been found to be at greater damage risk for shorter stature pedestrians, which may have implications on automotive design and pedestrian

  11. 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.

  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. Sir Hugh Cairns and World War II British advances in head injury management, diffuse brain injury, and concussion: an Oxford tale.

    PubMed

    Stone, James L; Patel, Vimal; Bailes, Julian E

    2016-11-01

    The authors trace the Oxford, England, roots of World War II (WWII)-related advances in head injury management, the biomechanics of concussion and brain injury, and postwar delineation of pathological findings in severe concussion and diffuse brain injury in man. The prominent figure in these developments was the charismatic and innovative Harvey Cushing-trained neurosurgeon Sir Hugh Cairns. Cairns, who was to closely emulate Cushing's surgical and scholarly approach, is credited with saving thousands of lives during WWII by introducing and implementing innovative programs such as helmets for motorcyclists, mobile neurosurgical units near battle zones, and the military usage of penicillin. In addition, he inspired and taught a generation of neurosurgeons, neurologists, and neurological nurses in the care of brain and spinal cord injuries at Oxford's Military Hospital for Head Injuries. During this time Cairns also trained the first full-time female neurosurgeon. Pivotal in supporting animal research demonstrating the critical role of acceleration in the causation of concussion, Cairns recruited the physicist Hylas Holbourn, whose research implicated rotary acceleration and shear strains as particularly damaging. Cairns' work in military medicine and head injury remain highly influential in efforts to mitigate and manage brain injury.

  14. 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

  15. 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

  16. 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

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

    PubMed

    Kaufman, M H

    2001-10-01

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

  18. Reassessment of Acute Kidney Injury after Cardiac Surgery: A Retrospective Study

    PubMed Central

    Xie, Xiangcheng; Wan, Xin; Ji, Xiaobing; Chen, Xin; Liu, Jian; Chen, Wen; Cao, Changchun

    2017-01-01

    Objective To evaluate the incidence, risk, or protective factors of acute kidney injury (AKI) in patients after cardiac surgery based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Methods A retrospective analysis of 2,575 patients undergoing their first documented cardiac surgery with cardiopulmonary bypass (CPB) was conducted. Perioperative variables were collected and analyzed. Univariate and multiple logistic regression models were used for determining the association between the development of AKI and risk factors. Multiple Cox-proportional hazards modeling was performed to evaluate the impact of AKI on the mortality in the intensive care unit and hospital length of stay. Results Of 2,575 patients, 931 (36%) developed AKI. A total of 30 (1.2%) patients required renal replacement therapy. In the multivariate analysis, mechanical ventilation duration (OR1.446, 95% CI 1.195-1.749, p<0.001), CPB duration of ≥110 min (OR 1.314, 95% CI 1.072-1.611, p=0.009), erythrocytes transfusion (OR 1.078, 95% CI 1.050-1.106, p<0.001), and postoperative body temperature greater than 38℃ within 3 days (OR 1.234, 95% CI 1.018-1.496, p=0.032) were independent risk factors for CSA-AKI, while ulinastatin use was associated with a reduced incidence of CSA-AKI (OR 0.694, 95% CI 0.557-0.881, p=0.006). CSA-AKI was significantly associated with in-hospital mortality (adjusted HR: 2.218, 95% CI 1.161-4.238, p=0.016), especially in patients needing renal replacement therapy (adjusted HR: 18.683, 95% CI 8.579-40.684, p<0.001). Conclusion Mechanical ventilation duration, erythrocytes transfusion, and postoperative body temperature above 38℃ within 3 days were considered independent risk factors for CSA-AKI. The use of ulinastatin was associated with a reduced incidence of CSA-AKI. PMID:28154270

  19. Respiratory management of pediatric patients with spinal cord injuries: retrospective review of the duPont experience.

    PubMed

    Padman, Raj; Alexander, Michael; Thorogood, Christine; Porth, Susan

    2003-03-01

    Pulmonary complications contribute to morbidity and mortality in spinal cord injuries (SCIs). A retrospective review of 20 years of experience with tracheostomy- and ventilator-dependent SCI children is presented. The authors developed and analyzed a database of 47 children (average age = 11.4 years). Of the patients, 27% had concomitant brain injuries, 6% had prior histories of reactive airway disease, and 2% had thoracic fractures. Injuries were caused by motor vehicle accidents (53%); gunshot wounds (19%); sports-related accidents (19%); and vascular injuries, transverse myelitis, or spinal tumors (8%). Of the injuries, 52% were high level (C1 to C2) and 48% were mid- or low level (C3 to C5). Two groups were analyzed for demographic information. Complications included tracheitis, atelectasis, and pneumonia. Mean tidal volume was 14 cm2/kg (maximum = 22 cm2/kg). Bedside lung function parameters were attempted to assess readiness and the rapidity of weans. T-piece sprints were used to successfully wean 63% of patients. Successfully weaned patients were compared with those not weaned. No deaths or readmissions for late-onset respiratory failure postwean occurred. The authors' clinical impression favors higher tidal volumes and aggressive bronchial hygiene to minimize pulmonary complications and enhance weaning. Successfully weaned patients had fewer complications. A critical pathway for respiratory management of SCI children is presented.

  20. Resuscitation after severe burn injury using high-dose ascorbic acid: a retrospective review.

    PubMed

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W

    2011-01-01

    Resuscitation of burn victims with high-dose ascorbic acid (vitamin C [VC]) was reported in Japan in the year 2000. Benefits of VC include reduction in fluid requirements, resulting in less tissue edema and body weight gain. In turn, these patients suffer less respiratory impairment and reduced requirement for mechanical ventilation. Despite these results, few burn centers resuscitate patients with VC in fear that it may increase the risk of renal failure. A retrospective review of 40 patients with greater than 20% TBSA between 2007 and 2009 was performed. Patients were divided into two groups: one received only lactated Ringer's (LR) solution and another received LR solution plus 66 mg/kg/hr VC. Both groups were resuscitated with the Parkland formula to maintain stable hemodynamics and adequate urine output (>0.5 ml/kg/hr). Patients with >10-hour delay in transfer to the burn center were excluded. Data collected included age, gender, weight, %TBSA, fluid administered in the first 24 hours, urine output in the first 24 hours, and Acute Physiology and Chronic Health Evaluation II score. PaO2 in millimeters mercury:%FIO2 ratio and positive end-expiratory pressure were measured at 12-hour intervals, and hematocrit was measured at 6-hour intervals. Comorbidities, mortality, pneumonia, fasciotomies, and renal failure were also noted. After 7 patients were excluded, 17 patients were included in the VC group and 16 in the LR group. VC and LR were matched for age (42 ± 16 years vs 50 ± 20 years, P = .2), burn size (45 ± 21%TBSA vs 39 ± 15%TBSA, P = .45), Acute Physiology and Chronic Health Evaluation II (17 ± 7 vs 18 ± 8, P = .8), and gender. Fluid requirements in the first 24 hours were 5.3 ± 1 ml/kg/%TBSA for VC and 7.1 ± 1 ml/kg/%TBSA for LR (P < .05). Urine output was 1.5 ± 0.4 ml/kg/hr for VC and 1 ± 0.5 ml/kg/hr for LR (P < .05). Vasopressors were needed in four VC patients and nine LR patients (P = .07). VC patients required vasopressors to maintain mean

  1. ACL injury mechanisms and related factors in male and female carving skiers: a retrospective study.

    PubMed

    Ruedl, G; Webhofer, M; Linortner, I; Schranz, A; Fink, C; Patterson, C; Nachbauer, W; Burtscher, M

    2011-10-01

    In recreational alpine skiing, ACL injury risk is 3 times greater in females. However, since the introduction of carving skis ACL injury risk seems to have decreased. No study has yet investigated the distribution of ACL injury mechanisms in male and female carving skiers. Therefore, the aim of the study was to investigate potential gender specific differences of ACL injury mechanisms and related factors among carving skiers. In total, 220 recreational carving skiers (59 males and 161 females) suffering from an ACL injury volunteered for this study. Demographic data, skiing ability, equipment related and environmental factors, circumstances and causes for the fall, and type of fall (injury mechanisms) were collected by questionnaire. The forward twisting fall is the most reported ACL injury mechanism in both gender (p=0.672) accounting for 54% of all injuries, although male and female skiers differed significantly with regard to circumstances of fall (p=0.001) and actions when ACL injury occurred (p=0.04). Bindings not releasing at the time point of accident occurred 2.6 times more with females than with males (p=0.005). The forward twisting fall seems to have become the dominant ACL injury mechanism both in male and female recreational skiers since the introduction of carving skis.

  2. Five-Year Retrospective Review of Blunt Renal Injuries at a Level I Trauma Center.

    PubMed

    Burns, Jessica; Brown, Megan; Assi, Zakaria I; Ferguson, Eric J

    2017-02-01

    We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality. The registry identified 48 blunt renal injury patients. Median Injury Severity Score was higher and hospital length of stay was significantly longer in those with blunt renal injury when compared with those without blunt renal injury (P < 0.001). The majority of patients with blunt renal injury were managed nonoperatively. Mortality was three out of 48 patients (5%). Nine patients underwent exploratory laparotomy. These operations were always performed for reasons other than the renal trauma (e.g., splenic injury, free fluid, free air). No patient underwent invasive renal operation. Six patients were treated using angiography with embolization. Of the six, one patient died of pulmonary septic complications. We conclude that selective nonoperative management is the mainstay of treatment for blunt renal injury. Angiography with embolization is a useful modality for cases of ongoing bleeding, and is typically preferable to nephrectomy in our experience.

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

    PubMed

    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 PointsWhile many authors have proposed that neck strengthening could be an effective strategy in preventing cervical spine injuries in Rugby

  4. 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.

  5. 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.

  6. Spinal Column Injuries Among Americans in the Global War on Terrorism

    DTIC Science & Technology

    2012-09-19

    toward the lumbar spine. Three hundred and nineteen (15%) of the 2101 injuries occurred in the cervical spine, while 591 (28%) were located in the...with spinal injuries solely to the cervical spine, four (24%) with injuries to the lumbar region, and one with an isolated thoracic spine injury. Fig. 1...fractures were reported in 3% of patients each, and there were ten documented flexion -distraction injuries and two fracture- dislocations. One hundred

  7. Clearing the Cervical Spine in a War Zone: What Other Injuries Matter?

    DTIC Science & Technology

    2015-07-01

    injuries in proximity to the neck ( head , thoracic spine, chest, or humerus) in 17 (85%) patients. In 3 patients(15%), coexisting injuries were not in...proximity to the neck and included pelvic, femur, and tibia fractures. All patients without coexisting injury (n = 37) had a positive physical examination...Conclusion: Physical examination of multitrauma casualties with neck injury may be unreliable when distracting injuries are present. When no

  8. 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.

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

    PubMed Central

    2013-01-01

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

  10. 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.

  11. Type of sport is related to injury profile: a study on cross country skiers, swimmers, long-distance runners and soccer players. A retrospective 12-month study.

    PubMed

    Ristolainen, L; Heinonen, A; Turunen, H; Mannström, H; Waller, B; Kettunen, J A; Kujala, U M

    2010-06-01

    This 12-month retrospective questionnaire compared the occurrence of sports injuries in 149 cross country skiers, 154 swimmers, 143 long-distance runners and 128 soccer players aged 15-35 years. Soccer had significantly more injuries (5.1 injuries/1000 exposure hour) than other sports (2.1-2.8, P<0.001). More runners than soccer players reported overuse injuries (59% vs 42%, P=0.005), locating typically in the foot in runners, soccer players and skiers. Swimmers reported overuse injuries in the shoulder more commonly than skiers (40% vs 1%, P<0.001), who also intensively load shoulders. Acute injuries in skiers (80%) and in swimmers (58%), and overuse injuries in skiers (61%), occurred during exercise other than own event. In soccer and running the absence time from sport because of injuries was significantly longer than in skiing and swimming. No severe permanent disabilities occurred due to injury but seven women quit sports because of injury. In conclusion, type of loading is strictly associated with the anatomical location of an overuse injury as shown by the difference in shoulder injury incidence between swimmers and cross country skiers. In some sports, a significant proportion of acute injuries occur in other than the main event.

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

    PubMed Central

    2009-01-01

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

  13. 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%).

  14. 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.

  15. 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.

  16. 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.

  17. Inferior Alveolar Nerve Injuries Associated with Mandibular Fractures at Risk: A Two-Center Retrospective Study

    PubMed Central

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

    2014-01-01

    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

  18. 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…

  19. 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

  20. A review of 41 upper extremity war injuries and the protective gear worn during Operation Enduring Freedom and Operation Iraqi Freedom.

    PubMed

    Greer, Michelle A; Miklos-Essenberg, M Elizabeth; Harrison-Weaver, Sandra

    2006-07-01

    Forty-one patients with upper extremity war injuries sustained during combat operations Operation Enduring Freedom and Operation Iraqi Freedom were reviewed to report on protective gear availability and usage at the time of injury. Participants treated at the Madigan Army Medical Center occupational therapy clinic from August 2004 until February 2005 completed a questionnaire regarding injuries sustained during deployment. Overall, 6 injuries were to upper extremity regions that were covered with issued protective gear; 21 injuries were to areas not covered with issued protective gear (i.e., participant was not wearing issued gear), and 22 injuries were to regions that were not covered because no protective gear was issued for that body area. Although this study is limited, future research would provide valuable insights about the efficacy of current body armor and the need for additional or modified gear.

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

    PubMed Central

    2011-01-01

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

  2. The Epidemiology of Vascular Injury in the Wars in Iraq and Afghanistan

    DTIC Science & Technology

    2011-06-01

    scale (AIS) and In- ternational Classification of Diseases , Ninth Revision (ICD-9) codes for vascular injury (arterial and venous) and vascular injury...denominator of significant wounding in the tabulation of rates. Nonbattle-related injuries (ie, disease nonbattle or DNBI) were not included in the...Coronary 2 0.13 Celiac 3 0.19 Superior mesenteric artery 13 0.83 Aorta 45 2.9 Vena cava (n = 21) Superior 5 0.32 Inferior 16 1.1 Iliac (n = 61) Iliac

  3. Detailed description of anatomy of the fracture line in hangman's injury: a retrospective observational study on motor vehicle accident victims

    PubMed Central

    Menon, K Venugopal

    2016-01-01

    Objective: To study the precise location of fracture line in hangman's fracture to determine the fracture patterns, symmetry and involvement of different vertebral elements. Methods: 32 cases of hangman's fractures were retrospectively evaluated. All patients presented with motor vehicle accidents. CT scans were studied to accurately localize the fracture lines. Symmetry of fracture lines on both sides was assessed, and involvement of the vertebral bodies, lamina, facet joints and foramen transversarium was also determined. Results: 20 patients showed asymmetric fracture locations, 13 of them had a unilateral pedicle fracture and a contralateral pars fracture which comprised the most common injury pattern (40% of cases). Less frequent combinations for the two sides of asymmetric C2 ring disruption include pars–vertebral body (3 patients), pedicle–vertebral body (2 patients) and pedicle–lamina (2 patients). 12 patients showed symmetrical fractures (5 through the pars and 7 through the pedicles). Vertebral body and facet joint involvement were demonstrated in 15 (47%) and 16 (50%) cases, respectively. 18 cases had fractures extending into the foramen transversarium (56%). In total, 26 fracture lines primarily affected the pars (40%) and 31 affected the pedicles (49%). Conclusion: Asymmetric hangman's fracture is more common with the usual pattern being fracture pedicle on one side and pars on the other followed by the symmetric bilateral pedicle and bilateral pars fractures. Fracture lines running into the transverse foramen and facet joints are very frequent as well as those involving the vertebral bodies. Advances in knowledge: There is controversy in literature regarding the fracture locations in hangman's injury owing to lack of studies that address this subject. This article is the first to describe precisely the anatomical locations and patterns of this injury. PMID:26607649

  4. 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.

  5. 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.

  6. A retrospective study of traumatic dental injuries in a Brazilian dental urgency service.

    PubMed

    Guedes, Orlando Aguirre; de Alencar, Ana Helena Gonçalves; Lopes, Lawrence Gonzaga; Pécora, Jesus Djalma; Estrela, Carlos

    2010-01-01

    Epidemiologic aspects of traumatic dental injuries (TDI) were evaluated in the permanent dentition in a sample of 847 patients treated at the Dental Urgency Service of the Dental School of the Federal University of Goiás, Brazil, between May 2000 and May 2008. The statistical treatment analyzed data from frequency distribution and chi-square test. The level of significance was set at 5% for all analyses. The results showed a higher incident among males (610; 72.01%) with mean age of 6-10 year-old. Uncomplicated crown fracture (without pulp exposure) (502; 26.95%), avulsion (341; 18.30%) and complicated crown fracture (with pulp exposure) (330; 17.71%) were the most prevalent TDI. The prevalence of trauma throughout the years showed proportionality, being observed a larger number of cases between July and September (249; 29.39%). The most affected teeth were the maxillary central incisors (65.65%), followed by the maxillary left lateral incisors (19.67%). In 311 participants (18.25%), only one tooth was involved, while in most patients (536; 81.75%), TDI occurred in more than one tooth. Significant proportion (82.27%) of traumatized teeth presented completely formed root apex. The main etiologic factors involved in TDI were falls (51.71%), traffic accidents (22.90%) and violence (5.67%). Based on the obtained data, it may be concluded that accurate policies of TDI prevention must be established, capable of stimulating the exposure of appropriate protocols for management of these lesions. The prevalence of TDI in Goiânia subpopulation is compared to the prevalence reported in epidemiological studies in others populations.

  7. Sciatic nerve entrapment in the upper thigh caused by an injury sustained during World War II at the battle of Anzio. Case report.

    PubMed

    Oldershaw, John B; Salem, Ayman; Storrs, Bruce B; Milner, Brenton; Omer, George E

    2004-03-01

    The authors present an unusual case of sciatic nerve entrapment due to a World War II shrapnel injury to the left thigh suffered during the battle of Anzio in 1943. The patient presented for evaluation of left lower-extremity pain in the sciatic nerve distribution. Magnetic resonance imaging of the lumbosacral spine revealed a disc bulge at L5-S1 that would not explain severe sciatica. A positive Tinel sign was present in the posterior aspect of the upper thigh at the site of a scar resulting from a World War II shrapnel injury. The patient underwent exploratory external neurolysis of the area, and the sciatic nerve was released from fibrous adhesive entrapment. The patient improved dramatically following surgery. During a 3-year follow-up period, no recurrence of symptoms was noted.

  8. Peculiarities and Patterns of Cervical Spine Injuries in Children and Adolescents: A Retrospective Series of 84 Patients from a Single Institute.

    PubMed

    Babu, R Arun; Arivazhagan, Arimappamagan; Devi, B Indira; Bhat, Dhananjaya I; Sampath, Somanna; Chandramouli, B A

    2016-01-01

    Cervical spine injuries occur infrequently in children but are associated with significant disability and mortality. A retrospective analysis was performed of 84 consecutive pediatric spine injuries treated at our institute from January 2002 to December 2011. The mean age was 14.7 years. There were 18 patients (21%) in group A (0-12 years) and 66 patients (79%) in group B (13-18 years). Overall, injury was more common in boys (ratio of 6:1). Trivial fall was the predominant cause in group A and fall from height in group B. There were 30 children (36%) with injuries of the upper cervical spine, 53 (63%) with injuries of the lower cervical spine and 1 patient (1%) with a combined injury of upper cervical spine and thoracic spine. Overall, 22% of the group A children and 67% of the group B patients had more severe injuries (Frankel grades A, B and C); 21% (18/84) were treated by surgical fusion. Where follow-up was available, 17 out of 22 children (77%) had good outcome (Frankel grade >C). In conclusion, mechanisms and patterns of injury in children are age related and the majority of the children had good outcome.

  9. 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

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

    PubMed

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

    2009-01-01

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

  11. 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

  12. Orthopaedic war injuries: from combat casualty care to definitive treatment: a current review of clinical advances, basic science, and research opportunities.

    PubMed

    Covey, Dana C; Aaron, Roy K; Born, Christopher T; Calhoun, Jason H; Einhorn, Thomas A; Hayda, Roman A; Levin, Lawrence Scott; Mazurek, Michael T; Murray, Clinton K; Powell, Elisha T; Schwarz, Edward M; Wenke, Joseph C

    2008-01-01

    Musculoskeletal war wounds often involve massive injury to bone and soft tissue that differ markedly in character and extent compared with most injuries seen in civilian practice. These complex injuries have challenged orthopaedic surgeons to the limits of their treatment abilities on the battlefield, during medical evacuation, and in subsequent definitive or reconstructive treatment. Newer methodologies are being used in the treatment of these wounds to prevent so-called second hit complications, decrease complications associated with prolonged medical evacuation, reduce the incidence of infection, and restore optimal function. Basic science advances hold the promise of providing foundations for future treatment options that may improve both bone and soft-tissue healing. Research on the treatment of these often devastating wounds also will have broad applicability to trauma resulting from acts of terrorism or from natural disasters.

  13. The epidemiology of blast lung injury during recent military conflicts: a retrospective database review of cases presenting to deployed military hospitals, 2003–2009

    PubMed Central

    Smith, J. E.

    2011-01-01

    Blast injuries are becoming increasingly common in military conflicts as the nature of combat changes from conventional to asymmetrical warfare and counter-insurgency. This article describes a retrospective database review of cases from the UK joint theatre trauma registry from 2003 to 2009, containing details of over 3000 patients, mainly injured in Iraq and Afghanistan. During this period, 1678 patients were injured by explosion of whom 113 had evidence of blast lung injury. Of the 50 patients who survived to reach a medical facility, 80 per cent required ventilatory support. Injuries caused by explosion are increasing when compared with those caused by other mechanisms, and blast lung represents a significant clinical problem in a deployed military setting. Management of these patients should be optimized from point of wounding to definitive care. PMID:21149365

  14. Traumatic arteriovenous fistula due to an old gunshot injury: a victim from the Afghanistan War.

    PubMed

    Dabbagh, Ali; Mar'ashi, Ali S; Malek, Bahman

    2007-10-01

    A 75-year-old man referred to the outpatient vascular surgery clinic of Taleghani Hospital (Shaheed Beheshti University of Medicine, Tehran, Iran) due to a local nontender mass in his groin. In his history, it was discovered that the mass had appeared a few months after a gunshot injury. He had a history of shortness of breath with a New York Heart Association functional class fluctuating between II and III, but no history of smoking or addiction. In the physical examination, a 5-cm by 5-cm nonpulsatile mass with engorged vessels was found in the anterior portion of the left groin, which was not tender. An elective arterial angiography revealed an arteriovenous fistula joining the femoral artery to the femoral vein at the left groin. The cardiac assessments revealed cor pulmonale (with a restrictive pattern and diastolic dysfunction) and pulmonary hypertension due to primary pulmonary dysfunction. The patient was anesthetized with a balanced general anesthesia method, considering all relevant cardiac and respiratory monitoring methods and specially withholding drugs increasing pulmonary vascular bed pressure, suppressing the myocardium, or increasing the regurgitant flow across the mitral and, especially, the tricuspid valve. The moment the fistula was closed, a rapid fall in the patient's heart rate was noted, from approximately 60 beats per minute to above 40 beats per minute; this decreased heart rate continued up to a few hours after the surgery and did not accompany any significant hemodynamic derangement including the patient's blood pressure. The patient received his postoperative care in the ordinary surgical ward and was discharged a few days later.

  15. 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.

  16. Neurological findings in pediatric penetrating head injury at a university teaching hospital in Durban, South Africa: a 23-year retrospective study.

    PubMed

    Muballe, Kadhaya David; Hardcastle, Timothy; Kiratu, Erastus

    2016-11-01

    OBJECTIVES Penetrating traumatic brain injuries (TBIs) can be divided into gunshot wounds or stab wounds based on the mechanisms of injury. Pediatric penetrating TBIs are of major concern as many parental and social factors may be involved in the causation. The authors describe the penetrating cranial injuries in pediatric patient subgroups at risk and presenting to the Department of Neurosurgery at the University of KwaZulu-Natal, by assessment of the Glasgow Coma Scale (GCS) score and review of the common neurological manifestations including cranial nerve abnormalities. METHODS The authors performed a retrospective chart review of children who presented with penetrating TBIs between 1985 and 2007 at a university teaching hospital. Descriptive statistical analysis with univariate and multivariate logistic regression was used to assess the variables. RESULTS Out of 223 children aged 16 years and younger with penetrating TBIs seen during the study period, stab wounds were causal in 127 (57%) of the patients, while gunshot injuries were causal in 96 (43%). Eighty-four percent of the patients were male. Apart from abnormal GCS scores, other neurological abnormalities were noted in 109 (48.9%) of the patients, the most common being cranial nerve deficits (22.4%) and hemiparesis. There was a strong correlation between left-sided stab wounds and development of seizures. The mean age of patients with neurological abnormalities was 11.72 years whereas that of patients with no neurological abnormalities was 8.96 years. CONCLUSIONS Penetrating head injuries in children are not as uncommon as previously thought. There was no correlation between the age group of the patients and the mechanism of injury, which implies that stab or gunshot injuries could occur in any of our pediatric population with the same frequency. While gunshot injuries accounted for 56% of the patient population, stab injuries still accounted for 44%. Following penetrating head injuries, neurological

  17. Civil and war peripheral arterial trauma: review of risk factors associated with limb loss.

    PubMed

    Davidovic, Lazar B; Cinara, Ilijas S; Ille, Tanja; Kostic, Dusan M; Dragas, Marko V; Markovic, Dragan M

    2005-01-01

    We sought to analyze the early results of civil and war peripheral arterial injury treatment and to identify risk factors associated with limb loss. Between 1992 and 2001, data collected retrospectively and prospectively on 413 patients with 448 peripheral arterial injuries were analyzed. Of these, there were 140 patients with war injuries and 273 patients with civil injuries. The mechanism of injury was gunshot in 40%, blunt injury in 24%, explosive trauma in 20.3%, and stabbing in 15.7% of the cases. The most frequently injured vessels were the femoral arteries (37.3%), followed by the popliteal (27.8%), axillary and brachial (23.5%), and crural arteries (6.5%). Associated injuries, which included bone, nerve, and remote injuries affecting the head, chest, or abdomen, were present in 60.8% of the cases. Surgery was carried out on all patients, with a limb salvage rate of 89.1% and a survival rate of 97.3%. In spite of a rising trend in peripheral arterial injuries, our total and delayed amputation rates remained stable. On statistical analysis, significant risk factors for amputation were found to be failed revascularization, associated injuries, secondary operation, explosive injury, war injury (p < .01) and arterial contusion with consecutive thrombosis, popliteal artery injury, and late surgery (p < .05). Peripheral arterial injuries, if inadequately treated, carry a high amputation rate. Explosive injuries are the most likely to lead to amputations, whereas stab injuries are the least likely to do so. The most significant independent risk factor for limb loss was failed revascularization.

  18. A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study

    PubMed Central

    Liu, Xing; Ye, Yongkai; Mi, Qi; Huang, Wei; He, Ting; Huang, Pin; Xu, Nana; Wu, Qiaoyu; Wang, Anli; Li, Ying; Yuan, Hong

    2016-01-01

    Background Acute kidney injury (AKI) is a serious post-surgery complication; however, few preoperative risk models for AKI have been developed for hypertensive patients undergoing general surgery. Thus, in this study involving a large Chinese cohort, we developed and validated a risk model for surgery-related AKI using preoperative risk factors. Methods and Findings This retrospective cohort study included 24,451 hypertensive patients aged ≥18 years who underwent general surgery between 2007 and 2015. The endpoints for AKI classification utilized by the KDIGO (Kidney Disease: Improving Global Outcomes) system were assessed. The most discriminative predictor was selected using Fisher scores and was subsequently used to construct a stepwise multivariate logistic regression model, whose performance was evaluated via comparisons with models used in other published works using the net reclassification index (NRI) and integrated discrimination improvement (IDI) index. Results Surgery-related AKI developed in 1994 hospitalized patients (8.2%). The predictors identified by our Xiang-ya Model were age, gender, eGFR, NLR, pulmonary infection, prothrombin time, thrombin time, hemoglobin, uric acid, serum potassium, serum albumin, total cholesterol, and aspartate amino transferase. The area under the receiver-operating characteristic curve (AUC) for the validation set and cross validation set were 0.87 (95% CI 0.86–0.89) and (0.89; 95% CI 0.88–0.90), respectively, and was therefore similar to the AUC for the training set (0.89; 95% CI 0.88–0.90). The optimal cutoff value was 0.09. Our model outperformed that developed by Kate et al., which exhibited an NRI of 31.38% (95% CI 25.7%-37.1%) and an IDI of 8% (95% CI 5.52%-10.50%) for patients who underwent cardiac surgery (n = 2101). Conclusions/Significance We developed an AKI risk model based on preoperative risk factors and biomarkers that demonstrated good performance when predicting events in a large cohort of

  19. Risk Factors for Acute Kidney Injury after Congenital Cardiac Surgery in Infants and Children: A Retrospective Observational Study

    PubMed Central

    Kim, Eunhee; Park, Jung Bo; Kim, Youngwon; Yang, Ji-Hyuk; Jun, Tae-Gook; Kim, Chung Su

    2016-01-01

    Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Ninety-two patients (41.8%) developed AKI and 18 (8.2%) required renal replacement therapy within the first postoperative week. Among patients who developed AKI, 57 patients (25.9%) were KDIGO stage 1, 27 patients (12.3%) were KDIGO stage 2, and eight patients (3.6%) were KDIGO stage 3. RACHS-1 (Risk-Adjusted classification for Congenital Heart Surgery) category, perioperative transfusion and fluid administration as well as fluid overload were compared between patients with and without AKI. Multivariable logistic regression analyses determined the risk factors for AKI. AKI was associated with longer hospital stay or ICU stay, and frequent sternal wound infections. Younger age (<12 months) [odds ratio (OR), 4.01; 95% confidence interval (CI), 1.77–9.06], longer cardiopulmonary bypass (CPB) time (OR, 2.45; 95% CI, 1.24–4.84), and low preoperative hemoglobin (OR, 2.40; 95% CI, 1.07–5.40) were independent risk factors for AKI. Fluid overload was not a significant predictor for AKI. When a variable of hemoglobin concentration increase (>3 g/dl) from preoperative level on POD1 was entered into the multivariable analysis, it was independently associated with postoperative AKI (OR, 6.51; 95% CI, 2.23–19.03 compared with no increase). This association was significant after adjustment with patient demographics, medication history and RACHS-1 category (hemoglobin increase >3g/dl vs. no increase: adjusted OR, 6.94; 95% CI, 2.33–20

  20. Child road traffic crash injuries at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa in 1992, 2002 and 2012.

    PubMed

    Isaac, Kihurani N; Van Niekerk, Ashley; Van As, Arjan Bastiaan

    2015-01-01

    Road traffic crashes are a significant cause of the disease burden among children, with the highest mortality in low- and middle-income countries. This observational study explores such injuries in Cape Town, South Africa through an analysis of data for cases in 1992, 2002 and 2012 at the Red Cross War Memorial Children's Hospital, a referral paediatric hospital for children younger than 13 years. Descriptive and time trend analysis of demographic data as well as of the causes, severity and place of injury was conducted. Logistic regression and generalised linear models described factors influencing hospital admission. In the years 1992, 2002 and 2012, a total of 4690 patients presented with injuries sustained as a result of a road traffic crash. Nearly 50% (n = 2201) of them were between five and nine years of age, with 1.7 males for every female. Three-quarters of those who got injured were pedestrians while the second most commonly injured ones were unrestrained passengers. The majority had minor injuries (58%), but with notably higher proportions with moderate to severe injuries in the years 2002 and 2012. Forty per cent were admitted for inpatient treatment, with the highest proportion (50%) in 2002. Admission was related to mechanism and severity. The epidemiological factors assessed remain largely unchanged over the assessment points calling into question the impact of local safety strategies.

  1. 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…

  2. 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

  3. Ten Years of War: A Characterization of Craniomaxillofacial Injuries Incurred During Operations Enduring Freedom and Iraqi Freedom

    DTIC Science & Technology

    2012-01-01

    common, but that is often because the facial fractures were broken up into maxilla, nasal , zygoma, and orbit.15,21 When these numbers are combined...injury. Injuries were classified according to type (wounds, fractures , burns, vascular injuries, and nerve injuries) using DRG International...of patients evacuated out of theater. There is a high preponderance of multiple wounds and open fractures in this region. The primary mechanism of

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

    PubMed Central

    Baker, Edward James; Lee, Geraldine Ann

    2016-01-01

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

  5. Identifying Future Unexpected Survivors: A Retrospective Cohort Study of Fatal Injury Patterns in Victims of Improvised Explosive Devices

    DTIC Science & Technology

    2013-01-01

    vehicle collisions ( MVCs ).20 Nelson et al21 reported a case series of 18 US military IED casualties injured in Iraq in 2004, of whom 9 died. Injuries...of injury (DOW 72%, KIA 74%) followed by GSWs (DOW 25%, KIA 22%), and then the other causes (DOW, MVCs 2%, helicopter crashes 1%, KIA ‘other’ (eg... MVC , crush) 4%). Both DOW and KIA groups showed TBI to be the predominant cause of death in their NS groups (83% and 45%, respectively) and haem

  6. Is Sexual Abuse a Part of War? A 4-Year Retrospective Study on Cases of Sexual Abuse at the Kenyatta National Hospital, Kenya

    PubMed Central

    Omondi, Lilian; Olando, Yvonne; Makenyengo, Margaret; Bukusi, David

    2013-01-01

    The harmful effects of sexual abuse are long lasting. Sexual abuse when associated with violence is likely to impact negatively on the life of the victim. Anecdotal reports indicate that there was an increase in the number of cases of sexual violence following the 2007 post election conflict and violence in Kenya. Although such increases in sexual abuse are common during war or conflict periods the above reports have not been confirmed through research evidence. The purpose of the current study is to establish the trend in numbers of reported cases of sexual abuse at Kenyatta National Hospital over a 4-year period (2006-2009). Data on sexually abused persons for the year 2006-2009 was retrieved from the hospitals record. A researcher designed questionnaire was used to collect relevant data from the completed Post Rape Care (PRC) form. The PRC-Ministry of Health no. 363 (MOH363) form is mandatorily completed by the physician attending the sexually abused patient. There was an increase in the number of cases of sexual abuse reported in 2007 election year in Kenya, with a statistically significant increase in the sexually abused male cases. Sexual crime is more prevalent when there is war or conflict. PMID:28299094

  7. 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.

  8. 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

  9. Autologous Skin Cell Spray for Massive Soft Tissue War Injuries: A Prospective, Case-Control, Multicenter Trial

    DTIC Science & Technology

    2014-04-01

    extrapolated to complex traumatic civilian injuries that likewise pose significant issues with available autologous skin coverage (e.g. necrotizing ... fasciitis , motor vehicle accidents or other trauma with associated soft tissue avulsion injuries, etc.). Important data on the mechanism of action

  10. Proposed Iraq/Afghanistan War-Lung Injury (IAW-LI) Clinical Practice Recommendations: National Academy of Sciences' Institute of Medicine Burn Pits Workshop.

    PubMed

    Szema, Anthony; Mirsaidi, Niely; Patel, Bhumika; Viens, Laura; Forsyth, Edward; Li, Jonathan; Dang, Sophia; Dukes, Brittany; Giraldo, Jheison; Kim, Preston; Burns, Matthew

    2015-12-14

    High rates of respiratory symptoms (14%) and new-onset asthma in previously healthy soldiers (6.6%) have been reported among military personnel post-deployment to Iraq and Afghanistan. The term Iraq/Afghanistan War-Lung Injury (IAW-LI) is used to describe the constellation of respiratory diseases related to hazards of war, such as exposure to burning trash in burn pits, improvised explosive devices, and sandstorms. Burnpits360.org is a nonprofit civilian website which voluntarily tracks medical symptoms among soldiers post-deployment to the Middle East. Subsequent to initiation of the Burnpits360.org website, the Department of Veterans Affairs started the Airborne Hazards and Open Burn Pit registry. This paper: (a) analyzes the latest 38 patients in the Burnpits360.org registry, validated by DD214 Forms; (b) compares strengths and weaknesses of both registries as outlined at the National Academy of Sciences Institute of Medicine Burn Pits Workshop; (c) further characterizes the spectrum of disease in IAW-LI; (d) describes the risk factors of affected populations; (e) summarizes current practices regarding management of the condition; and (f) defines future research objectives.

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

    PubMed

    Lanska, Douglas J

    2016-01-01

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

  12. 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

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

    PubMed Central

    Pollock, Richard A.

    2011-01-01

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

  14. 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

  15. 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

  16. Incidence, risk factors and clinical outcomes of acute kidney injury associated with scrub typhus: a retrospective study of 510 consecutive patients in South Korea (2001–2013)

    PubMed Central

    Hwang, Kyungo; Jang, Ha Nee; Lee, Tae Won; Cho, Hyun Seop; Bae, Eunjin; Chang, Se-Ho; Park, Dong Jun

    2017-01-01

    Objectives Renal involvement in scrub typhus ranges from simple urinary abnormalities to acute kidney injury (AKI) leading to death. This study evaluated the incidence, predictors and prognosis of AKI associated with scrub typhus according to the RIFLE (risk, injury, failure, loss, end-stage kidney disease) criteria. Methods We retrospectively evaluated the medical records of patients diagnosed with scrub typhus from January 2001 to November 2013 in Gyeongsang National University Hospital. Results During the study period, 510 patients were diagnosed with scrub typhus and the incidence of AKI was 35.9%. There were 132 (25.9%) patients at risk, 37 (7.3%) with injury and 14 (2.7%) with failure. In comparison with the non-AKI group, the AKI group was older (73.9 vs 63.4 years, p<0.001) and had more comorbidities such as hypertension, diabetes mellitus and chronic kidney disease (CKD). AKI frequently occurs in hypertensive patients taking angiotensin receptor blockers or ACE inhibitors (p=0.002), and in patients with diabetes with higher glycated haemoglobin levels (p=0.033). Haematuria and proteinuria were more frequent in the AKI group. There was no relationship between the severity of proteinuria and occurrence of AKI. Intensive care unit admission and death were more frequent in the AKI group. The renal function of most patients with AKI recovered without sequelae, except for 1 patient who had underlying CKD. Multivariate analysis showed that age, presence of CKD, serum albumin level and time to hospital presentation after symptom onset were independent predictors of AKI in patients with scrub typhus. Conclusions Our current results suggest that the presence of underlying CKD, older age, lower serum albumin level and time to hospital presentation after symptom onset were important risk factors to determine occurrence of AKI. Whether earlier diagnosis and treatment in patients with the above risk factors reduce the incidence and severity of AKI deserves to be

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

    PubMed

    Martin, Gregory J; Tribble, David R

    2010-07-01

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

  18. Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

    PubMed

    Chan, Jeffrey C Y; Purcell, Elizabeth M; Kelly, John L

    2007-01-01

    The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.

  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. Anatomic Distribution and Mortality of Arterial Injury in the Wars in Afghanistan and Iraq with Comparison to a Civilian Benchmark

    DTIC Science & Technology

    2012-09-01

    Costanzo G, Jenkins D, Spott MA, Wade C, Greydanus D, et al. Impact of joint theater trauma system initiatives on battlefield injury outcomes. Am J Surg...ntdb.html. Accessed September 1, 2009. 4. Eastridge BJ, Wade CE, Spott MA, Costanzo G, Dunne J, Flaherty S, et al. Utilizing a trauma systems approach to

  1. 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.

  2. 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

  3. Electroconvulsive therapy in adolescents with intellectual disability and severe self-injurious behavior and aggression: a retrospective study.

    PubMed

    Consoli, Angele; Cohen, Johan; Bodeau, Nicolas; Guinchat, Vincent; Wachtel, Lee; Cohen, David

    2013-01-01

    Efficacious intervention for severe, treatment-refractory self-injurious behavior and aggression (SIB/AGG) in children and adolescents with intellectual disability and concomitant psychiatric disorders remains a complex and urgent issue. The aim of this study is to assess the efficacy of electroconvulsive therapy (ECT) on severe and treatment-resistant SIB/AGG in young people with intellectual disability and current psychiatric disorder. We reviewed the charts of all patients (N = 4) who received ECT in the context of SIB/AGG with resistance to behavioral interventions, milieu therapy and pharmacotherapy from 2007 to 2011. We scored the daily rate of SIB/AGG per patient for each hospital day. Inter rater reliability was good (intraclass correlations = 0.91). We used a mixed generalized linear model to assess whether the following explanatory variables (time, ECT) influenced the course of SIB/AGG over time, the dependant variable. The sample included two girls and two boys. The mean age at admission was 13.8 years old [range 12-14]. The patients had on average 19 ECT sessions [range 16-26] and one patient received maintenance ECT. There was no effect of time before and after ECT start. ECT was associated with a significant decrease in SIB/AGG scores (p < 0.001): mean aggression score post-ECT was half the pre-ECT value. ECT appears beneficial in severe, treatment-resistant SHBA in adolescents with intellectual disability.

  4. The use of recombinant factor VIIa in warfarin patients with traumatic brain injury: a retrospective case-control study.

    PubMed

    DeLoughery, Emma P; Lenfesty, Barbara; DeLoughery, Thomas G

    2013-04-01

    Patients on warfarin who have traumatic intracranial haemorrhage have a high mortality. The procoagulant recombinant factor VIIa (rFVIIa) is widely used off-label to treat intracranial haemorrhaging in patients taking warfarin to try to improve these adverse outcomes, but its effectiveness is unknown. In this study, medical records from 2002 to 2010 were reviewed for 27 warfarin patients who received rFVIIa for their traumatic intracranial haemorrhage and were compared with a matched control group of 27 warfarin patients who did not receive rFVIIa. The two groups were matched for sex, age and Injury Severity Score. The rFVIIa patients had 33.3% mortality compared with the 37% for the control patients, but this was not a statistically significant difference. There was also no significant difference in plasma unit use between the groups. However, the rFVIIa group had a significantly higher number of subdural haemorrhages, which carry a better prognosis. The initial international normalized ratios (INRs) of the rFVIIa patients were higher, and the decrease of INR was more pronounced than in the control patients. From the data, it appears that although the INRs of rFVIIa patients did improve compared with the control group, there was no reduction in plasma use or mortality.

  5. Acute Kidney Injury and Rhabdomyolysis after Protobothrops flavoviridis Bite: A Retrospective Survey of 86 Patients in a Tertiary Care Center

    PubMed Central

    Nishimura, Hiroaki; Enokida, Hideki; Kawahira, Shuichirou; Kagara, Ichiro; Hayami, Hiroshi; Nakagawa, Masayuki

    2016-01-01

    Acute kidney injury (AKI) is the main cause of death for victims of hematoxic snakebites. A few studies have described improvement in AKI rates in snakebite cases, but the reasons for the improvement have not been investigated. Eighty-six patients with Protobothrops flavoviridis bites admitted to a single center from January 2003 through March 2014 were included in the study. Clinical variables, including age, sex, blood pressure (BP), and serum creatinine (S-Cre), on admission were compared between patients with and without AKI. One patient died of disseminated intravascular coagulation following AKI (mortality rate 1.1%). Six patients developed AKI with rhabdomyolysis. Systolic BP, S-Cre, serum creatine kinase, white blood cell count, and platelet count differed significantly between the AKI and non-AKI groups (P = 0.01). Three of the six patients were physically challenged to a degree that made it difficult for them to move or communicate, and these difficulties likely exacerbated the severity of snakebite complications. Our study demonstrated that the risk of snakebite-induced AKI for physically challenged patients was high. To further reduce mortality due to snakebite-induced AKI, we need to make it possible for physically challenged patients to receive first aid sooner. PMID:26643529

  6. 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

  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. Incidence and risk factors of acute kidney injury associated with continuous intravenous high-dose vancomycin in critically ill patients: A retrospective cohort study.

    PubMed

    Lacave, Guillaume; Caille, Vincent; Bruneel, Fabrice; Palette, Catherine; Legriel, Stéphane; Grimaldi, David; Eurin, Mathilde; Bedos, Jean-Pierre

    2017-02-01

    For vancomycin therapy of severe infections, the Infectious Diseases Society of America recommends high vancomycin trough levels, whose potential for inducing nephrotoxicity is controversial. We evaluated the incidence and risk factors of acute kidney injury (AKI) in critically ill patients given continuous intravenous vancomycin with target serum vancomycin levels of 20 to 30 mg/L.We retrospectively studied 107 continuous intravenous vancomycin treatments of ≥48 hours' duration with at least 2 serum vancomycin levels ≥20 mg/L in critically ill patients. Nephrotoxicity was defined according to the Kidney Disease Improving Global Outcomes Clinical Practice Guideline for AKI (ie, serum creatinine elevation by ≥26.5 μmoL/L or to ≥1.5 times baseline). Risk factors for AKI were identified by univariate and multivariate analyses.AKI developed in 31 (29%) courses. Higher serum vancomycin levels were associated with AKI (P < 0.01). Factors independently associated with AKI were highest serum vancomycin ≥40 mg/L (odds ratio [OR], 3.75; 95% confidence interval [CI], 1.40-10.37; P < 0.01), higher cumulative number of organ failures (OR, 2.63 95%CI, 1.42-5.31; P < 0.01), and cirrhosis of the liver (OR, 5.58; 95%CI, 1.08-31.59; P = 0.04).In this study, 29% of critically ill patients had AKI develop during continuous intravenous vancomycin therapy targeting serum levels of 20 to 30 mg/L. Serum vancomycin level ≥40 mg/L was independently associated with AKI.

  9. Traumatic brain injury and palliative care: a retrospective analysis of 49 patients receiving palliative care during 2013–2016 in Turkey

    PubMed Central

    Kahveci, Kadriye; Dinçer, Metin; Doger, Cihan; Yaricı, Ayse Karhan

    2017-01-01

    Traumatic brain injury (TBI), which is seen more in young adults, affects both patients and their families. The need for palliative care in TBI and the limits of the care requirement are not clear. The aim of this study was to investigate the length of stay in the palliative care center (PCC), Turkey, the status of patients at discharge, and the need for palliative care in patients with TBI. The medical records of 49 patients with TBI receiving palliative care in PCC during 2013–2016 were retrospectively collected, including age and gender of patients, the length of stay in PCC, the cause of TBI, diagnosis, Glasgow Coma Scale score, Glasgow Outcome Scale score, Karnofsky Performance Status score, mobilization status, nutrition route (oral, percutaneous endoscopic gastrostomy), pressure ulcers, and discharge status. These patients were aged 45.4 ± 20.2 years. The median length of stay in the PCC was 34.0 days. These included TBI patients had a Glasgow Coma Scale score ≤ 8, were not mobilized, received tracheostomy and percutaneous endoscopic gastrostomy nutrition, and had pressure ulcers. No difference was found between those who were discharged to their home or other places (rehabilitation centre, intensive care unit and death) in respect of mobilization, percutaneous endoscopic gastrostomy, tracheostomy and pressure ulcers. TBI patients who were followed up in PCC were determined to be relatively young patients (45.4 ± 20.2 years) with mobilization and nutrition problems and pressure ulcer formation. As TBI patients have complex health conditions that require palliative care from the time of admittance to intensive care unit, provision of palliative care services should be integrated with clinical applications. PMID:28250751

  10. 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.

  11. From Star Wars to 'turf wars'.

    PubMed

    1999-09-01

    Just as we are witnessing the re-emergence of Star Wars, it seems the 'turf wars' that have dogged A&E care are back. Since its inception as a specialty, A&E nurses have been accused of being 'Jacks (and Jill's, to be politically correct) of all trades and masters of none'. The inference being that all we do is 'mind' patients until they receive definitive care. Clearly this is not the case. As A&E nurses have demonstrated over the years, our skills are in the recognition and management of acute illness or injury, regardless of the patient's age, physical or psychological condition. Rather than being a 'master of none' we are masters of immediate care.

  12. 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.

  13. 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.

  14. 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

  15. Impact of Glasgow Coma Scale score and pupil parameters on mortality rate and outcome in pediatric and adult severe traumatic brain injury: a retrospective, multicenter cohort study.

    PubMed

    Emami, Pedram; Czorlich, Patrick; Fritzsche, Friederike S; Westphal, Manfred; Rueger, Johannes M; Lefering, Rolf; Hoffmann, Michael

    2017-03-01

    OBJECTIVE Prediction of death and functional outcome is essential for determining treatment strategies and allocation of resources for patients with severe traumatic brain injury (TBI). The aim of this study was to evaluate, by using pupillary status and Glasgow Coma Scale (GCS) score, if patients with severe TBI who are ≤ 15 years old have a lower mortality rate and better outcome than adults with severe TBI. METHODS A retrospective cohort analysis of patients suffering from severe TBI registered in the Trauma Registry of the German Society for Trauma Surgery between 2002 and 2013 was undertaken. Severe TBI was defined as an Abbreviated Injury Scale of the head (AIShead) score of ≥ 3 and an AIS score for any other part of the body that does not exceed the AIShead score. Only patients with complete data (GCS score, age, and pupil parameters) were included. To assess the impact of GCS score and pupil parameters, the authors also used the recently introduced Eppendorf-Cologne Scale and divided the study population into 2 groups: children (0-15 years old) and adults (16-55 years old). Each patient's outcome was measured at discharge from the trauma center by using the Glasgow Outcome Scale. RESULTS A total of 9959 patients fulfilled the study inclusion criteria; 888 (8.9%) patients were ≤ 15 years old (median 10 years). The overall mortality rate and the mortality rate for patients with a GCS of 3 and bilaterally fixed and dilated pupils (19.9% and 16.3%, respectively) were higher for the adults than for the pediatric patients (85% vs 80.9%, respectively), although cardiopulmonary resuscitation rates were significantly higher in the pediatric patients (5.6% vs 8.8%, respectively). In the multivariate logistic regression analysis, no motor response (OR 3.490, 95% CI 2.240-5.435) and fixed pupils (OR 4.197, 95% CI 3.271-5.386) and bilateral dilated pupils (OR 2.848, 95% CI 2.282-3.556) were associated with a higher mortality rate. Patients ≤ 15 years old had a

  16. 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

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

    PubMed Central

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

    2014-01-01

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

  18. 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

  19. 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.

  20. Severity and pattern of injuries caused by the traditional Swiss team sport ‘Hornussen’: first retrospective study at a level I trauma centre in Switzerland

    PubMed Central

    Waterkamp, Volkmar; Ricklin, Meret; Schaller, Benoît; Katsoulis, Konstantinos; Exadaktylos, Aristomenis

    2016-01-01

    Background This article addresses typical injury patterns related to the traditional Swiss team sport of Hornussen. A small plastic disk is struck with a special elastic racket and then intercepted in the field. Severe injuries have occasionally been reported. We present a systematic review of all cases of Hornussen injuries treated in the University Hospital of Bern from 2000 to 2014. Methods To assess the frequency, type and outcome of Hornussen injuries, we performed a database search of all inpatient and outpatient cases related to Hornussen and that were admitted to and/or treated in Bern University Hospital from 2000 to 2014. Results A total of 28 such patients could be identified. Apart from 1 woman injured as a bystander and treated as an outpatient, all patients were male and active players. Typical injury patterns comprised midfacial fractures and severe ocular traumata, very often in combination. Almost all of these patients had to be hospitalised due to the severity of the trauma suffered and underwent surgery. 1 patient had to be admitted to the intensive care unit prior to the operation. Conclusions Eye and face injuries caused by Hornussen can be devastating. This resembles the potential risk of other bat-and-ball sports, such as cricket and baseball. Apart from the economic loss due to treatment costs and sick leave, these injuries can be disabling for life. It should therefore be mandatory for all players to wear protective gear, as is already the case for Hornussen players born in 1984 or later. PMID:27900183

  1. Gulf War Illness Research Program

    DTIC Science & Technology

    2010-01-01

    neurofibromato- sis; autism ; and other areas with military health interests including psychological health, traumatic brain injury, and Gulf War Illness (GWI...the national news headlines, it has not dimmed our hope that treatments and cures for GWI are waiting to be discovered and brought to bear against

  2. 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…

  3. Altered gut microbiome in a mouse model of Gulf War Illness causes neuroinflammation and intestinal injury via leaky gut and TLR4 activation

    PubMed Central

    Dattaroy, Diptadip; Chandrashekaran, Varun; Ryan, Caitlin N.; Chan, Luisa S.; Testerman, Traci; Burch, James; Hofseth, Lorne J.; Horner, Ronnie; Nagarkatti, Mitzi; Nagarkatti, Prakash; Lasley, Stephen M.; Chatterjee, Saurabh

    2017-01-01

    Many of the symptoms of Gulf War Illness (GWI) that include neurological abnormalities, neuroinflammation, chronic fatigue and gastrointestinal disturbances have been traced to Gulf War chemical exposure. Though the association and subsequent evidences are strong, the mechanisms that connect exposure to intestinal and neurological abnormalities remain unclear. Using an established rodent model of Gulf War Illness, we show that chemical exposure caused significant dysbiosis in the gut that included increased abundance of phylum Firmicutes and Tenericutes, and decreased abundance of Bacteroidetes. Several gram negative bacterial genera were enriched in the GWI-model that included Allobaculum sp. Altered microbiome caused significant decrease in tight junction protein Occludin with a concomitant increase in Claudin-2, a signature of a leaky gut. Resultant leaching of gut caused portal endotoxemia that led to upregulation of toll like receptor 4 (TLR4) activation in the small intestine and the brain. TLR4 knock out mice and mice that had gut decontamination showed significant decrease in tyrosine nitration and inflammatory mediators IL1β and MCP-1 in both the small intestine and frontal cortex. These events signified that gut dysbiosis with simultaneous leaky gut and systemic endotoxemia-induced TLR4 activation contributes to GW chemical-induced neuroinflammation and gastrointestinal disturbances. PMID:28328972

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

    PubMed

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

    2015-06-01

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

  5. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) military mental health issues. Information on the wars' signature wounds: posttraumatic stress disorder and traumatic brain injury.

    PubMed

    Wieland, Diane; Hursey, Melodee; Delgado, Deborah

    2010-09-01

    This topic can be related to the nursing profession and the need to be better educated on military mental health. Since mood disorder, suicide, alcohol abuse, PTSD and TBI are evident in actively serving and returning service members, it is imperative to educate nurses and healthcare providers about these conditions, the available evidence-based treatments and referrals to programs for these signature OEF/OIF wounds. The authors encourage nurse educators to consider ways to include military mental health and other service-related health issues into nursing curricula and to use Veterans Administration and veterans-related healthcare facilities for clinical courses. As the wars in Afghanistan and Iraq continue into the foreseeable future, many veterans will be seen not only in VA facilities, but they will self-refer to academic and community hospitals, and psychiatric and rehabilitation centers. It is important for all nurses to be aware of the effects of PTSD, depression, suicide, substance abuse and TBI on our patients and to be effective advocates for quality care of veterans in all settings. Nurses need to advocate for screening and provision of mental health services in primary care settings. When such services are offered in primary care settings, it normalizes the care and the service member will more likely allow themselves to receive the care (Jones, 2004). All nurses must understand the price of war experienced by U.S. service members and their families, and in particular, the invisible wounds of war.

  6. Altered gut microbiome in a mouse model of Gulf War Illness causes neuroinflammation and intestinal injury via leaky gut and TLR4 activation.

    PubMed

    Alhasson, Firas; Das, Suvarthi; Seth, Ratanesh; Dattaroy, Diptadip; Chandrashekaran, Varun; Ryan, Caitlin N; Chan, Luisa S; Testerman, Traci; Burch, James; Hofseth, Lorne J; Horner, Ronnie; Nagarkatti, Mitzi; Nagarkatti, Prakash; Lasley, Stephen M; Chatterjee, Saurabh

    2017-01-01

    Many of the symptoms of Gulf War Illness (GWI) that include neurological abnormalities, neuroinflammation, chronic fatigue and gastrointestinal disturbances have been traced to Gulf War chemical exposure. Though the association and subsequent evidences are strong, the mechanisms that connect exposure to intestinal and neurological abnormalities remain unclear. Using an established rodent model of Gulf War Illness, we show that chemical exposure caused significant dysbiosis in the gut that included increased abundance of phylum Firmicutes and Tenericutes, and decreased abundance of Bacteroidetes. Several gram negative bacterial genera were enriched in the GWI-model that included Allobaculum sp. Altered microbiome caused significant decrease in tight junction protein Occludin with a concomitant increase in Claudin-2, a signature of a leaky gut. Resultant leaching of gut caused portal endotoxemia that led to upregulation of toll like receptor 4 (TLR4) activation in the small intestine and the brain. TLR4 knock out mice and mice that had gut decontamination showed significant decrease in tyrosine nitration and inflammatory mediators IL1β and MCP-1 in both the small intestine and frontal cortex. These events signified that gut dysbiosis with simultaneous leaky gut and systemic endotoxemia-induced TLR4 activation contributes to GW chemical-induced neuroinflammation and gastrointestinal disturbances.

  7. [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.

  8. 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.

  9. 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.

  10. The preventive effect of dexmedetomidine on paroxysmal sympathetic hyperactivity in severe traumatic brain injury patients who have undergone surgery: a retrospective study

    PubMed Central

    Tang, Qilin; Wu, Xiang; Weng, Weiji; Li, Hongpeng; Feng, Junfeng; Mao, Qing; Jiang, Jiyao

    2017-01-01

    Background Paroxysmal sympathetic hyperactivity (PSH) results and aggravates in secondary brain injury, which seriously affects the prognosis of severe traumatic brain injury patients. Although several studies have focused on the treatment of PSH, few have concentrated on its prevention. Methods Ninety post-operation (post-op) severe traumatic brain injury (sTBI) patients admitted from October 2014 to April 2016 were chosen to participate in this study. Fifty of the post-op sTBI patients were sedated with dexmedetomidine and were referred as the “dexmedetomidine group” (admitted from May 2015 to April 2016). The other 40 patients (admitted from October 2014 to May 2015) received other sedations and were referred as the “control group.” The two groups were then compared based on their PSH scores and the scores and ratios of those patients who met the criteria of “probable,” “possible” and “unlikely” using the PSH assessment measure (PSH-AM) designed by Baguley et al. (2014). The durations of the neurosurgery intensive care unit (NICU) and hospital stays and the Glasgow outcome scale (GOS) values for the two groups were also compared to evaluate the therapeutic effects and the patients’ prognosis. Results The overall PSH score for the dexmedetomidine group was 5.26 ± 4.66, compared with 8.58 ± 8.09 for the control group. The difference between the two groups’ PSH scores was significant (P = 0.017). The score of the patients who met the criterion of “probable” was 18.33 ± 1.53 in the dexmedetomidine group and 22.63 ± 2.97 in the control group, and the difference was statistically significant (P = 0.045). The ratio of patients who were classified as “unlikely” between the two groups was statistically significant (P = 0.028); that is, 42 (84%) in the dexmedetomidine group and 25 (62.5%) in the control group. The differences in NICU, hospital stays and GOS values between the two groups were not significant. Conclusion

  11. Plate osteosynthesis of the humerus shaft fracture an its association with radial nerve injury--a retrospective study in Melaka General Hospital.

    PubMed

    Lim, K E; Yap, C K; Ong, S C; Aminuddin

    2001-06-01

    Over a seven-year period, 170 cases of humerus fractures were plated in Hospital Melaka. Of these, 131 cases were successfully traced for this study. Besides looking at fracture epidemiology, its relationship with radial nerve injury was examined. The incidence of post-traumatic wrist drop in closed and compound fractures were 14.9% and 35.3% respectively. In relation to the site of fracture, lower third fracture had the highest incidence of wrist drop (29%). The recovery from post-traumatic wrist drop was 83%. The average duration taken for recovery was 11.8 weeks. The incidence of post-operative wrist drop was high at 17.6% but all recovered during follow-up.

  12. Amputation versus functional reconstruction in the management of complex hind foot injuries caused by land-mine explosions: a long-term retrospective comparison.

    PubMed

    Demiralp, Bahtiyar; Ege, Tolga; Kose, Ozkan; Yurttas, Yuksel; Basbozkurt, Mustafa

    2014-05-01

    The purpose of this study is to compare the long-term clinical outcomes of patients who were treated with either hind foot reconstruction or amputation in complex hind foot injuries accompanied with bone and soft tissue loss due to land-mine explosions. Between 1994 and 2004, all patients with hind foot complex injuries due to land-mine explosion, who were operated in our clinic, were enrolled to the study. All patients were evaluated with Short-Form 36 (SF-36), Foot and Ankle Disability Index (FADI) and Body Image Quality of Life Inventory (BIQLI) after a mean of 15.1 ± 2.2 (range 9-19) years of follow-up. Demographic characteristics, number of operations, necessity of psychiatric treatment and all complications were compared between groups. There were a total of 42 patients [21 in reconstruction group (Gr I) and 21 in amputation group (Gr II)]. The mean age at the time of final follow-up was 38.4 ± 3.04 years in Gr I and 38.2 ± 4.24 years in Gr II (p = 0.732). The mean follow-up duration was 15.7 ± 2.07 years in Gr I and 14.57 ± 2.29 years in Gr II (p = 0.081). The number of operations was significantly higher in Gr I (8.66 ± 10.2 times vs. 4.42 ± 7.7 times, respectively, p = 0.001). The mean FADI score at the final follow-up was 64.3 ± 18.1 in Gr I. In amputation group, more patients needed psychotherapy due to major depression (12 patients vs. 4 patients, p = 0.012). Major complications in Gr I were musculocutaneous flap atrophy in calcaneal region (n = 8 patients), limited ankle motion (n = 11) and painful osteophytes on plantar region (n = 6). In Gr II, stump problems were dominating (pain and tenderness n = 10, ulcer n = 2, allergic skin lesions n = 7, painful neuroma n = 10, bony spur n = 5, paresthesia n = 1, excessive sweating n = 12). At the final visit, although SF-36 scores were similar between groups (p = 0.182), extremity reconstruction group had significantly higher BIQLI scores than the amputation group (p = 0.016). If the dorsalis pedis is

  13. 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.

  14. Expanding Clinical Assessment for Traumatic Brain Injury and Comorbid Post-Traumatic Stress Disorder: A Retrospective Analysis of Virtual Environment Tasks in the Computer-Assisted Rehabilitation Environment.

    PubMed

    Onakomaiya, Marie M; Kruger, Sarah E; Highland, Krista B; Kodosky, Paula N; Pape, Marcy M; Roy, Michael J

    2017-03-01

    The objective of this study was to determine whether physical performance during virtual environment (VE) tasks in the Computer-Assisted Rehabilitation Environment (CAREN) could differentiate between service members (SMs) with a history of traumatic brain injury (TBI) with and without comorbid post-traumatic stress disorder (PTSD). Data were obtained by independent review of clinical notes, objective outcomes, and validated questionnaires from 214 SMs (208 males) with a history of TBI assessed in the CAREN from 2010 to 2015. Three preliminary VEs acclimatized patients to the CAREN: Balance Balls, weight shifting on a static platform (timed); Balance Cubes, step shifting with and without platform motion (timed); and Continuous Road, flat ambulation (self-selected speed). Multiple regression analyses revealed that patients with comorbid TBI-PTSD were significantly slower in completing the VE tasks than patients without PTSD. Logistic regression showed that the Balance Cubes VE without platform motion significantly predicted diagnostic category (i.e., no PTSD vs. comorbid PTSD). In conclusion, in SMs with a history of TBI, physical performance on the CAREN effectively distinguished those with comorbid PTSD, as their performance was significantly slower than SMs without PTSD. These results portray the potential of the CAREN as a novel assessment tool in SMs with a history of TBI.

  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, 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...

  17. 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...

  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, 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...

  20. 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

  1. 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.

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

    PubMed Central

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

    2015-01-01

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

  3. 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.

  4. 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

  5. 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…

  6. 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.

  7. 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.

    PubMed

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

    2015-03-20

    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 cross-validation 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 R(2) 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.

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. Teaching About War and War Prevention.

    ERIC Educational Resources Information Center

    Nesbitt, William A.

    The book provides a conceptual framework along with classroom suggestions for secondary social studies teachers dealing with the complex war/peace subjects. The book aims at studying wars as a social phenomenon in a new course, or in combination with interdisciplinary courses. It is divided into four major parts. Part I, Developing an…

  13. Traumatic Brachial Artery Injuries

    PubMed Central

    Ergunes, Kazim; Yilik, Levent; Ozsoyler, Ibrahim; Kestelli, Mert; Ozbek, Cengiz; Gurbuz, Ali

    2006-01-01

    We performed this retrospective study to analyze our strategies for managing and surgically treating brachial artery injuries. Fifty-seven patients with a total of 58 traumatic brachial artery injuries underwent surgery at our institution, from August 1996 through November 2004. Fifty-four patients were male and 3 were female (age range, 7 to 75 years; mean, 29.4 years). Forty-four of the patients had penetrating injuries (18 had stab wounds; 16, window glass injuries; and 10, industrial accidents), 10 had blunt trauma injuries (traffic accidents), and 3 had gunshot injuries. Fourteen patients (24.6%) had peripheral nerve injury. All patients underwent Doppler ultrasonographic examination. The repair of the 58 arterial injuries involved end-to-end anastomosis for 32 injuries (55.2%), reverse saphenous vein graft interpositional grafts for 18 (31%), and primary repair for 8 (13.8%). Venous continuity was achieved in 11 (84.6%) of 13 patients who had major venous injuries. Nine of the 57 patients (15.8%) required primary fasciotomy. Follow-up showed that 5 of the 14 patients with peripheral nerve injury had apparent disabilities due to nerve injury. One patient underwent amputation. There were no deaths. We believe that good results can be achieved in patients with brachial artery injuries by use of careful physical examination, Doppler ultrasonography, and restoration of viability with vascular repair and dbridement of nonviable tissues. Traumatic neurologic injury frequently leads to disability of the extremities. PMID:16572866

  14. Periods of War

    DTIC Science & Technology

    2006-05-01

    Snyder’s Historical Guide to World War Two (Westport, CT: Greenwood, 1982), p. 736; and the World Almanac of World War II, ed. Brigadier Peter Young...his historic broadcast to the Japanese people telling of Japan’s surrender, is cited as V-J Day in The World Almanac of World War II, p. 353. World

  15. 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

  16. Costs of war: excess health care burdens during the wars in Afghanistan and Iraq (relative to the health care experience pre-war).

    PubMed

    2012-11-01

    This report estimates the health care burden related to the wars in Iraq and Afghanistan by calculating the difference between the total health care delivered to U.S. military members during wartime (October 2001 to June 2012) and that which would have been delivered if pre-war (January 1998 to August 2001) rates of ambulatory visits, hospitalizations, and hospital bed days of active component members of the U.S. Armed Forces had persisted during the war. Overall, there were estimated excesses of 17,023,491 ambulatory visits, 66,768 hospitalizations, and 634,720 hospital bed days during the war period relative to that expected based on pre-war experience. Army and Marine Corps members and service members older than 30 accounted for the majority of excess medical care during the war period. The illness/injury-specific category of mental disorders was the single largest contributor to the total estimated excesses of ambulatory visits, hospitalizations, and bed days. The total health care burdens associated with the wars in Afghanistan and Iraq are undoubtedly greater than those enumerated in this report because this analysis did not address care delivered in deployment locations or at sea, care rendered by civilian providers to reserve component members in their home communities, care of veterans by the Departments of Defense and Veterans Affairs, preventive care for the sake of force health protection, and future health care associated with wartime injuries and illnesses.

  17. 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.

  18. 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.…

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

    PubMed

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

    2014-01-01

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

  20. Blunt ocular trauma secondary to "war games".

    PubMed

    Mamalis, N; Monson, M C; Farnsworth, S T; White, G L

    1990-11-01

    "War games" are gaining popularity in the western United States. These recreational contests involve members of one team attempting to shoot their opponents with high-velocity dye or paint pellets fired from air guns. Unfortunately, serious eye injuries occur when participants do not use protective eye wear. We report a case of severe blunt ocular trauma resulting in a hyphema, choroidal rupture, and retinal and vitreal hemorrhage secondary to a paint pellet striking an unprotected eye. This injury resulted in a significant visual defect in this patient.

  1. Snowboarding injuries of the abdomen: comparison with skiing injuries.

    PubMed

    Machida, T; Hanazaki, K; Ishizaka, K; Nakamura, M; Kobayashi, O; Shibata, H; Nakafuji, H; Amano, J

    1999-01-01

    A retrospective study was conducted to identify the characteristics of snowboarding injury of the abdomen in comparison with those of alpine skiing injuries. Between December 1988 and April 1997, 1579 patients were treated for snowboarding injuries and 9108 patients were treated after skiing accidents. 19 patients (1.2%) in snowboarding and 64 (0.7%) in skiing had abdominal injuries. The abdominal injury rate in snowboarders was significantly higher than that in skiers. Snowboarders with abdominal injuries were similar to skiers with respect to epidemiology but the patterns of injury in the two groups showed several distinct differences. Riding mistakes after jumping for the snowboarders (31.6%) was significantly higher than that for the skiers (0%). The main organs involved in snowboarding and skiing injuries were kidney, liver and spleen. The incidence of solitary renal injury in snowboarding (68.4%) was significantly higher than that in skiing (29.7%).

  2. Injuries in paragliding.

    PubMed

    Zeller, T; Billing, A; Lob, G

    1992-01-01

    In a retrospective study, 376 paragliding accidents have been analysed. Leg injuries were most common, but a large number of spinal injuries also occurred. The causes were either misjudgement by the pilot or the influence of weather and terrain. Improvements in the instructor's knowledge and the pilot's training could have prevented most of the accidents. Analysis of the mechanisms of the crashes and the pattern of trauma help to produce an efficient approach to diagnosis and treatment.

  3. 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.

  4. 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.

  5. 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)

  6. 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.

  7. In Time of War.

    ERIC Educational Resources Information Center

    Becker, Patti Clayton

    2003-01-01

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

  8. 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.)

  9. 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)

  10. 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…

  11. Mechanisms of injury in wartime.

    PubMed

    Lehman, Cheryl

    2008-01-01

    A significant number of wounded servicemembers are returning from the conflicts in Iraq and Afghanistan. As the U.S. government finds itself with more wounded servicemembers than its systems can handle, the wounded are beginning to use private rehabilitation facilities. Mechanisms of injury in war are unlike those of most injuries encountered in civilian life. Rehabilitation nurses in both military and private rehabilitation facilities can benefit from learning about the mechanisms of injury in war to better help their patients and anticipate potential and hidden complications. This article reviews the mechanisms of injury in Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom, the unique characteristics of military personnel, and the implications for rehabilitation nurses.

  12. Epidemiology of Injury in Gaelic Handball.

    PubMed

    O'Connor, S; Downey, M; Moran, K

    2016-03-10

    The initial step in developing injury prevention strategies is to establish the epidemiology of injury. However there has been no published research on injury in Gaelic handball. This study describes the epidemiology of injury in 75 Gaelic handball players utilising a retrospective questionnaire. 88% of participants reported one or more injuries. Injuries to the upper limb were prevalent (52.9%), followed by the lower limb (30.3%). The shoulder (17.6%), finger (10.5%) and ankle (9.8%) were the primary sites of injury. Injuries occurred most frequently in December (9.7%), January (9.7%), February (9.7%) and November (8.7%). Injuries predominantly occurred during games (82.4%). Injuries were primarily severe (54.7%), with 14.6% of participants admitted to hospital due to injury. Given that this is the only study on Gaelic handball to date, prospective epidemiological studies and further research on injury prevention strategies are necessary.

  13. Resuscitative Thoracotomy following Wartime Injury

    DTIC Science & Technology

    2013-01-01

    H.P., T.E.R.), Fort Sam Houston, Texas; R Adams Cowley Shock Trauma Center (M.A.K.), University of Maryland, Baltimore, Maryland; and Academic...is characteristic of the dis- mounted complex blast injury, a signature injury of the war in Afghanistan (Fig. 1).25 Patients who are hypovolemic from...correction of their physiologic instability, are becoming in- creasingly recognized as a specific subgroup. Recently the term exsanguination shock has been

  14. Thinking About Preventing Nuclear War.

    ERIC Educational Resources Information Center

    Ground Zero, Washington, DC.

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

  15. The exhumation of a World War II Jewish grave.

    PubMed

    Chagowski, W; Madro, R

    1999-01-01

    The results of the exhumation of a mass grave from the time of the World War II are presented. In the course of exhumation it was established that the subjects were 190 individuals (men, women and children) of Jewish origin. All had died a violent death due to gunshot or mechanical injury.

  16. Battlefield trauma, traumatic shock and consequences: war-related advances in critical care.

    PubMed

    Allison, Carrie E; Trunkey, Donald D

    2009-01-01

    Over the course of history, while the underlying causes for wars have remained few, mechanisms of inflicting injury and our ability to treat the consequent wounds have dramatically changed. Success rates in treating war-related injuries have improved greatly, although the course of progress has not proceeded linearly. From Homer's Iliad to the Civil War to Vietnam, there have been significant improvements in mortality, despite a concurrent increase in the lethality of weapons. These improvements have occurred primarily as a result of progress in three key areas: management of wounds, treatment of shock, and systems of organization.

  17. 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.

  18. 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

  19. Hemipelvectomy images of loss caused by war

    PubMed Central

    Salamon, Tal; Kassis, Shokrey; Lerner, Alexander

    2014-01-01

    As we treat our 230th patient from the Syrian conflict, the pathology we see is more debilitating and the humanitarian needs of the wounded have become even more obvious. This case presents some graphic images of the realities of war. Care in the most advanced units cannot restore broken limbs, let alone broken lives. We present a case of a young war-injured man, who suffered severe crush injury to the pelvis and lower limb, arriving at our medical facility after a delay of hours. The lower limb was shattered from the pelvis down (essentially a traumatic hemipelvectomy). His life had been saved in Syria by ligation of the femoral vessels in an unknown facility by an unknown medical team. On arrival in a centre in Israel for definitive care of an unsalvageable leg, formal hemipelvectomy was performed. PMID:25008336

  20. Injuries in whitewater kayaking

    PubMed Central

    Fiore, D; Houston, J

    2001-01-01

    Objective—To provide epidemiological data on whitewater kayaking injuries using a descriptive study. Methods—A retrospective survey was distributed at whitewater events and club meetings, and made available and advertised on the world wide web, through postings and announcements to newsgroups, related sites, and search engines. Data on sex, age, experience, and ability were collected. Injury data collected included mechanism, activity, difficulty of rapid, and self reported severity. Results—Of the 392 kayaking respondents included in the final analysis, 219 suffered 282 distinct injury events. The number of days spent kayaking per season was the only independent predictor of injury. The overwhelming majority of injuries occurred while the kayaker was still in the boat (87%). Striking an object was the most common mechanism of injury (44%), followed by traumatic stress and overuse (25% each). The most common types of injury were abrasion (25%), tendinitis (25%), contusion (22%), and dislocation (17%). The upper extremity, especially the shoulder, was the most commonly injured area of the body. Although half of injured kayakers sought medical care for their injury, and almost one third missed more than one month of kayaking because of the injury, almost all (96%) reported a complete or good recovery. Conclusions—Factors relating to likelihood of injury appear to be connected with exposure, namely the number of days a year that the sport was pursued. Except for class V (extreme) kayakers, reports of injuries paralleled the number of participants. Kayakers reported injuries predominantly on rivers that they assessed to be at a level appropriate to their skills. Key Words: kayaking; whitewater; injuries PMID:11477016

  1. 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

  2. Firepower in Limited War

    DTIC Science & Technology

    1990-04-01

    strategists and field commanders was how to translate quickly the huge quantity of war materiel into the most destructive machines of war. Artillery and...Army in Indochina real- ized that its mastery of and ability to conduct European-style machine warfare was its greatest, and perhaps only, military...third bunker this month. There goes another 57 [recoilless rifles], two machine guns, ten grenades and the radio set. Hanoi is going to bitch like hell

  3. The American Home Front. Revolutionary War, Civil War, World War 1, World War 2

    DTIC Science & Technology

    1983-01-01

    wartime evolution of literature and the arts as well as popular culture, I have set those subjects aside and instead focused on war’s principal political...over war’s impact on American society. Decades of debate also stretched the antimilitarists’ argument well be- yond the basic proposition that a powerful...Indian raids on the frontier. British assaults on coastal cities, and sporadic fighting wherever it might occur. What is less well known is that about

  4. 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

  5. [Injuries during Equestrian Vaulting].

    PubMed

    Endruweit, M; Dargel, J; Siewe, J; Becker, I; Sobottke, R

    2016-12-01

    Background: Vaulting is the least studied equestrian sports regarding the occurrence of injuries. As its sequences of motion do not compare to riding, vaulting must be assessed separately. Material and Methods: This retrospective, questionnaire-aided survey was aimed to gain insight into the overall frequency of injuries among equestrian vaulters. The second part of the study looked into the knee injuries that occurred. Survey forms were sent to 60 vaulting and equestrian clubs all over Germany, making for a response rate of 63 %. Results: 95 % of 624 responding athletes were female. The pool of participants consisted of both amateur and professional level vaulters with a mean age of 15 years. The survey showed a mean number of 4.1 injuries sustained during the observation period, i. e. the entire time an athlete had been active in the sport up to the data collection. The lower extremities were the most commonly injured area with a total proportion of 45 %, followed by injuries to the spine and the head with 30 %, and the upper extremities with 25 %. Contusions accounted for the highest number of reported injuries. Other frequently reported injuries included muscle strain to the head and spine, fractures to the upper extremity and ligament damage to the lower extremity. 14 % of the participants experienced at least one knee injury. The medial collateral ligament (27 %) was found to be most prone to lesions, followed by the anterior cruciate ligament (23 %) and the medial meniscus (22 %). Half of all knee injuries occurred during dismounts, especially when swing-offs or flanks led to faulty landings. Conclusions: The results show that the lower extremity is the most commonly affected area. The ligamentous injuries affecting the lower extremity mainly result from dismounts. A specific training aimed at improving landing techniques might therefore prove beneficial in preventing injuries. The frequency of contusions and fractures to the upper

  6. 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

  7. 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.

  8. 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.

  9. Injuries and injury prevention among indigenous children and young people.

    PubMed

    Berger, Lawrence R; Wallace, L J David; Bill, Nancy M

    2009-12-01

    Throughout the world, injuries and violence are a leading cause of mortality and suffering among Indigenous communities. Among American Indian and Alaska Native children aged 1 to 19 years, 71% of deaths are from injuries. Motor-vehicle accidents, attempted suicide, and interpersonal violence are the most common causes of injuries in highly industrialized countries. For Indigenous populations in middle- and low-income countries, trauma caused by motor-vehicle accidents, agricultural injuries, interpersonal violence, child labor, and the ravages of war are priorities for intervention. To be effective, injury-prevention efforts should be based on scientific evidence, be developmentally and culturally appropriate, and draw on the inherent strengths of Indigenous communities.

  10. [Sanitary and chemical protection during the Great Patriotic War].

    PubMed

    Imangulov, R G; Grebeniuk, A N; Rybalko, V M; Nosov, A V

    2011-05-01

    During the Great Patriotic War (1941-1945) there was a real danger of use by German armies of the chemical weapon against staff of Red Army. However German command didn't risked to go on conducting large-scale chemical war against the USSR that rescued from painful death millions person. A principal cause of this decision was well organized and technically provided system of antigas protection in Red Army, including precisely organized actions of sanitary-chemical protection, qualitative preparation of military doctors on these questions and presence at them effective antidotes and other means of treatment of injuries by fighting poison gases.

  11. 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…

  12. 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)

  13. 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 ...

  14. 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 ...

  15. 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.

  16. [Cholera and war].

    PubMed

    Ganin, V S

    2009-09-01

    During last centures wars were the main account of spread of cholera. It is caused by movement of great mass of troops and peaceful populace, acute fall of living circumstances, decline of sanitarium conditions of population aggregates, difficultness or impossibility of effectuating of contra-epidemic measures. Cholera casualty was multifold bigger, the weapon casualty in fighting armies. The article presents data of cholera epidemics, were in fighting armies of different states. During the XXth century fight casualty began to overpass the disease casualty. It is caused by grand increasing of damage effects of measures of war, organized using of prophylaxis measures and success in treatment of infectious diseases. The article presents data about cholera falling ill during the Great Patriotic War and about system of contro-epidemic barrier on fronts and rear of state.

  17. After the war in Nicaragua: a psychosocial study of war wounded ex-combatants.

    PubMed

    Hume, F; Summerfield, D

    1994-01-01

    Despite 150 wars in the Third World since 1945, there have been virtually no psychosocial studies of war wounded ex-combatants. This community study of 72 such men, on average 4.9 years post-injury, had both quantitative (General Health Questionnaire [GHQ] and clinical interview) and qualitative (personal narrative) components. Most men were coping adaptively. However their overall GHQ scores were significantly higher than an ex-combatant control group, suggesting relative psychological vulnerability (P = 0.001). 13 (18 per cent) had post-traumatic stress disorder (PTSD) though in only three was this clinically significant, two of whom were aggressive alcoholics. Social dysfunction was a better indicator of the minority who needed psychological help than a diagnosis of PTSD. The one in three with a severe physical disability were not at greater risk than the rest of the group. Personal narratives illuminated the ways subjects had registered and responded to their war experiences. Identification with the social ideals being defended by the war effort had been psychologically bolstering. Ten severely disabled ex-Contra guerrillas, who had fought on the other side, were also interviewed. The availability of appropriate training/work, and thus the economic fortunes of the whole society, are likely to be major determinants of long-term psychosocial outcomes. Six illustrative personal histories are appended.

  18. Microbiology and risk factors associated with war-related wound infections in the Middle East.

    PubMed

    Sahli, Z T; Bizri, A R; Abu-Sittah, G S

    2016-10-01

    The Middle East region is plagued with repeated armed conflicts that affect both civilians and soldiers. Injuries sustained during war are common and frequently associated with multiple life-threatening complications. Wound infections are major consequences of these war injuries. The microbiology of war-related wound infections is variable with predominance of Gram-negative bacteria in later stages. The emergence of antimicrobial resistance among isolates affecting war-related wound injuries is a serious problem with major regional and global implications. Factors responsible for the increase in multidrug-resistant pathogens include timing and type of surgical management, wide use of antimicrobial drugs, and the presence of metallic or organic fragments in the wound. Nosocomial transmission is the most important factor in the spread of multidrug-resistant pathogens. Wound management of war-related injuries merits a multidisciplinary approach. This review aims to describe the microbiology of war-related wound infections and factors affecting their incidence from conflict areas in Iraq, Syria, Israel, and Lebanon.

  19. 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

  20. War Sailor syndrome.

    PubMed

    Askevold, F

    One third of the Norwegian sailors in the merchant navy, who survived World War II, are today disabled and on invalid pension. The majority suffer from a syndrome which is very similar to that present in the concentration camp survivors. The syndrome falls into two parts, the one consisting of non-neurotic anxiety repeating the terrors of war time, the other being a brain-organic one. This last part has in a few cases been confirmed by neuroradiology and neuropsychology. This is taken as an indicator that prolonged stress, as constant fear of death, may cause brain damage without physical trauma.

  1. 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.

  2. 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)

  3. Alternatives to War in History.

    ERIC Educational Resources Information Center

    Kimball, Jeffrey

    1994-01-01

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

  4. 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…

  5. Iowa and World War I.

    ERIC Educational Resources Information Center

    Hardesty, Carolyn, Ed.

    1989-01-01

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

  6. 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)

  7. 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,…

  8. A Spanish American War Database.

    ERIC Educational Resources Information Center

    Hands, Edmund

    1992-01-01

    Discusses a database used by honors high school U.S. history students learning about the Spanish-American War. Reports that the students compiled the database. Includes some of the historical background of the war, questions for study, a database key, and a table showing U.S. senators' votes relating to the War. (SG)

  9. '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.

  10. Air Sanctuaries in Limited War: A Korean War Case Study.

    DTIC Science & Technology

    1986-03-01

    these restrictions, however, FEAF managed to maintain air superiority throughout Korea for the duration of the war. It routinely bombed North Korean air...and National Policy. Vol III, The Korean War, part 2. Washington, Mar 1979. 555p. PERIODICALS Foot, Rosemary. The Sino American Conflict in Korea : The...A07 844 AlR SANCTUARIES IN LIMITED WAR. A KOREAN WAR CASE STWJY i/I (UJ) AIR WAR COLL MAXMd LL AFB AL C M HINKLE MAR 8 AUJ-AWC-86-898

  11. 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

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

    PubMed Central

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

    2012-01-01

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

  13. Military Adaptation in War

    DTIC Science & Technology

    2009-06-01

    the rights of Germans who lived in the duchy of Schleswig- Holstein . This conflict certainly looked much more like the European conception of war...hitting more trees and cows than their intended targets. The first raid on the Ruhr on 15 May 1940 killed one dairyman in Cologne and wounded two people in

  14. The Massachusetts Math Wars

    ERIC Educational Resources Information Center

    Stotsky, Sandra

    2007-01-01

    This article recounts the battle in the "math wars" that took place in Massachusetts, United States in 1999-2000 over the scope, content and teaching of the state's K-12 mathematics curriculum. Harsh controversies arose between the partisans of a "reform-math" movement stressing an undefined "conceptual understanding"…

  15. Waging War on Violence.

    ERIC Educational Resources Information Center

    Closing the Gap, 1995

    1995-01-01

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

  16. 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…

  17. 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…

  18. 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)

  19. 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…

  20. War. Peace. Film Guide.

    ERIC Educational Resources Information Center

    Dougall, Lucy

    The revised and expanded film guide designed for educators includes annotations of over 200 films, plus a large number of program resources for intelligent film use. Selected from over five hundred films previewed from 1969, up-to-date films were chosen that would help interpret the causes of war, increase awareness of the dehumanizing effects of…

  1. Ending a nuclear war

    SciTech Connect

    Cimbala, S.J.; Douglass, J.D.

    1988-01-01

    Western strategic concepts have had their own built-in images of nuclear war. These concepts concentrate largely upon the uncertainties of mass nuclear exchanges and the unbelievable devastation that would accompany such a conflict. By not considering in detail how a war of such magnitude and violence might unfold, let alone be ended, these nightmare strategists must resign themselves to either capitulation or cataclysm if their theories of deterrence should prove to be either inoperative or inappropriate in the acid test of reality. The world is at a crossroads in the development of its views of nuclear strategy. The rapid pace of technological development has profound implications for how both conventional and nuclear war might be either avoided or waged. The impact of technological development has been especially great in the area of strategic defense where, like never before, we have the opportunity to create an alternative to the exclusive reliance on the threat of retaliation. Ending a Nuclear War: Are the Superpowers Prepared provides contribution to the study of this vitally important component of deterrence.

  2. 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…

  3. 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…

  4. 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,…

  5. Modern sports eye injuries

    PubMed Central

    Capão Filipe, J A; Rocha-Sousa, A; Falcão-Reis, F; Castro-Correia, J

    2003-01-01

    Aims: To determine the severity and long term sequelae of eye injuries caused by modern sports that could be responsible for significant ocular trauma in the future. Methods: Prospective observational study of 24 (25 eyes) athletes with sports related ocular injuries from health clubs, war games, adventure, radical and new types of soccer, presenting to an eye emergency department between 1992 and 2002 (10 years). Results: Modern sports were responsible for 8.3% of the 288 total sports eye injuries reported. Squash (29.2%) was the most common cause, followed by paintball (20.8%) and motocross (16.6%). The most common diagnosis during the follow up period was retinal breaks (20%). 18 (75%) patients sustained a severe injury. The final visual acuity remained <20/100 in two paintball players. Conclusions: Ocular injuries resulting from modern sports are often severe. Adequate instruction of the participants in the games, proper use of eye protectors, and a routine complete ophthalmological examination after an eye trauma should be mandatory. PMID:14609827

  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.

  7. 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.

  8. The elephant in the room: critical reflections on militarism, war, and their health contingencies.

    PubMed

    McGuire, Sharon; Boyle, Joyceen

    2008-01-01

    This philosophical analysis critically explores an archeology of militarism as an underpinning to multiple forms of violence, especially war. Deconstructing militarism and its discourses reveal it as a pervasive geographical, cultural, political, and psychological presence. New war technologies, related health and environmental problems, injuries, social suffering, and disproportionality in military spending as a threat to health are uncovered. Continuing the dialogue in formal nursing associations, critiquing media complicity in securing consent for war, and reconstructing a nonviolent, healthier world through nonviolent resistance are advocated.

  9. 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.

  10. 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.

  11. 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…

  12. Theater Level War Games.

    DTIC Science & Technology

    1982-06-02

    models, (2) production of an annual catalog of Army Models with a review and analysis section, (3) increased dialogue between Army personnel concerned...catalog of Army Models with a review and analysis section, (3) increased dialogue between Army personnel con- cerned with modelc and the wider...tions that contribute to dialogue in the war gaming community. 4’ 31- -~- ".-.. ~ ~’’-L Purposes and Preliminary Results The purposes of this study were

  13. Fixing the War Powers

    DTIC Science & Technology

    1992-04-01

    peaceful. Indian tribes in the North and South caused continuous problems for settlers during the first term,261 and the Whiskey Rebellion occurred in...262the second term.. Neither of these situations had significant implications for the war powers. During the Whiskey Rebellion , Congress passed a law...militia. 263 Practices during suppression of the Republic’s first rebellion nominally264 ratify the conceptual model: Congress as the decision-maker and

  14. [From memories about war].

    PubMed

    Spivak, B A

    2010-04-01

    The article presents publication of memories of a military physician Spivak B.A., finished the First Kiev medical institute in 1941. The author held rank: from August 1941--chief of sanitary service of a separated battalion, April 1942-June 1945--chief of operation-bandaging unit of 246 SMSB SD. After war served in military treatment institutes on ranks of surgical profile, finished the military service in the rank of chief of surgical unit of Kovel garrison hospital in 1964.

  15. The American Home Front: Revolutionary War, Civil War, World War I, World War II

    DTIC Science & Technology

    1983-01-01

    impact on American society. Decades of’ debate also stretched the anti mil itarists’ argzument well be- yond the basic proposition that a powerful...history except b\\ the Confederacy’s economic collapse in the final stages of the Civil War. Although that inflation hurt all Americans on fixed incomes ... on the frontier. British assaults on coastal cities, and sporadic fighting wherever it might occur. What is less well known is that about 20,0X

  16. 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.

  17. 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

  18. Knee Injuries

    MedlinePlus

    ... injuries. Try weightlifting to strengthen your muscles and stretching, Pilates, and yoga to improve your flexibility because ... lead to injuries and inflammation from overuse. Regular stretching can help. After an injury or surgery has ...

  19. 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 ...

  20. 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 ...

  1. Lasting retinal injury in a mouse model of blast-induced trauma

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Traumatic brain injury (TBI) due to blast exposure is currently the most prevalent of war injuries. While secondary ocular blast injuries due to flying debris are more common, primary ocular blast exposure has been reported among survivors of explosions, but with limited understanding of the resulti...

  2. Politics in the Korean War

    DTIC Science & Technology

    1994-01-01

    aspect o£ its uniqueness was the open debate between President Truman and General MacArthur con- cernin9 the war’s military and political objectives...NATIONAL DEFENSE UNIVERSITY NATIONAL WAR COLLEG~ POLITICS IN THE KOREAN WAR Course II Essay LTC Paul N. DunnlClass of 1994 COURSE II SEMINAR...to 00-00-1994 4. TITLE AND SUBTITLE Politics in the Korean War 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  3. Electron Paramagnetic Resonance Retrospective Dosimetry

    SciTech Connect

    Romanyukha, Alex; Trompier, Francois

    2011-05-05

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

  4. 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)

  5. War wounds of the foot and ankle: causes, characteristics, and initial management.

    PubMed

    Bluman, Eric M; Ficke, James R; Covey, Dana C

    2010-03-01

    Foot and ankle trauma sustained in the Global War on Terror have unique causes and characteristics. At least one-quarter of all battle injuries involve the lower extremity. These severe lower extremity wounds require specialized early treatment. Ballistic mechanisms cause almost all injuries, and as such, most combat foot and ankle wounds are open in nature. Wounds are characteristically caused by blast mechanisms, but high velocity gunshot injuries are also common. The severe and polytraumatic nature of injuries sustained frequently call for damage control orthopaedics to be utilized. Cautious early treatment of irregular and highly exudative ballistic wounds with subatmospheric wound dressings may ease their early management.

  6. [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.

  7. Soviet Style in War.

    DTIC Science & Technology

    1982-04-01

    the methods for firing while running’ " 355-and ingenuity in devising procedures for training: I 56 Soviet Style in War The commander of a regiment...under friendly fire... .. " In fact, one of the characteristics of the "Russian method of attacking" was "to break into the positions of the defense...battle. ° For this gain one should use all available detours and instruments, should "utilize," in General Epishev’s words, "all forms and methods of

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. 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,…

  13. War, Journalism, and Oral History.

    ERIC Educational Resources Information Center

    Rice, Gary

    2000-01-01

    Describes a project where students conducted oral history with either a war correspondent or a U.S. combat veteran for the course "War and the News Media: From Vietnam through Desert Storm and Beyond." Discusses how the students prepared for the interviews and the evaluation of their projects. (CMK)

  14. 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.

  15. 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

  16. Injury risk of nonpowder guns.

    PubMed

    Laraque, Danielle

    2004-11-01

    Nonpowder guns (ball-bearing [BB] guns, pellet guns, air rifles, paintball guns) continue to cause serious injuries to children and adolescents. The muzzle velocity of these guns can range from approximately 150 ft/second to 1200 ft/second (the muzzle velocities of traditional firearm pistols are 750 ft/second to 1450 ft/second). Both low- and high-velocity nonpowder guns are associated with serious injuries, and fatalities can result from high-velocity guns. A persisting problem is the lack of medical recognition of the severity of injuries that can result from these guns, including penetration of the eye, skin, internal organs, and bone. Nationally, in 2000, there were an estimated 21840 (coefficient of variation: 0.0821) injuries related to nonpowder guns, with approximately 4% resulting in hospitalization. Between 1990 and 2000, the US Consumer Product Safety Commission reported 39 nonpowder gun-related deaths, of which 32 were children younger than 15 years. The introduction of high-powered air rifles in the 1970s has been associated with approximately 4 deaths per year. The advent of war games and the use of paintball guns have resulted in a number of reports of injuries, especially to the eye. Injuries associated with nonpowder guns should receive prompt medical management similar to the management of firearm-related injuries, and nonpowder guns should never be characterized as toys.

  17. 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…

  18. Suicide among war veterans.

    PubMed

    Rozanov, Vsevolod; Carli, Vladimir

    2012-07-01

    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.

  19. Motorcycle-related spinal injury: crash characteristics.

    PubMed

    Zulkipli, Zarir Hafiz; Abdul Rahmat, Abdul Manap; Mohd Faudzi, Siti Atiqah; Paiman, Noor Faradila; Wong, Shaw Voon; Hassan, Ahamedali

    2012-11-01

    This study presents an analysis of crash characteristics of motorcyclists who sustained spinal injuries in motorcycle crashes. The aim of the study is to identify the salient crash characteristics that would help explain spinal injury risks for motorcyclists. Data were retrospectively collected from police case reports that were archived at MIROS from year 2005 to 2007. The data were categorized into two subcategories; the first group was motorcycle crashes with spinal injury (case) and the second group was motorcycle crashes without spinal injury (control). A total of 363 motorcyclists with spinal injury and 873 motorcyclists without spinal injury were identified and analyzed. Descriptive analysis and multivariate analysis were performed in order to determine the odds of each characteristic in contributing to spinal injury. Single vehicle crash, collision with fixed objects and crash configuration were found to have significant influence on motorcyclists in sustaining spinal injury (p<0.05). Although relatively few than other impact configurations, the rear-end impacted motorcyclist shows the highest risk of spinal injury. Helmets have helped to reduce head injury but they did not seem to offer corresponding protection for the spine in the study. With a growing number of young motorcyclists, further efforts are needed to find effective measures to help reduce the crash incidents and severity of spinal injury. In sum, the study provides some insights on some vital crash characteristics associated with spinal injury that can be further investigated to determine the appropriate counter-measures and prevention strategies to reduce spinal injury.

  20. 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

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

    PubMed

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

    2015-01-01

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

  2. 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)

  3. 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…

  4. 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)

  5. 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…

  6. 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)

  7. [Nursing figures in the Great War].

    PubMed

    Marc, Bernard

    2014-06-01

    The three Red Cross associations worked hard in France before the First World War to prepare nurses to serve during a war. When war broke out, these nurses stepped up to the plate. They supported every phase of the war and demonstrated their high levels of creativity to overcome the difficult conditions related to the fighting.

  8. Breaking New Ground on War and Peace.

    ERIC Educational Resources Information Center

    Bock, Paul

    1983-01-01

    The American Catholic Church, which has historically supported America's involvement in wars through the concept of just wars, has broken new ground with its Pastoral Letter on War, Armaments, and Peace, which challenges the morality of present defense policy and nuclear war. Reasons for the change in attitude are discussed. (IS)

  9. Snowboarding injuries.

    PubMed

    Sachtleben, Thomas R

    2011-01-01

    Snowboarding has gained immense popularity during the past 30 years and continues to appeal to many young participants. Injury patterns and characteristics of injuries seen commonly in snowboarders have rapidly evolved during this time. Risk factors have emerged, and various methods of reducing injuries to snowboarders have been investigated. It is important that medical providers are knowledgeable about this growing sport and are prepared to adequately evaluate and treat snowboarding injuries. This article will review the issues and discuss diagnostic and treatment principles regarding injuries seen commonly in snowboarders. Injury prevention should be emphasized, particularly with young riders and beginners.

  10. 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.

  11. Hugh Cairns (1896-1952) and the mobile neurosurgical units of World War II.

    PubMed

    Hughes, J T

    2004-02-01

    In World War II, Hugh Cairns, Oxford Nuffield Professor of Surgery and brigadier in the Royal Army Medical Corps, designed and administered the mobile neurosurgical units that treated casualties with head injuries in the various campaigns fought by the British Army. Cairns also created the Combined Services Hospital for Head Injuries at St Hugh's College, Oxford, where the staff of the units were trained and where evacuated casualties were received. The excellent outcome of the head-injured in World War II and the impetus to the expansion of neurosurgery in the UK during and after that war were, in large measure, due to Cairns. Others had knowledge of neurosurgery but Cairns inspired surgeons, neurologists and nursing sisters to perform neurosurgery at the highest level on the battlefield.

  12. 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.

  13. Driving Simulator Performance of Veterans from the Iraq and Afghanistan Wars

    DTIC Science & Technology

    2013-01-01

    stress disorder, reintegration, safety, virtual reality. INTRODUCTION Motor vehicle crashes ( MVCs ) are among the leading causes of injury-related...the early years postdeployment [2]. Being deployed may increase risk for MVC -related fatalities because deployed gulf war Veterans were found to...Enduring Freedom Abbreviations: MANOVA = multivariate analysis of variance, MVC = motor vehicle crash, OIF/OEF = Operation Iraqi Free- dom/Operation

  14. 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.

  15. Ankle injury mechanisms: lessons learned from cadaveric studies.

    PubMed

    Funk, James R

    2011-04-01

    The biomechanics of ankle injury have been studied extensively, primarily through mechanical testing of human cadavers. Cadaveric testing is an invaluable methodology in biomechanics, because the magnitude and direction of the loading can be measured precisely and correlated with the resulting injury pattern. Clinical and epidemiological studies provide useful descriptions of injury patterns that occur in the real world, but their retrospective nature precludes a definitive analysis of the forces that caused the injury. Understanding the mechanism of ankle injuries is essential for developing countermeasures to prevent injury and for reconstructing injurious events. Knowledge of an injury's mechanism can also suggest potential associated injuries, which is helpful in diagnosis and treatment. The purpose of this review is to summarize the published research on ankle injury mechanisms with an emphasis on biomechanical experiments on human cadavers. Injury patterns are described based on the principal axis of force or torque producing the injury in conjunction with off-axis forces and out-of-plane foot positions. A mechanistic description of ankle injuries is complicated by the fact that the same mechanism can sometimes produce different injuries and the same injury can sometimes be caused by multiple mechanisms. Nonetheless, a framework for relating injury mechanisms and injury patterns is a valuable tool in the understanding, prevention, and treatment of ankle injuries.

  16. 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.”

  17. 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.

  18. Women and War

    PubMed Central

    Murdoch, Maureen; Bradley, Arlene; Mather, Susan H; Klein, Robert E; Turner, Carole L; Yano, Elizabeth M

    2006-01-01

    Most of today's 1.7 million women veterans obtain all or most of their medical care outside the VA health care system, where their veteran status is rarely recognized or acknowledged. Several aspects of women's military service have been associated with adverse psychologic and physical outcomes, and failure to assess women's veteran status, their deployment status, and military trauma history could delay identifying or treating such conditions. Yet few clinicians know of women's military history—or of military service's impact on women's subsequent health and well being. Because an individual's military service may be best understood within the historical context in which it occurred, we provide a focused historical overview of women's military contributions and their steady integration into the Armed Forces since the War for Independence. We then describe some of the medical and psychiatric conditions associated with military service. PMID:16637946

  19. High-pressure injection injuries.

    PubMed

    Neal, N C; Burke, F D

    1991-11-01

    A retrospective review of the 11 patients attending the Hand Unit at the Derbyshire Royal Infirmary over the last 5 years with high-pressure injection injuries is presented. The machines and materials that cause these injuries are outlined and the methods of treatment and rehabilitation are described in detail. The study demonstrates the morbidity of high-pressure injection injuries, particularly those inflicted by paint spray guns, and highlights a frequent delay between injury and decompression of the injured part. We wish to emphasize the importance of early diagnosis, referral, exploration and rehabilitation to ensure an optimal outcome, and to point out that failure to refer early is becoming an increasing focus of negligence claims.

  20. Bilateral Traumatic Intracranial Hematomas and its Outcome: a Retrospective Study.

    PubMed

    Pandey, Sharad; Sharma, Vivek; Singh, Kulwant; Pandey, Deepa; Sharma, Mukesh; Patil, Deepak Bhanudas; Shende, Neeraj; Chauhan, Richa Singh

    2017-02-01

    The objective of this study was to evaluate the age distribution, mode of injury, type of hematomas, and their surgical outcome in patients with bilateral traumatic head injuries. The present study included 669 cases of traumatic head injury who presented at the neurosurgery emergency out of which 94 cases had bilateral head injuries from the period of August 2009 to April 2014. The data from the hospital computerized database were retrospectively analysed. Cases of bilateral traumatic head injury included 94 patients out of which 88.29 % (n = 83) were males and 11.70 % (n = 11) were females. Commonest mode of injury was road traffic accident in 56.38 % (n = 53) followed by fall from height in 29.78 % (n = 28). In our study, 25.53 % patients had epidural hematoma (EDH) with intracerebral hematoma (ICH) or contusion (n = 24), followed by EDH with subarachnoid hemorrhage (SAH) in 18.08 % (n = 17). At the time of discharge, all those patients managed conservatively had good Glasgow outcome scale (GOS) while with surgical intervention 58 % patients had good GOS, 19 % had moderate disability, and 9 % remained with severe disability. In cases of bilateral hematomas, EDH is most common and should be managed in neurosurgical emergency. Other combinations of bilateral intracranial hematomas should be managed according to the surgical indication and serial CT imaging.

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

    PubMed Central

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

    2013-01-01

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

  2. 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…

  3. 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'.

  4. Bomb blast, mild traumatic brain injury and psychiatric morbidity: a review.

    PubMed

    Rosenfeld, Jeffrey V; Ford, Nick L

    2010-05-01

    Traumatic brain injury (TBI) arising from blast exposure during war is common, and frequently complicated by psychiatric morbidity. There is controversy as to whether mild TBI from blast is different from other causes of mild TBI. Anxiety and affective disorders such as Post-traumatic Stress Disorder (PTSD) and depression are common accompaniments of blast injury with a significant overlap in the diagnostic features of PTSD with post-concussive syndrome (PCS). This review focuses on this overlap and the effects of mild TBI due to bomb blast. Mild TBI may have been over diagnosed by late retrospective review of returned servicemen and women using imprecise criteria. There is therefore a requirement for clear and careful documentation by health professionals of a TBI due to bomb blast shortly after the event so that the diagnosis of TBI can be made with confidence. There is a need for the early recognition of symptoms of PCS, PTSD and depression and early multi-disciplinary interventions focussed on expected return to duties. There also needs to be a continued emphasis on the de-stigmatization of psychological conditions in military personnel returning from deployment.

  5. 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

  6. 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.

  7. 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 ...

  8. 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 ...

  9. ACL Injuries

    MedlinePlus

    ... Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury ... Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury ...

  10. Head Injuries

    MedlinePlus

    ... scalp 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 ...

  11. Urethral Injuries

    MedlinePlus

    ... and Related Injuries (Video) Rotator Cuff Injury (News) Violent Video Games May Not 'Desensitize' Players, Brain Scans ... Comfort Am I Correct? More Videos News HealthDay Violent Video Games May Not 'Desensitize' Players, Brain Scans ...

  12. Injury risk evaluation in sport climbing.

    PubMed

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

    2011-10-01

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

  13. Outcomes of truncal vascular injuries in children

    PubMed Central

    Allison, Nathan D.; Anderson, Christopher M.; Shah, Shinil K.; Lally, Kevin P.; Hayes-Jordan, Andrea; Tsao, Kuo-Jen; Andrassy, Richard J.; Cox, Charles S.

    2011-01-01

    Background Pediatric truncal vascular injuries occur infrequently and have a reported mortality rate of 30% to 50%. This report examines the demographics, mechanisms of injury, associated trauma, and outcome of patients presenting for the past 10 years at a single institution with truncal vascular injuries. Methods A retrospective review (1997-2006) of a pediatric trauma registry at a single institution was undertaken. Results Seventy-five truncal vascular injuries occurred in 57 patients (age, 12 ± 3 years); the injury mechanisms were penetrating in 37%. Concomitant injuries occurred with 76%, 62%, and 43% of abdominal, thoracic, and neck vascular injuries, respectively. Nonvascular complications occurred more frequently in patients with abdominal vascular injuries who were hemodynamically unstable on presentation. All patients with thoracic vascular injuries presenting with hemodynamic instability died. In patients with neck vascular injuries, 1 of 2 patients who were hemodynamically unstable died, compared to 1 of 12 patients who died in those who presented hemodynamically stable. Overall survival was 75%. Conclusions Survival and complications of pediatric truncal vascular injury are related to hemodynamic status at the time of presentation. Associated injuries are higher with trauma involving the abdomen. PMID:19853755

  14. Cycling injuries.

    PubMed Central

    Cohen, G. C.

    1993-01-01

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

  15. 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.

  16. 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.

  17. 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.

  18. Orienteering injuries

    PubMed Central

    Folan, Jean M.

    1982-01-01

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

  19. Military Governance and War Termination

    DTIC Science & Technology

    2011-05-19

    existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments...amount of census data was collected, which served civil administration purposes and provided intelligence for military operations.123 Additionally, in...York: Henry Holt and Company, 2005. Bade , Bruce C. War Termination: Why Don’t We Plan It? Fort McNair: National War College, 1994. Barthlomees, J

  20. Biomarker Discovery in Gulf War Veterans: Development of a War Illness Diagnostic Panel

    DTIC Science & Technology

    2015-10-01

    Award Number: W81XWH-12-1-0382 TITLE: Biomarker Discovery in Gulf War Veterans: Development of a War Illness Diagnostic Panel PRINCIPAL...SUBTITLE Biomarker Discovery in Gulf War Veterans: Development of a War Illness Diagnostic Panel 5a. CONTRACT NUMBER W81XWH-12-1-0382 5b. GRANT NUMBER...b. ABSTRACT U c. THIS PAGE U UU 11 19b. TELEPHONE NUMBER (include area code) Biomarker Discovery in Gulf War Veterans: Development of a Gulf War

  1. The history and evolution of traumatic brain injury rehabilitation in military service members and veterans.

    PubMed

    Cifu, David X; Cohen, Sara I; Lew, Henry L; Jaffee, Michael; Sigford, Barbara

    2010-08-01

    The field of traumatic brain injury has evolved since the time of the Civil War in response to the needs of patients with injuries and disabilities resulting from war. The Department of Veterans Affairs and the Defense and Veterans Brain Injury Center have been in the forefront of the development of the interdisciplinary approach to the rehabilitation of soldiers with traumatic brain injury, particularly those injured from the recent conflicts in Iraq and Afghanistan. The objectives of this literature review are to examine how the casualties resulting from major wars in the past led to the establishment of the current model of evaluation and treatment of traumatic brain injury and to review how the field has expanded in response to the growing cohort of military service members and veterans with TBI.

  2. [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.

  3. Waterbike injuries.

    PubMed Central

    Jeffery, R S; Caiach, S

    1991-01-01

    Jet skiing is a rapidly growing sport. The craft incorporate safety features and the manufacturers issue detailed safety instructions. Racing is conducted with adequate attention to clothing, safety and insurance. However, casual use is widespread and is sometimes irresponsible. Serious injuries to riders are uncommon: dental and knee injuries are described. A case of renal contusion and a head injury were caused by other riders and two potentially fatal injuries illustrate the risk for other water users. The number of injuries associated with the use of personal watercraft is likely to increase and may be influenced by appropriate organization or regulation. Images Figure 2 Figure 3 Figure 4 PMID:1810620

  4. 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

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

    PubMed

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

    2016-09-01

    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.

  6. 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.

  7. Reducing Secondary Insults in Traumatic Brain Injury

    DTIC Science & Technology

    2013-04-01

    persons, and leaves 99,000 persons permanently disabled [1]. The total cost for treatment and rehabilitation of patients with brain injuries is...registry based or retrospective or include only secondary insults that occur in the intensive care unit ( ICU ) setting. Most prior investigations have...in the surgical and neurosurgical ICU diagnosed with a traumatic brain injury requiring a diagnostic procedure were eligible for the study. The study

  8. Burns and frostbite in the Red Army during World War II.

    PubMed

    Sokolov, Vladimir; Biryukov, Alexey; Chmyrev, Igor; Tarasenko, Mikhail; Kabanov, Pavel

    2017-01-01

    The start of World War II (WWII) led to the deployment of combat troops in several continents. Destruction and many casualties among both the military and civilians became an inevitable consequence. A large amount of people injured were in need of life-saving treatment and a speedy return to duty. Intensive studies of the specific issues of diagnosis and treatment of thermal injury were conducted in the Soviet Union before the war. The first special units for patients with burn injuries were created, and the first specialists received their first clinical experience. The contributions of famous Soviet scientists in the development of the treatment of burns and frostbite in WWII are studied in this article. The structure of thermal injuries among military personnel and the results of their treatment are shown. Treatment, classification and quantity frostbite in the structure of sanitary losses during the WWII are studied in this article.

  9. 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)

  10. Injury - kidney and ureter

    MedlinePlus

    Kidney damage; Toxic injury of the kidney; Kidney injury; Traumatic injury of the kidney; Fractured kidney; Inflammatory injury of the kidney; Bruised kidney; Ureteral injury; Pre-renal failure - injury, ...

  11. 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.

  12. 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

  13. Long Range Transport of War-Related Burn Casualties

    DTIC Science & Technology

    2008-02-01

    ted to the Army’s burn center between March 2003 and February 2007. Data in- cluded total body surface area (TBSA) burn, ventilatory status... total body surface area (range, ə%–95%) with a mean Injury Severity Score of 12.2 13.7. One hundred eight-one (33.5%) casualties required venti...Long Range Transport of War-Related Burn Casualties 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT

  14. [Surgical strategy for iatrogenic injuries of the spleen].

    PubMed

    Masliakov, V V; Barsukov, V G; Dmitriev, N V

    2010-01-01

    A retrospective investigation of 1226 case histories of patients operated on the stomach and duodenum was made. Organ-saving operations using laser technique were assessed. The main cause of injuries to the spleen during operation was traction of the stomach when mobilizing it. The performance of organ-saving operations for such injuries using laser technique is possible in 76% of cases.

  15. Risk of Early Childhood Injuries in Twins and Singletons

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  16. 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.

  17. Environmental injuries.

    PubMed

    Leikin, J B; Aks, S E; Andrews, S; Auerbach, P S; Cooper, M A; Jacobsen, T D; Krenzelok, E P; Shicker, L; Weiner, S L

    1997-12-01

    Environmental injuries and illnesses can happen in home, work, or recreational settings. The variety and severity of these injuries might require the clinician to call on skills from internal medicine, emergency medicine, and toxicology. Diseases of thermoregulation are hypothermia and hyperthermia. In each instance, treatment is based on the need to restore the patient's core temperature to normal and on monitoring for complications. The victim of a fire might suffer inhalation injury in addition to burns, and it is more likely that the inhalation injury will be fatal. Oxygen deprivation and inhalation of irritant or asphyxiant chemicals contribute to injury. Toxic plants can be the source of poisoning emergencies, especially in children. Misinformation and myths that surround common plants can create diagnostic problems (i.e., which plants really are toxic and require emergency measures). Venomous marine organisms can cause a wide range of injury, from cutaneous eruption to fatal envenomation. Most are encountered in a recreational setting, such as water sports, but keepers of home aquariums are subject to stings from venomous fish. Lightning injury can present many diagnostic and treatment dilemmas. An important point in this regard is that lightning injury and high-voltage electrical injury are different in pathology and require different approaches for treatment. A discussion of electrical, chemical, and thermal burns makes such differences apparent.

  18. Paragliding injuries.

    PubMed Central

    Krüger-Franke, M; Siebert, C H; Pförringer, W

    1991-01-01

    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries. Images p99-a p100-a p100-b p100-c PMID:1751899

  19. Paragliding injuries.

    PubMed

    Krüger-Franke, M; Siebert, C H; Pförringer, W

    1991-06-01

    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries.

  20. Head Injuries

    MedlinePlus

    ... injury, cerebral contusion, cerebral laceration, coma, head trauma, hematoma, impaired consciousness, postconcussion syndrome, skull fracture, skull penetration, stupor, vegetative state Family Health, Infants ...

  1. Hamstring Injury

    MedlinePlus

    ... result. Hamstring injury risk factors include: Sports participation. Sports that require sprinting or running, or other activities such as dancing that might require extreme stretching, make a hamstring ...

  2. 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...

  3. 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…

  4. 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…

  5. 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.

  6. Nuclear War. The moral dimension

    SciTech Connect

    Child, J.W.

    1985-01-01

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

  7. 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…

  8. Selecting a Retrospective Conversion Vendor.

    ERIC Educational Resources Information Center

    Lisowski, Andrew; Sessions, Judith

    1984-01-01

    Discussion of using vendors for retrospective conversion of library catalogs rather than in-house projects highlights reasons to consider vendors, four conversion methodologies, and vendor selection criteria (database, non-matches, local data, accuracy, charging, schedule, product delivery time, local system compatibility, MARC format, impact on…

  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. 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.

  11. Long-term sequelae of electrical injury

    PubMed Central

    Wesner, Marni L.; Hickie, John

    2013-01-01

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

  12. Space technologies and the war in Iraq

    NASA Astrophysics Data System (ADS)

    Getsov, Petar

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

  13. Vascular Injury in Orthopedic Trauma.

    PubMed

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

    2016-07-01

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

  14. Weight-training injuries in adolescents.

    PubMed

    Risser, W L; Risser, J M; Preston, D

    1990-09-01

    We studied the incidence of injury caused by weight training in junior and senior high school football players. Three hundred fifty-four subjects completed a retrospective injury questionnaire; histories were confirmed for high school athletes. Cumulative incidence and incidence rates were determined for injuries causing more than 7 days of missed participation. The cumulative incidences of injuries were as follows: all athletes, 7.6% (27/354); junior high school athletes, 7.1% (7/98); high school freshman/junior varsity athletes, 9.4% (15/159); and high school varsity athletes, 5.2% (5/97). The total incidence rate was 0.082 injuries per person-year, with 0.11 injuries per person-year in junior high school athletes, 0.091 injuries per person-year in high school freshman/junior varsity players, and 0.051 injuries per person-year in high school varsity players. Differences in the incidence measures among groups were not statistically significant. The most common injury type was a strain (74.1%), and the most common site was the back (59.3%). Certain exercise apparently caused more back injuries in older athletes.

  15. 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.

  16. Injuries and Illnesses of Vietnam War POWs. 2. Army POWs

    DTIC Science & Technology

    1975-01-01

    were diagnosed in 3() of the RI’Ws’, (30 pier Intestinal Protozoal Infections cent ) the( :30 individuals represent 42 diagnoses, of which 23 4oo I...punched for computer analysis, and analyzed 460.0-466.9 Acute Upper Respiratory Infection 14 19 using standard statistical programs. 805.0-805.9 Fractured...a pulmol(nary embolus. 23.0 I iiency Sy dronia4 A variety (If’ gastrointestinal diagnoses were made at 20.00. Ierosesi~eC 4n~i 6 0/H, notably two

  17. Extremity War Injuries: Current Management and Research Priorities

    DTIC Science & Technology

    2012-01-01

    sal- vage and amputation. The 13 articles generated from this symposium ad- dress these topics as well as multi- modal strategies for pain control...advent of pain man- agement protocols and techniques that have enabled earlier initiation of therapy, rehabilitation remains less effective for limb...reconstruc- tion, and rehabilitation, including the development of mechanisms to obtain junctional large-vessel control in the groin and axilla

  18. 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)

  19. Librarians and Censorship during Three Modern Wars.

    ERIC Educational Resources Information Center

    Murphy, Katherine B.

    The wars of the twentieth century have clarified American librarians' evolving attitudes toward censorship, while at the same time providing impetus for changes in those attitudes. This study uses content analysis to examine librarians' attitudes toward censorship during three periods: the First World War, the Second World War, and the Vietnam…

  20. Musical Images of the Vietnam War.

    ERIC Educational Resources Information Center

    Chilcoat, George W.; Vocke, David E.

    Teaching the Vietnam War in high school history courses is a challenge to the instructor, and study that relies only on textbooks may neglect the controversy surrounding the War and the issues that faced the nation. This paper discusses how to use songs about the Vietnam War as an instructional tool to investigate the role of songs during the War…

  1. 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…

  2. U.S. Periods of War

    DTIC Science & Technology

    2010-01-07

    Louis L. Snyder’s Historical Guide to World War Two (Westport, CT: Greenwood, 1982), p. 736; and the World Almanac of World War II, ed. Brigadier Peter...Japanese Emperor made his historic broadcast to the Japanese people telling of Japan’s surrender, is cited as V-J Day in The World Almanac of World War II

  3. The Civil War in Literature: English.

    ERIC Educational Resources Information Center

    Boone, Dave

    The Civil War in Literature is a course in which investigation is made into the legacy that this war left to humanity. Through the reading and discussion of literary works written during or about the Civil War, including "Jubilee,""Gone with the Wind,""Red Badge of Courage," poetry by Walt Whitman, and the essays of…

  4. American Women in a World at War.

    ERIC Educational Resources Information Center

    Litoff, Judy Barrett; Smith, David C.

    2002-01-01

    Focuses on women during World War II stating that the events of the war changed the lives of women. Addresses the role of women during wartime by sharing excerpts and information gleaned from letters written by women during World War II. (CMK)

  5. Teaching the Vietnam War: A Sociological Approach.

    ERIC Educational Resources Information Center

    Starr, Jerold M.

    1995-01-01

    Maintains that, because of its importance in modern U.S. history, over 300 college courses are taught on the Vietnam War. Asserts that studying the war helps students develop critical thinking skills needed for citizenship. Describes the texts, formats, and assignments used in a college sociology course on the Vietnam War. (CFR)

  6. 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)

  7. 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)

  8. 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…

  9. [Psychiatric aid during the Great Patriotic War].

    PubMed

    2010-05-01

    The article presents an observe of questions of organization of psychiatric aid during the Great Patriotic War, main disadvantages of the first period of war, their dependence from circumstances of prewar period, ignoring of experience of last war. There was marked the role of famous native psychiatrists in organization of psychiatric aid to military servicemen in theatre of combat actions.

  10. The Unprincipled War: Looking at the War on Drugs

    DTIC Science & Technology

    1993-06-18

    Into Air Interdiction of Drug Trafficking from South America, p. 12, (Santa Monica, CA: Rand, 1991); 16. Edmundo Morales, Cocaine: White Gold Rush in...Newport RI: naval War College Press, 21 May, 1991. Morales, Edmundo. Cocaine: White Gold Rush in Peru. 1989. Morganthau, Tom, Miller, Mark, Sandza

  11. Global War on Terrorism: Executing War without Unity of Command

    DTIC Science & Technology

    2007-03-09

    American Disease: Origins of Narcotics Control (Oxford: Oxford University Press, 1987), 54. 35 Schake and Berkowitz, 3. 36 Larry M. Keeton , Collegial...Status of the Drug War, 104th Cong., 2d sess., 19 March 1996, 1. 38 Ibid. 39 Keeton , 20. 40 Gordon Witkin, “The Trouble Reign of the Nation’s Drug

  12. Gulf War Illness and the Health of Gulf War Veterans

    DTIC Science & Technology

    2008-11-01

    and provided important insights concerning their biological and psychological correlates. Commentators have pointed out that it is somewhat artificial ...consultation with the Armed Forces Epidemiological Board and Armed Forces Medical Intelligence Center.1622 The specific vaccines received by individual U.S...against biological warfare agents. Prior to the war, intelligence reports indicated that Iraq had weaponized two biological agents, anthrax and

  13. Medical resources after nuclear war. Availability v need.

    PubMed

    Abrams, H L

    1984-08-03

    In defining capacity to "survive" a massive nuclear exchange, it is important to assess the medical resources that will be available in the post-nuclear war world. Approximately 80% of these resources--hospital beds and personnel, blood, drugs, and medical supplies--will have been destroyed, since they are located in or near the densely populated areas that constitute primary targets of attack. Casualty estimates published by federal agencies, together with data from the Hiroshima-Nagasaki experience, suggest the numbers and types of injuries that will afflict the US population. With a probable 48,000 surviving physicians to treat 32 million casualties, there will be one physician for every 663 patients. Of the trauma and burn victims, approximately 55% will require hospitalization; this will mean 64 patients for each available hospital bed. Data from recent wars have been utilized to determine the trauma-related blood requirements in the post-nuclear war world. Of the 64 million units of whole blood needed, only 14,000 will be available. Other medical resources will be in equally short supply. This disparity between need and availability indicates the difficulty of developing a meaningful medical response for the surviving injured.

  14. Whiplash injuries.

    PubMed

    Malanga, Gerard; Peter, Jason

    2005-10-01

    Whiplash injuries are very common and usually are associated with rear-end collisions. However, a whiplash injury can be caused by any event that results in hyperextension and flexion of the cervical spine. These injuries are of serious concern to all consumers due to escalating cost of diagnosis, treatment, insurance, and litigation. Most acute whiplash injury cases respond well to conservative treatments, which result in resolution of symptoms usually within weeks to a few months after the injury occurred. Chronic whiplash injuries often are harder to diagnose and treat and often result in poor outcomes. Current research shows that various structures in the cervical spine receive nociceptive innervation and potentially may be the cause of chronic pain symptoms. One potential pain generator showing promise is the facet or zygapophyseal joints. Various researchers have proven that these joints are injured during whiplash injuries and that diagnosis and temporary pain relief can be obtained with facet joint injections. The initial evaluation of any patient should follow an organized and stepwise approach, and more serious causes of neck pain must first be ruled out through the history, physical examination, and diagnostic testing. Treatment regimens should be evidence-based, focusing on treatments that have proven to be effective in treating acute and chronic whiplash injuries.

  15. Epidemiologic Change of Patients With Spinal Cord Injury

    PubMed Central

    Shin, Ji Cheol; Yu, Su Jin; Yang, Hea Eun; Yoon, Seo Yeon

    2013-01-01

    Objective To evaluate the epidemiologic change of patients with spinal cord injury who were admitted to a Rehabilitation Hospital, Yonsei University College of Medicine, during 1987-1996 and 2004-2008. Methods Medical records of 629 patients with spinal cord injury admitted to the Rehabilitation Hospital, Yonsei University College of Medicine, from 2004 to 2008 were collected and reviewed retrospectively. Results The male-to-female ratio decreased to 2.86:1, the mean age at injury increased, nontraumatic etiology increased, traffic accident remained to be the most common in traumatic spinal cord injury, and falling increased significantly. Tumor was the most common etiology in nontraumatic spinal cord injury, tetraplegia and incomplete injuries occurred more than paraplegia and complete injuries, indwelling catheter was the most common voiding method, and the duration of hospitalization decreased. Conclusion Many trends changed in epidemiology of spinal cord injury. PMID:23525183

  16. Dismounted complex blast injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee.

    PubMed

    Fleming, Mark; Waterman, Scott; Dunne, James; D'Alleyrand, Jean-Claude; Andersen, Romney C

    2012-01-01

    The objective of this report is to analyze the resource utilization and injury patterns of complex dismounted blast injuries. A retrospective review of U.S. service members injured in combat between 2007 and 2010 was conducted. Data analyzed included age, injury mechanism, amputated limbs, number and type of associated injuries, blood products utilized, intensive care unit length of stay (ILOS), hospital length of stay (HLOS) and the Injury Severity Score (ISS). Patients were stratified based on the number of amputations. Sixty-three patients comprised the multiple extremity amputation (MEA) group. Ninety-eight percent sustained injuries from an improvised explosive device (IED) and 96% were dismounted. The ISS, number of surgical encounters, blood products utilized and ILOS were all clinically significantly different than controls. Care of multiple extremity amputees involves the utilization of significant resources. This knowledge may better help surgeons and administrators allocate assets at hospitals, both military and civilian, who care for this complex and challenging patient population.

  17. 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

  18. Head injuries.

    PubMed

    Yanko, J

    1984-08-01

    In summary, the broad term "head injury" represents a large variety of more specific injuries. In order to anticipate and plan appropriate patient care, nurses need information regarding the cause of injury, the impact site, and the patient's clinical course in addition to current assessment findings. The nurse must also anticipate sequelae from secondary brain injury due to hypoxia, edema, increased intracranial pressure, changes in regional blood flows, or hypovolemic shock due to internal bleeding in another body system or cavity. The head-injured patient is a complex patient requiring intensive nursing care, observation, and assessment. By incorporating knowledge of the mechanisms of injury into nursing observations and assessments, nurses can provide more effective nursing interventions.

  19. 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)

  20. Retrospective

    NASA Astrophysics Data System (ADS)

    Brooks, David A.

    Charting a course toward an uncertain future is always a risky business, especially among shoals of fiscal restraint or national tragedy, and the prudent navigator is well advised to remember where he's been as he looks ahead. The ocean and space sciences are poised for grand joint adventures, but shrinking budgets and the lingering Challenger numbness are restrictive lee shores that must be considered when laying plans. To sharpen the focus on future choices, it may be helpful to glance in the geophysical rearview mirror and remember some of the challenges and opportunities of a different era.A quarter century is a long time, but many images from 25 years ago can still be recalled in crisp detail, like photographs in a scrapbook. In 1961, results from the International Geophysical Year (IGY) filled the pages of the Transactions of the American Geophysical Union, and the U.S. program of space exploration finally was underway with conviction. The Indian Ocean Expedition, conceived during the IGY, ushered in a new era of international oceanography. The TIROS III satellite beamed to earth fuzzy pictures of tropical storms and revealed the intricate writhings of the Gulf Stream. Forecasters and fluid dynamicists suddenly saw new horizons, and geophysical turbulence became a major topic at the IUGG Symposium in Marseilles, France. Papers with prescient themes were presented at the AGU Ocean Section meeting: June Pattullo (then at Oregon State College, Corvallis) on heat storage in the Pacific; Ferris Webster (then at Woods Hole Oceanographic Institution, Woods Hole, Mass.) on Gulf Stream meanders. Polar oceanography was well represented in AGU journals: Kenneth Hunkins (at what was then called the Lamont Geological Observatory, Palisades, N.Y.) described the Alpha Rise, discovered from a drifting Arctic ice island, and Edward Thiel (then at the University of Minnesota, Minneapolis) and his co-workers discussed open ocean tides, gravimetrically measured from Antarctic ice shelves.

  1. 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…

  2. Young Children and War Play.

    ERIC Educational Resources Information Center

    Carlsson-Paige, Nancy; Levin, Diane E.

    1988-01-01

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

  3. 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…

  4. 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)

  5. The Revolutionary War. [Lesson Plan].

    ERIC Educational Resources Information Center

    Buchberg, Wendy

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

  6. The Civil War and Iowa.

    ERIC Educational Resources Information Center

    Gore, Deborah, Ed.

    1987-01-01

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

  7. Mild Traumatic Brain Injury

    MedlinePlus

    ... Questions Glossary Contact Us Visitor Feedback mild Traumatic Brain Injury mild Traumatic Brain Injury VIDEO STORIES What is TBI Measuring Severity ... most common deployment injuries is a mild Traumatic Brain Injury (TBI). A mild TBI is an injury ...

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. Wartime vascular injuries in the pediatric population of Iraq and Afghanistan: 2002-2011

    DTIC Science & Technology

    2014-01-01

    Wartime vascular injuries in the pediatric population of Iraq and Afghanistan: 2002–2011☆ Carole Y. Villamaria a,b,⁎, Jonathan J. Morrison b, Colleen...Accepted 4 October 2013 Key words: Vascular injury Trauma Children Pediatric Wartime Reconstruction Background: Contemporary war-related studies focus...primarily on adults with few reporting the injuries sustained in local pediatric populations. The objective of this study is to characterize pediatric

  13. 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.

  14. [The value of surgical experience gained during the Great Patriotic War for the modern military surgery].

    PubMed

    Efimenko, N A; Samokhvalov, L M

    2015-05-01

    The surgical experience gained during the Great Patriotic War (1941-1945) is a basis of the modern Russian military surgery, which allows providing any options for surgical care to the wounded. The article describes the main achievements of the military surgeons in our country during the Great Patriotic War, which helped the Soviet (Russian) military field surgery to achieve a leading position in the world of military medicine. The role of the united martial medical doctrine, three editions of "Guidelines for the military surgery", the qualified surgical assistance as a mean that helped to deliver surgical care to the wounded, the introduction of specialized medical care, technology development of medical triage, as well as the origins of the tactics of a multi-stage surgical treatment of combat trauma and special treatment of minimally wounded during the war. The problems in establishing registers of combat injuries. and training military surgeons are analysed.

  15. 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.

  16. 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

  17. 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.

  18. A Guerilla War At Sea: The Sri Lankan Civil War

    DTIC Science & Technology

    2011-09-09

    Donoughmore Commission, set up to introduce constitutional reform in the colony, promulgated universal suffrage at a time when the population‟ s political...of ocean going merchant ships that delivered supplies to the insurgents. With close ties to the LTTE‟ s women ‟ s directorate (30% of Sea Tiger...6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Naval War College,Joint

  19. Electrical injury

    MedlinePlus

    ... damage, especially to the heart, muscles, or brain. Electric current can cause injury in three ways: Cardiac arrest ... How long you were in contact with the electricity How the electricity moved through your body Your ...

  20. Testicular Injuries

    MedlinePlus

    ... Also, the location of the testicles makes them prime targets to be accidentally struck on the playing ... you might also feel nauseated for a short time. If it's a minor testicular injury, the pain ...

  1. Inhalation Injuries

    MedlinePlus

    ... devastating types of trauma resulting from exposure to fire and smoke. PREVENT you and your loved ones! ... people die annually in the United States from fire injuries. • Over half of these deaths result from ...

  2. Birth Injury

    MedlinePlus

    ... cesarean delivery may be done in certain circumstances. Did You Know... Serious birth injuries are now quite ... are typically not needed. Resources In This Article Did You Know 1 Did You Know... Sidebar 1 ...

  3. Ear Injury

    MedlinePlus

    ... doctors usually give an antibiotic to prevent infection. Did You Know... If left untreated, a swollen, bruised ... can be corrected surgically. Resources In This Article Did You Know 1 Did You Know... Facial Injuries ...

  4. Lightning Injuries

    MedlinePlus

    ... cause internal burns than electrical injuries from generated electricity. However, it can kill a person by instantaneously ... water do not attract lightning but easily transmit electricity once they are hit. Electricity from lightning can ...

  5. Spinal injury

    MedlinePlus

    ... and drive. Do not dive into pools, lakes, rivers, and other bodies of water, particularly if you cannot determine the depth of the ... Central nervous system Spinal cord injury Spinal anatomy Two person roll - ...

  6. 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.

  7. 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

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

    PubMed

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

    2016-09-01

    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

  9. 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.

  10. Experience of Soviet Medicine in a Great Patriotic War, 1941-1945. Volume 16, Section 1.

    DTIC Science & Technology

    1980-10-22

    special features/peculiarities of immobilization technique on the separate segments are presented in the appropriate sections. DOC = 80093602 PAGE...procassing/tr a- atent . Statistical survcy/ccv;rau. Almost the half injurrd p opla, who preserved extrzmity wih h combined injuries of shoular (49.0o/o...the period of the first world war, keeping in mind aneurisms. In the second place, documentary is revealed/detected the value of a number of factors

  11. 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

  12. A Comparison of Post-Deployment Hospitalization Incidence Between Vietnam and Gulf War Veterans

    DTIC Science & Technology

    2000-03-01

    contraction of an infectious disorder such as leishmaniasis ,15 multiple chemical sensitivities,16,17 and combat stress. 18-2 In short, many Gulf War veterans...the diagnosis ’no need for further medical care’ injury admissions with identical 3-digit ICD diagnoses and occurring within the same 60-day period...a desert environment. Mil Med. 1992;157:250-254. 14 Viet/Gulf-CGB 15. Magill AJ, Grogl M, Johnson SC, Gasser RA Jr. Visceral infection due to

  13. Medical Department, United States Army. Surgery in World War 2. Neurosurgery. Volume 2

    DTIC Science & Technology

    1959-01-01

    many references to the Peripheral Nerve Registry set up in the Office of the Surgeon General in November 1944. It is ironical to record that the 5-year...the symptoms and signs of compound wounds of the spinal cord, as well as the pathologic processes in these injuries, was accumulated during World War I...subject of great controversy. For this reason, it was difficult to define and establish a uniform policy of treatment. As experience accumulated during

  14. Coastal zone color scanner retrospective

    NASA Astrophysics Data System (ADS)

    Mitchell, B. Greg

    1994-04-01

    The following special section of the Journal of Geophysical Research is dedicated to a retrospective of scientific studies using the coastal zone color scanner (CZCS) instrument. The CZCS was launched in late 1978 aboard the Nimbus 7 satellite as a "proof-of-concept" instrument to demonstrate the feasibility of using satellite platforms to monitor the distribution of oceanic phytoplankton in the world's oceans. It provided data until the middle of 1986. Phytoplankton primary production contributes approximately one half of the global biospheric fixation of organic matter by photosynthesis, thereby forming the base of the oceanic food web and providing a major sink for atmospheric CO2.

  15. The reported thoracic injuries in Homer's Iliad

    PubMed Central

    2010-01-01

    Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%), the stones (7.4%), the arrow (5.5%) and the sword (5.5%). We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim), medium (those which cause the victim to abandon the battlefield), and severe (those which cause death of the victim). According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95%) and the remaining 8 an Achaean (21.05%). The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield. PMID:21087529

  16. The reported thoracic injuries in Homer's Iliad.

    PubMed

    Apostolakis, Efstratios; Apostolaki, Georgia; Apostolaki, Mary; Chorti, Maria

    2010-11-19

    Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%), the stones (7.4%), the arrow (5.5%) and the sword (5.5%). We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim), medium (those which cause the victim to abandon the battlefield), and severe (those which cause death of the victim). According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95%) and the remaining 8 an Achaean (21.05%). The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield.

  17. Epidemiology of injuries in adventure racing athletes

    PubMed Central

    Fordham, S; Garbutt, G; Lopes, P

    2004-01-01

    Objectives: To assess the demographics and training characteristics of adventure racing athletes in the United Kingdom, the prevalence and anatomical distribution of hazardous encounter, and overuse injury in this population, and the effects these injuries have on training. Methods: A retrospective training and injury questionnaire for the previous 18 months was distributed to 300 adventure racing athletes at two national race meetings. The definition of an injury was "any musculoskeletal problem causing a stop in training for at least one day, reduction in training mileage, taking of medicine, or seeking of medical aid." Results: The data were derived from the responses of 223 athletes. Advanced level athletes did 11 (4) sessions and 17 (8) hours of training a week (mean (SD)). An injury was reported in the previous 18 months by 73% of the respondents. The most common site of acute injury was the ankle (23%) and of chronic/overuse injury, the knee (30%), followed by the lower back, shin, and Achilles tendon (12% each). There were significant correlations (p<0.01) between the hours spent cycling per week and number of acute injuries, and between the number of days off per week and number of chronic/overuse injuries. Injuries resulted in an average of 23 days training cessation or reduction. Conclusions: Acute injuries were sustained mainly as a result of the nature of the terrain over which athletes train and compete. In overuse injuries lack of adequate rest days was a significant contributing factor. Only a small proportion of training time was spent developing flexibility and core stability. PMID:15155432

  18. Afghanistan: A War of Necessity?

    DTIC Science & Technology

    2010-03-12

    candidates running for National Office sometimes find it difficult to articulate. During an interview on September 11, 2008, ABC “World News...July 2009.25 An ABC News-Washington Post poll supported the Gallup poll’s results, finding that the majority of Americans believe the War in...Charlie Gibson’s Gaffe”, Washington Post, September 13, 2008. 13 Charles Krauthammer, “The Bush Doctrine ABM , Kyoto, and the New American

  19. The Operational Level of War

    DTIC Science & Technology

    1985-12-01

    Ramsay III, Dr. William G. Robertson, Major Claude R. Sasso, and Lieutenant Colonel Gary H. Wade. We owe special thanks to a few individuals who...initially assembled this bibliography in response to a requirement by Brigadier General William A. Stofft, then a colonel and director of CSI...and World War I. This battle analysis is accomplished largely at the operational level and is beneficial to the reader. Balck, Wilhelm ( William

  20. Nuclear War: A Selected Bibliography.

    DTIC Science & Technology

    1983-05-01

    International Institute for Strategic Studies, 1975. 37pp. (U162.6• .R7) 109. Rotblat , Joseph . Nuclear Radiation in Warfare. Cambridge, MA...and Political Policy. Rutherford, NJ: Fairleigh Dickinson University Press, 1971. 265pp. (UA23 .B66) 18. Boyce, Joseph B. Winning the Unthinkable War... Joseph P. Tactical Nuclear WeOns Detgrrent or Deytriirent. aW Ineitablo: A Cmprehenive Test Ban Treaty. Two Monographs. Carlisle Barracks: US Army

  1. Injury Patterns Among Illegal Migrants from Africa in Israel.

    PubMed

    Perlman, Amotz; Radomislensky, Irina; Peleg, Kobi

    2015-08-01

    In recent years Israel has become a destination for many migrants from Africa that illegally cross the Egyptian-Israeli border. The objective of this paper is to describe the epidemiological characteristics of injuries among illegal migrants in Israel. The study was carried out retrospectively using data from 19 trauma centers that participated in the Israel National Trauma Registry between 1 January 2006 and 31 December 2011. Illegal migrants from Africa were compared to the local population. Migrants were injured more often than the local population from intentional injuries (57.11 %). Migrants were also less likely than the local population (58.38 %) to sustain a minor injury (i.e., injury severity ≤8). The study also shows the hospitalization cost as a result of injuries among migrants from Africa. Preventive measures among illegal migrants from Africa should prioritize intentional injuries and industrial site injuries.

  2. Moving Past the Systematics Wars.

    PubMed

    Sterner, Beckett; Lidgard, Scott

    2017-03-02

    It is time to escape the constraints of the Systematics Wars narrative and pursue new questions that are better positioned to establish the relevance of the field in this time period to broader issues in the history of biology and history of science. To date, the underlying assumptions of the Systematics Wars narrative have led historians to prioritize theory over practice and the conflicts of a few leading theorists over the less-polarized interactions of systematists at large. We show how shifting to a practice-oriented view of methodology, centered on the trajectory of mathematization in systematics, demonstrates problems with the common view that one camp (cladistics) straightforwardly "won" over the other (phenetics). In particular, we critique David Hull's historical account in Science as a Process by demonstrating exactly the sort of intermediate level of positive sharing between phenetic and cladistic theories that undermines their mutually exclusive individuality as conceptual systems over time. It is misleading, or at least inadequate, to treat them simply as holistically opposed theories that can only interact by competition to the death. Looking to the future, we suggest that the concept of workflow provides an important new perspective on the history of mathematization and computerization in biology after World War II.

  3. 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.

  4. 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.

  5. 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.

  6. Posttraumatic Stress Disorder and Metabolic Syndrome: Retrospective Study of Repatriated Prisoners of War

    DTIC Science & Technology

    2011-04-01

    In the absence of diabetes, the 10-year risk for coronary heart disease events is only mildly elevated. 10 Furthermore, several authorities argue... heart disease mortality among Vietnam veterans: implications for surveillance and pre- vention . Psychosomatic Med 2008 ; 70: 668 – 76 . 23...density lipoprotein (HDL) cholesterol (HDL-C), elevated triglycerides (TGs), and impaired fasting glucose or impaired glucose tolerance. 3 MbS is a

  7. Role of Pre-Morbid Factors and Exposure to Blast Mild Traumatic Brain Injury on Post-Traumatic Stress in United States Military Personnel.

    PubMed

    Manners, Jody L; Forsten, Robert D; Kotwal, Russ S; Elbin, R J; Collins, Michael W; Kontos, Anthony P

    2016-10-01

    Mild traumatic brain injury (mTBI), the signature injury of the recent wars in Afghanistan and Iraq, is a prevalent and potentially debilitating condition that is associated with symptoms of post-traumatic stress/post-traumatic stress disorder (PTS/PTSD). Prior mTBI, severity and type of injury (blast vs. non-blast), and baseline psychiatric illness are thought to impact mTBI outcomes. It is unclear if the severity of pre-morbid PTS/PTSD is a risk factor of post-injury levels of PTS and mTBI symptoms. The objective of the study was to examine predictors of post-injury PTS/PTSD, including pre-morbid PTS symptoms, and physical and cognitive symptoms in the sub-acute phase (1 week-3 months) following an acute mTBI. A retrospective review of medical records was performed of 276 servicemen assigned to the United States Army Special Operations Command referred for mTBI evaluation between December 2009 and March 2011. Post-Concussion Symptom Scale and PTSD Checklist scores were captured pre- and post-injury. A total of 276 records were reviewed. Pre-morbid and post-injury data were available for 91% (251/276). Of the 54% (136/251) of personnel with mTBI, 29% (39/136) had positive radiology findings and 11% (15/136) met criteria for clinical PTS symptoms at baseline. Logistic regression analysis found baseline PTS symptoms predicted personnel who met clinical levels of PTSD. Receiver operating characteristic curve analysis revealed that baseline PTS (p = 0.001), baseline mTBI symptoms (p = 0.001), and positive radiology (magnetic resonance imaging or computed tomography) findings for complicated mTBI (p = 0.02) accurately identified personnel with clinical levels of PTSD following mTBI. Years of military service, combat deployment status, age, and injury mechanism (blast vs. non-blast) were not associated with increased risk of PTS following mTBI. Pre-morbid PTS symptoms are associated with an increased risk for clinical levels of PTS following a subsequent m

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

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

    PubMed Central

    Lundquist, Jennifer H.; Massey, Douglas S.

    2010-01-01

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

  14. Cold injuries.

    PubMed

    Long, William B; Edlich, Richard F; Winters, Kathryne L; Britt, L D

    2005-01-01

    Exposure to cold can produce a variety of injuries that occur as a result of man's inability to adapt to cold. These injuries can be divided into localized injury to a body part, systemic hypothermia, or a combination of both. Body temperature may fall as a result of heat loss by radiation, evaporation, conduction, and convection. Hypothermia or systemic cold injury occurs when the core body temperature has decreased to 35 degrees C (95 degrees F) or less. The causes of hypothermia are either primary or secondary. Primary, or accidental, hypothermia occurs in healthy individuals inadequately clothed and exposed to severe cooling. In secondary hypothermia, another illness predisposes the individual to accidental hypothermia. Hypothermia affects multiple organs with symptoms of hypothermia that vary according to the severity of cold injury. The diagnosis of hypothermia is easy if the patient is a mountaineer who is stranded in cold weather. However, it may be more difficult in an elderly patient who has been exposed to a cold environment. In either case, the rectal temperature should be checked with a low-reading thermometer. The general principals of prehospital management are to (1) prevent further heat loss, (2) rewarm the body core temperature in advance of the shell, and (3) avoid precipitating ventricular fibrillation. There are two general techniques of rewarming--passive and active. The mechanisms of peripheral cold injury can be divided into phenomena that affect cells and extracellular fluids (direct effects) and those that disrupt the function of the organized tissue and the integrity of the circulation (indirect effects). Generally, no serious damage is seen until tissue freezing occurs. The mildest form of peripheral cold injury is frostnip. Chilblains represent a more severe form of cold injury than frostnip and occur after exposure to nonfreezing temperatures and damp conditions. Immersion (trench) foot, a disease of the sympathetic nerves and blood

  15. Injuries and overuse syndromes in powerlifting.

    PubMed

    Siewe, J; Rudat, J; Röllinghoff, M; Schlegel, U J; Eysel, P; Michael, J W-P

    2011-09-01

    Powerlifting is a discipline of competitive weightlifting. To date, no investigations have focused on pain encountered during routine training. The aim of the study was to identify such pain, assign it to particular exercises and assess the data regarding injuries as well as the influence of intrinsic and extrinsic factors. Data of 245 competitive and elite powerlifters was collected by questionnaire. Information regarding current workout routines and retrospective injury data was collected. Study subjects were selected from 97 incorporated powerlifting clubs. A percentage of 43.3% of powerlifters complained of problems during routine workouts. Injury rate was calculated as 0.3 injuries per lifter per year (1 000 h of training=1 injury). There was no evidence that intrinsic or extrinsic factors affected this rate. Most commonly injured body regions were the shoulder, lower back and the knee. The use of weight belts increased the injury rate of the lumbar spine. Rate of injury to the upper extremities was significantly increased based on age >40 years (shoulder/p=0.003, elbow/p=0.003, hand+wrist/p=0.024) and female gender (hand+wrist/p=0.045). The daily workout of a large proportion of powerlifters is affected by disorders which do not require an interruption of training. The injury rate is low compared to other sports.

  16. Eye injuries in Canadian amateur hockey.

    PubMed

    Pashby, T J

    1979-01-01

    Two studies, one retrospective (1972 to 1973) and one prospective (1974 to 1975), CONcerning eye injuries incurred by hockey players were conducted by the Canadian Ophthalmological Society with questionnaires to its members. Responses to the questionnaires were analyzed by age, type of injury, cause (i.e., hockey stick, puck, or other means), and results to visual acuity. The results were also designated by organized or unorganized participation. Almost 300 eye injuries were reported in each study. In the first study, 13.7% of the injured players became legally blind as a result of the injury; in the second study, 16% became legally blind. Organized hockey produced more injuries than unorganized hockey. The majority of the injuries were caused by the hockey stick. The injuries were both intraocular and extraocular. The group of 11- to 15-year olds received the highest number of injuries, and the older age group had the higher incidence of blindness. Studies have led to setting more rigid standards, altering rules of the game, and selecting face protectors for hockey players. Older players who care for their equipment prefer the plastic shield face protectors, and the younger players (who complain of fogging and scratching of the plastic) prefer mesh protectors through which neither the stick nor the puck can penetrate. New high sticking (above the shoulder level) rules were included in the 1976 official rule book for Canadian amateur hockey.

  17. Neglected Thoraco Lumbar Traumatic Spine Injuries

    PubMed Central

    Khatri, Kavin; Sharma, Vijay; Gupta, Babita; Gamanagatti, Shivanand

    2016-01-01

    Study Design Retrospective study. Purpose To outline the etiology, complications and management difficulties encountered in the management of neglected thoracolumbar spine injuries. Overview of Literature The English literature describes overlooked diagnosis as the most common cause of neglected spine injuries. However, the reasons differ in developing or under-developed nations. Moreover, there is scarcity of literature about the neglected spinal injuries. Methods Patients presenting with thoracolumbar traumatic injuries who had not received any form of treatment for more than three weeks were included in the study. The demographic details, operative procedure performed and complications encountered, along with American Spinal Injury Association grade and spinal cord independence measure score recorded on the history sheets were noted. The data were analyzed. Results Forty patients were included in the study. Inadequate treatment at the first contact hospital (45%) followed by late presentation (38%) and missed injury (17%) were the major etiological factors for the neglected traumatic injuries in the thoracolumbar spine. The most common complications seen in the management of these cases were pressure sores (58%), back pain (57%), urinary tract infection (42%) and residual kyphotic deformity (42%). Conclusions Management of neglected thoracolumbar injuries is challenging. The delay in presentation should not prevent spine surgeon in proceeding with operative intervention as good results can be expected. PMID:27559447

  18. The Spanish Civil War: An Analysis

    DTIC Science & Technology

    2003-10-31

    Témime, The Revolution and the Civil War in Spain (Cambridge, MA: The MIT Press, 1970), 34. 2 Spartacus , <http://www.spartacus.schoolnet.co.uk> (25...Ithaca, NY: Cornell University Press, 1985), 8- 10. 8 Beevor, 281. 9 Spartacus . 10 Imperial War Museum, <http://www.iwm.org.uk> (25 October...2003), Spanish Civil War exhibition. 11 Beevor, 281. 12 Spartacus . 13 Beevor, 267. 14 A.K. Starinov, Behind Fascist Lines: A Firsthand

  19. Air Command and Control in Small Wars

    DTIC Science & Technology

    2011-12-01

    Books, 1987. Kinnard, Douglas. The War Managers. Lebanon, NH: University Press of New England , 1977. Kometer, Michael W. Command in Air War... new aircraft would be operated by an independent air arm, but not integrated into combined arms in the way a modern military operates.14 Airpower in...50Quinn, 375. 51Ibid. 52For a comprehensive text on the French in Algeria see Alistair Horne, A Savage War of Peace: Algeria 1954-1962 ( New York: Viking

  20. Operational Intelligence Failures of the Korean War

    DTIC Science & Technology

    2014-05-22

    cultural bias and a lack of understanding of Chinese operational art and tactics. Operational intelligence failures, created by post-World War II...of Chinese operational art and tactics. Operational intelligence failures, created by post-World War II policies, led to poor readiness and lack...development of state-of-the- art equipment. The United States government and the Army discarded the lessons learned post-World War I downsizing

  1. Operational Art in Pontiac’s War

    DTIC Science & Technology

    2015-05-23

    several British forts in the Great Lakes region, also known as the pays d’en haut. Pontiac’s War emerged following the French defeat in the French ...movement attacked several British forts in the Great Lakes region, also known as the pays d’en haut. Pontiac’s War emerged following the French ...defeat in the French and Indian War, as it was known in America. The Ottawa chief Pontiac rallied support from several different Indian tribes to fight

  2. The Critical Error of World War II,

    DTIC Science & Technology

    1981-02-01

    ammunition, and other supplies, was primarily responsible for our failure to inflict a decisive defeat on the Germans before the close of 1944 ...efficiently it might have been operated, it could not have improved the supply situation sufficiently to hove ended the war in 1944 . A Reappraisal...WAR i. Had the war ended in 1944 , the Berlin problem would not today exist and the resulting complications, with which the world is wrestling, would not

  3. Financing Wars on Terrorism and Iraq

    DTIC Science & Technology

    2003-01-01

    Macroeconomic Effects of War Finance in the United States: World War II and the Korean War" American Economic Review (March 1997). Rodrik , Dani , "How...Far Will International Economic Integration Go?" Journal of Economic Perspectives (Winter 2000) Rodrik , Dani , "Feasible Globalizations" John F... Rodrik , 2000, 2002). The trilemma problem states that the international monetary order is influenced by the pursuit of three goals, of which only two

  4. 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.

  5. Epidemiology of infections associated with combat-related injuries in Iraq and Afghanistan.

    PubMed

    Murray, Clinton K

    2008-03-01

    Enhanced medical training of front line medical personnel, personal protective equipment, and the presence of far forward surgical assets have improved the survival of casualties in the current wars in Iraq and Afghanistan. As such, casualties are at higher risk of infectious complications of their injuries including sepsis, which was a noted killer of casualties in previous wars. During the current conflicts, military personnel who develop combat-related injuries are at substantial risk of developing infections with multidrug resistant bacteria. Herein, we describe the bacteriology of combat-related injuries in Operation Iraqi Freedom and Operation Enduring Freedom that develop infections with particular attention to injuries of the extremities, central nervous system, abdomen and thorax, head and neck, and burns. In addition, the likely sources of combat-related injuries with multidrug resistant bacteria infections are explored.

  6. Clinical consequences of road traffic injuries among the elderly in Japan

    PubMed Central

    2010-01-01

    Background Road traffic injuries among the elderly have recently become a public health issue; therefore, we investigated the clinical characteristics of such injuries among the elderly in Japan. Methods A retrospective study was performed using data from a medium-sized hospital emergency department. Data were extracted from medical records for one year, and patients were categorized into groups ages 18-64, 65-74 and 75+. Variables included demographic characteristics, injury circumstances, and nature of injury. Univariate and bivariate descriptive statistical analyses were performed, and multivariate logistic regression was used to evaluate injury severity and hospital admission by age groups. Results A total of 1,656 patients were studied. Patients aged 65+ had more chest wall injury, intracranial injury, lower extremity fracture, and intrathoracic injury than patients aged 18-64. Conclusions Injury circumstances and nature of injuries associated with traffic incidents showed different patterns by age groups, particularly among the elderly. PMID:20584283

  7. American Orthopaedic Surgeons in World War I.

    PubMed

    Green, David P; DeLee, Jesse C

    2017-04-05

    On April 6, 1917, the United States declared war on Germany and entered what was then called the Great War. Among the first officers sent to Europe were 21 orthopaedic surgeons in the so-called First Goldthwait Unit. Prior to the war, orthopaedics had been a nonoperative "strap-and-buckle" specialty that dealt primarily with infections, congenital abnormalities, and posttraumatic deformity. The Great War changed all of that forever, creating a new surgical specialty with emphasis on acute treatment, prevention of deformity, restoration of function, and rehabilitation.

  8. 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…

  9. Providing for the Casualties of War: The American Experience Through World War II

    DTIC Science & Technology

    2013-01-01

    military families. The linchpin of these new social realities of war was the all-volunteer force. The nation moved from a mixed force of conscripts and......fairly presented to the average Roman as wars of survival, self-defense, or expansion of Rome within recognized social and cultural boundaries. The wars

  10. 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…

  11. 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…

  12. Musculoskeletal Injuries Resulting from Use of Hoverboards.

    PubMed

    Ho, Michelle; Horn, B David; Lin, Ines C; Chang, Benjamin; Carrigan, Robert B; Shah, Apurva

    2017-01-01

    Hoverboards were recently introduced to the US consumer market and experienced rapid popularity. Given the high frequency of musculoskeletal injury with other wheeled recreation devices, we sought to analyze hoverboard injuries in children. A retrospective review of patients with musculoskeletal injury related to hoverboard use was performed at a tertiary care children's hospital. From November 2015 to January 2016, 2.3% of all fractures were related to hoverboards. Common injury mechanisms were fall (79%) and finger entrapment between wheel and wheel-well (10%). The most frequently fractured sites included the distal radius (43%) and phalanx (17%). Common surgical procedures were nailbed repair and pinning for Seymour fracture and percutaneous pinning for distal radius fracture. There exists high risk for distal radius fractures from falls and phalanx fractures from finger entrapment between the wheel and wheel-well. Hoverboard safety can be improved with regular use of wrist guards and improved wheel-well design.

  13. Lightning injuries.

    PubMed

    O'Keefe Gatewood, Medley; Zane, Richard D

    2004-05-01

    Lightning is persistently one of the leading causes of death caused by environmental or natural disaster. To understand the pathophysiology and treatment of lightning injuries one must first discount the innumerable myths, superstitions, and misconceptions surrounding lightning. The fundamental difference between high voltage electrical injury and lightning is the duration of exposure to current. Reverse triage should be instituted in lightning strike victims because victims in cardiopulmonary arrest might gain the greatest benefit from resuscitation efforts, although there is no good evidence suggesting that lightning strike victims might benefit from longer than usual resuscitation times. Many of the injuries suffered by lightning strike victims are unique to lightning, and long-term sequelae should be anticipated and addressed in the lightning victim.

  14. Blast Injury

    PubMed Central

    de Candole, C. A.

    1967-01-01

    The shock wave generated by an explosion (“blast wave”) may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742

  15. Hamstring injuries

    PubMed Central

    Guanche, Carlos A.

    2015-01-01

    There is a continuum of hamstring injuries that can range from musculotendinous strains to avulsion injuries. Although the proximal hamstring complex has a strong bony attachment on the ischial tuberosity, hamstring injuries are common in athletic population and can affect all levels of athletes. Nonoperative treatment is mostly recommended in the setting of low-grade partial tears and insertional tendinosis. However, failure of nonoperative treatment of partial tears may benefit from surgical debridement and repair. The technique presented on this article allows for the endoscopic management of proximal hamstring tears and chronic ischial bursitis, which until now has been managed exclusively with much larger open approaches. The procedure allows for complete exposure of the posterior aspect of the hip in a safe, minimally invasive fashion. PMID:27011828

  16. 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)

  17. Retrospectively evaluated preinjury personality traits influence postconcussion symptoms.

    PubMed

    Yuen, Kit-Man; Tsai, Yi-Hsin; Lin, Wei-Chi; Yang, Chi-Cheng; Huang, Sheng-Jean

    2016-01-01

    Postconcussion symptoms (PCS) are not uncommon following mild traumatic brain injury (mTBI). Personality traits have always been viewed as one of the most important explanations for persistent postconcussion symptoms (PPCS). Unfortunately, studies on the association between preinjury personality traits and the PPCS are still limited. This study thus aimed to examine the relationship between the preinjury personality and PCS in patients with mTBI. A total of 106 participants including 53 healthy participants were recruited. All participants complete the modified Checklist of Postconcussion Symptoms and the Health, Personality, & Habit Scale. Participants were evaluated within 4 weeks and at 4 months, respectively, after injury. The results showed patients reported significantly more PCS than healthy participants did within 4 weeks postinjury. A significant positive association between PCS and retrospectively evaluated preinjury personality was found. Specifically, patients who reported that their preinjury personality was depressive or anxious-related presented more PCS. This study might be the first to directly demonstrate that preinjury personality traits are closely linked to PCS reporting in patients with mTBI. Importantly, PCS reporting might be associated with different personality traits at different periods after injuries, and thus, a careful evaluation for personality characteristics is merited after mTBI.

  18. Waging the Wrong War: Drug War Strategy and Issues

    DTIC Science & Technology

    1992-04-15

    College, 1991. Dwyer, Paula. "Marines Aren’t the Answer to America’s Drug Problem." Business Week, 4 September 1989, p. 30. Dziedzic, Michael J . "The...18I. SUBJECT TERMS (Continue an reverse if necessary and .dentify by block number) FIELD f GROUP J SUB-RODUP J 19. ABSTRACT (Conwu on reverse if...for this part will conclude with an analysis of factors preventing a"drug war" victory. Grant Wardlaw does an outstanding job of explaining why it is

  19. Diabetes and burns: retrospective cohort study.

    PubMed

    McCampbell, Beth; Wasif, Nabil; Rabbitts, Angela; Staiano-Coico, Lisa; Yurt, Roger W; Schwartz, Suzanne

    2002-01-01

    Burn injuries are often associated with multisystemic complications, even in otherwise healthy individuals. It is therefore intuitive that for the diabetic patient, the underlying pathophysiologic alterations in vascular supply, peripheral neuropathy, and immune function could have a profoundly devastating impact on patient outcome. The effects of diabetes on morbidity and mortality of the burn-injured patient have not been examined in great detail. The purpose of this retrospective study was to compare clinical outcomes between diabetic and nondiabetic burn patients. We reviewed the charts of 181 diabetic (DM) and 190 nondiabetic (nDM) patients admitted with burns between January 1996 and May 2000, matched by sex and date of admission. Burn cause and size, time to presentation, clinical course, and outcomes were evaluated. Because age was a factor, the analysis was done by three age groups: younger than 18 years, 18 to 65 years, and older than 65 years. Of patients 18 to 65 years, 51% (98/191) were diabetic, whereas 84% (81/96) of those older than 65 and only 4% (3/85) of patients younger than 18 were diabetic. Because of the disproportion in numbers of diabetics compared with nondiabetics in the younger than 18 and older than 65 years-old groups, these patients will not be discussed. Diabetics were more likely to incur scald injury from tub or shower water rather than hot fluid spills (33% DM vs 15% nDM; P < or = 0.01), and have a delayed presentation (45 vs 23%; P = 0.00001). There was no difference in total burn size in all groups. Diabetics in the 18 to 65 years group had a higher rate of full-thickness burns (51 vs 31%; P = 0.025), skin grafts (50 vs 28%; P = 0.01) and burn-related procedures (57 vs 32%; P = 0.001), infections (65 vs 51%; P = 0.05), and longer lengths of stay (23 vs 12 days; P = 0.0001). Although there was no statistically significant difference in incidence of specific infections, the rates of cellulitis, wound infection, urinary tract

  20. Injury rates and injury risk factors among federal bureau of investigation new agent trainees

    PubMed Central

    2011-01-01

    Background A one-year prospective examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation (FBI) new agent training. Methods Injury incidents were obtained from medical records and injury compensation forms. Potential injury risk factors were acquired from a lifestyle questionnaire and existing data at the FBI Academy. Results A total of 426 men and 105 women participated in the project. Thirty-five percent of men and 42% of women experienced one or more injuries during training. The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women, respectively (risk ratio (women/men) = 1.3, 95% confidence interval = 0.9-1.7). The activities most commonly associated with injuries (% of total) were defensive tactics training (58%), physical fitness training (20%), physical fitness testing (5%), and firearms training (3%). Among the men, higher injury risk was associated with older age, slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the physical fitness test (PFT), lower self-rated physical activity, lower frequency of aerobic exercise, a prior upper or lower limb injury, and prior foot or knee pain that limited activity. Among the women higher injury risk was associated with slower 300-meter sprint time, slower 1.5-mile run time, lower total points on the PFT, and prior back pain that limited activity. Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents. PMID:22166096

  1. Retrospective Birth Dating of Cells

    SciTech Connect

    L.Spalding, K; Bhardwaj, R D; Buchholz, B A; Druid, H; Frisen, J

    2005-04-19

    The generation of cells in the human body has been difficult to study and our understanding of cell turnover is limited. Extensive testing of nuclear weapons resulted in a dramatic global increase in the levels of the isotope {sup 14}C in the atmosphere, followed by an exponential decrease after the test ban treaty in 1963. We show that the level of {sup 14}C in genomic DNA closely parallels atmospheric levels, and can be used to establish the time point when the DNA was synthesized and cells were born. We use this strategy to determine the age of cells in the cortex of the adult human brain, and show that whereas non-neuronal cells are exchanged, occipital neurons are as old as the individual, supporting the view that postnatal neurogenesis does not take place in this region. Retrospective birth dating is a generally applicable strategy that can be used to measure cell turnover in man under physiological and pathological conditions.

  2. Propensity Score Matching: Retrospective Randomization?

    PubMed

    Jupiter, Daniel C

    Randomized controlled trials are viewed as the optimal study design. In this commentary, we explore the strength of this design and its complexity. We also discuss some situations in which these trials are not possible, or not ethical, or not economical. In such situations, specifically, in retrospective studies, we should make every effort to recapitulate the rigor and strength of the randomized trial. However, we could be faced with an inherent indication bias in such a setting. Thus, we consider the tools available to address that bias. Specifically, we examine matching and introduce and explore a new tool: propensity score matching. This tool allows us to group subjects according to their propensity to be in a particular treatment group and, in so doing, to account for the indication bias.

  3. Analysis of sharps injury occurrences at a hospital in Singapore.

    PubMed

    Ng, Leng Nee; Lim, Hui Li; Chan, Yiong Huak; Bin Bachok, Dzulazwan

    2002-10-01

    Relatively little attention has been directed to investigating the risks of sharps injuries in Singapore. This study examines the epidemiology and causes of sharps injuries at a university teaching hospital. The type of instruments, site of injuries and personnel involved in each sharps injury were determined retrospectively by reviewing the Incident Reports forms and Infection Control records between 1997 and 2000. Descriptive information on the forms and records were extracted and collected on standard charts. The data were then analysed using SPSS Windows software. The rates of sharps injuries were 11.0 per 100 medical staff and 6.9 per 100 nursing staff. Medical staff yielded highest proportion of sharps injuries rendering 33 cases (40.2%), followed by 24 cases involving nursing staff (29.3%) and 12 cases of nursing students (14.6%). In total, 62.2% of injuries were caused by hollow bore needles (51 cases). Non-hollow bore needle injuries only accounted for 17.1% of total injuries (14 cases). Hollow bore needles accounted for the highest proportion of sharps injuries in this study, corresponding to findings in other studies. Rates of injuries were similar to the rates found at another local hospital. At the hospital studied, sharps with safety features had effectively produced no reported cases of sharps injuries.

  4. US pediatric injuries involving amusement rides, 1990-2010.

    PubMed

    Thompson, Meghan C; Chounthirath, Thiphalak; Xiang, Huiyun; Smith, Gary A

    2013-05-01

    This study investigates pediatric injuries involving amusement rides treated in US emergency departments by retrospectively analyzing data from the National Electronic Injury Surveillance System. From 1990 to 2010, an estimated 92 885 children ≤17 years sought treatment in US hospital emergency departments for injuries involving amusement rides, yielding an annual average of 4423 injuries. The average annual injury rate was 6.24 injuries per 100 000 US children, and the mean patient age was 8.73 years. The head and neck was the most commonly injured body region (28.0%), and the most common type of injury was a soft tissue injury (29.4%). Falling in, on, off, or against the ride was the most frequent mechanism of injury (31.7%). Only 1.5% of injuries resulted in hospitalization. An improved national system for monitoring injuries involving amusement rides is needed. There are opportunities to improve the safety of amusement rides for children, especially to prevent injuries from falls.

  5. 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.

  6. Misinformation, disinformation, and violent conflict: from Iraq and the "War on Terror" to future threats to peace.

    PubMed

    Lewandowsky, Stephan; Stritzke, Werner G K; Freund, Alexandra M; Oberauer, Klaus; Krueger, Joachim I

    2013-10-01

    The dissemination and control of information are indispensable ingredients of violent conflict, with all parties involved in a conflict or at war seeking to frame the discussion on their own terms. Those attempts at information control often involve the dissemination of misinformation or disinformation (i.e., information that is incorrect by accident or intent, respectively). We review the way in which misinformation can facilitate violent conflicts and, conversely, how the successful refutation of misinformation can contribute to peace. We illustrate the relevant cognitive principles by examining two case studies. The first, a retrospective case, involves the Iraq War of 2003 and the "War on Terror." The second, a prospective case, points to likely future sources of conflict arising from climate change and its likely consequences.

  7. 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.

  8. Refining the focus of construction injury surveillance.

    PubMed

    Glazner, Judith; Lipscomb, Hester; Bondy, Jessica

    2006-01-01

    We conducted two studies of construction injury occurring at Denver International Airport (DL4), whose construction required 31 million work hours. Initially we conducted a retrospective cohort study that allowed estimation of injury and workers' compensation (WC) payment rates for strata such as size of employer and type of work; risk factors were also estimated. The second study examined written injury reports for 4,000 injuries at DIA. We modified Haddon's matrix to classify factors contributing to injury. We identified 108 factors within 4 broad categories: human, object, environment and organization. This approach provided information on rates at which each factor contributed to injury and the WC payment rates for each factor. A study shortcoming was that injury reports varied in completeness and quality. In a third ongoing study, to compensate for the shortcomings of injury reports, particularly to improve consistency and completeness of data, we designed a worker questionnaire completed immediately after injury, which included questions specific to hazards associated with each type of injury. Upon completion, the interviewer (a safety professional) uses the modified Haddon's matrix to note contributors to the injury and explain briefly the reasons for each notation. This requires the interviewer to consider a full set of possible factors and determine whether they contributed to injury. This process elicits richer data and places specific factors within the four higher-level categories. This process confer advantages on both contractors and researchers. Contractors can become immediately aware of contributing factors and ameliorate them quickly. The data can also be used in post hoc analysis of injury etiology. Moreover, the data are sufficiently flexible and complete that they can be coded into schemes describing sequences of events leading to injury, as well as those simply identifying factors contributing to injury. Haddon's matrix is invaluable in such

  9. Electrical Injuries

    MedlinePlus

    ... your injuries are depends on how strong the electric current was, what type of current it was, how it moved through your body, and how long you were exposed. Other factors include how ... you should see a doctor. You may have internal damage and not realize it.

  10. Pediatric Injury

    MedlinePlus

    ... Control and Prevention’s Safe Child website . What is pediatric critical care? Children who have severe or life-threatening injuries ... are staffed by physicians with specialized training in pediatric critical care medicine ("pediatric intensivists"). Because children can experience a ...

  11. Northeastern Pennsylvania Retrospective Case Study Fact Sheet

    EPA Pesticide Factsheets

    EPA conducted a retrospective case study in northeastern Pennsylvania to investigate reported instances of contaminated drinking water resources in areas where hydraulic fracturing activities occurred

  12. Turf wars in radiology: introduction.

    PubMed

    Levin, David C; Rao, Vijay M

    2004-01-01

    Turf wars over medical imaging have become ubiquitous. At many centers, radiologists already have lost access to important technologies and their applications. A combination of decreasing revenues in other specialties and a growing attachment to imaging further threatens radiologists' practices in the future. This is the first of an extended series of articles that will address the phenomenon of self-referral--its motivations, extent, and the threats it poses to radiologists. Each article will focus on a specific aspect and provide advice on how radiologists can deal with self-referral in their locales.

  13. GWOT Vascular Injury Study 2 Supplemental Project: Impact of Prophylactic Fasciotomy

    DTIC Science & Technology

    2015-10-01

    for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT This study will involve a retrospective analysis of large patient...Participants & Other Collaborating Organizations 4 8. Special Reporting Requirements 4 9. Appendices 5 1. INTRODUCTION: This is a retrospective analysis of a...REPORTING REQUIREMENTS QUAD CHARTS: See attached 9. APPENDICES: Quad Chart GWOT Vascular Injury Study 2 Supplemental Project: Impact of Prophylactic

  14. 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.

  15. Probiotic (VSL#3) for Gulf War Illness

    DTIC Science & Technology

    2014-10-01

    efforts are ongoing to recruit more Gulf War veterans. The first set of stool samples have been sent to Lawrence Berkeley Laboratory microbiota analysis...the Lawrence Berkeley laboratory for microbiota analysis.  We have received the list of Gulf War Veterans in the Salt Lake City are from the Defense

  16. Looking at the Vietnam War through Literature.

    ERIC Educational Resources Information Center

    Muller, Lisa S.

    1992-01-01

    Suggests a lesson plan in which history students discuss the effects of the Vietnam War on individuals and society. Explains that the students compare their responses before and after hearing a reading of two different works on the war. Includes suggested readings and questions for students to use in interviewing people in the community. (DK)

  17. The Vietnam Conflict: "America's Best Documented War?"

    ERIC Educational Resources Information Center

    Shaughnessy, C. A.

    1991-01-01

    Discusses problems with military documentation during the Vietnam War. Reports poor record keeping practices, destruction of permanent files, and mislabeled and missing records. Describes the National Archives' Vietnam project that organized and preserved the remaining military records. Concludes that the Vietnam War was better documented than the…

  18. Creative Chaos: Learning from the Yugoslavian War

    ERIC Educational Resources Information Center

    Roberson, Donald N., Jr.

    2010-01-01

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

  19. 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)

  20. 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…