Postdeployment Fertility Challenges and Treatment in the Modern Era

2019 ◽  
Vol 37 (05/06) ◽  
pp. 239-245
Author(s):  
Jessica A. Lentscher ◽  
Joshua C. Combs ◽  
Karrie Walker ◽  
Christopher M. Young ◽  
Rebecca Chason
Keyword(s):  
Brain Injuries ◽  
Spinal Cord Injuries ◽  
Blast Injuries ◽  
New Wave ◽  
Sperm Retrieval ◽  
Female Soldier ◽  
Perineal Wounds ◽  
New Applications ◽  
Improvised Explosive ◽  
Explosive Devices

AbstractCurrent war-fighting environments have shifted dramatically over the past decade, and with this change, new types of injuries are afflicting American soldiers. Operative Enduring Freedom and Operation Iraqi Freedom have noted an increased use of sophisticated improvised explosive devices by adversaries. Injuries not frequently seen in previous conflict are dismounted complex blast injuries, which involve multiple proximal amputations, pelvic fractures, and extensive perineal wounds. Thus, an unforeseen consequence of the decreased mortality rate after these complex blast injuries is a new wave of U.S. service members facing the challenges of recovering from the catastrophic amputations and genitourinary injuries. New applications of sperm retrieval methods may be used in these specific populations, as they recover and wish to purse family-building goals. Spinal cord injuries, traumatic brain injuries, and considerations unique to the female soldier are explored in this review of urologic care in wounded veterans.

Military Medicine in Contemporary Armed Conflict

2021 ◽  
pp. 73-91
Author(s):  
Michael L. Gross
Keyword(s):  
Brain Injuries ◽  
Military Medicine ◽  
The United States ◽  
Medical Attention ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Improvised Explosive ◽  
Explosive Devices ◽  
Provincial Reconstruction Teams ◽  
Host Nation

In the Iraq and Afghanistan wars (2001 and ongoing), military medicine saved more wounded than in any previous conflict. Improvised explosive devices (IEDs) injured tens of thousands of the more than three million warfighters deployed. Prominent wounds included multisystem injuries, traumatic brain injuries, limb loss, and post-traumatic stress (PTSD). To care for wounded service personnel, multinational forces established in-theater facilities for lightly and moderately wounded, while evacuating the critically injured to Europe and the United States. Coalition facilities could not offer comprehensive medical attention to host-nation allies or civilians. As the fighting progressed, multinational forces teamed up with local government agencies to slowly rebuild local medical infrastructures through Medical Civic Action Programs (MEDCAP) and Provincial Reconstruction Teams (PRT). As the conflicts wind down, Coalition nations face their responsibility to rebuild each country and to tend discharged veterans at home. Both tasks prove daunting.

Mass-Casualty Terrorist Bombings In Istanbul, Turkey, November 2003: Report of the Events and the Prehospital Emergency Response

2004 ◽  
Vol 19 (2) ◽  
pp. 133-145 ◽  
Author(s):  
Ülkümen Rodoplu ◽  
Jeffrey L. Arnold ◽  
Rifat Tokyay ◽  
Gurkan Ersoy ◽  
Serkan Cetiner ◽  
...  
Keyword(s):  
Emergency Response ◽  
Mass Casualty ◽  
Terrorist Attacks ◽  
Blast Injuries ◽  
American Hospital ◽  
Direct Measurements ◽  
Medical Facilities ◽  
Prehospital Emergency ◽  
Improvised Explosive ◽  
Explosive Devices

AbstractBackground:This paper describes the two mass-casualty, terrorist attacks that occurred in Istanbul, Turkey in November 2003, and the resulting prehospital emergency response.Methods:A complex, retrospective, descriptive study was performed, using open source reports, interviews, direct measurements of street distances, and hospital records from the American Hospital (AH) and Taksim Education and Research State Hospital (TERSH) in Istanbul.Results:On 15 November, improvised explosive devices (IEDs) in trucks were detonated outside the Neve Shalom and Beth Israel Synagogues, killing 30 persons and injuring an estimated additional 300. Victims were maldistributed to 16 medical facilities. For example, AH, a private hospital located six km from both synagogues, received 69 injured survivors, of which 86% had secondary blast injuries and 13% were admitted to the hospital. The TERSH, a government hospital located 1 km from both synagogues, received 48 injured survivors. On 20 November, IEDs in trucks were detonated outside the Hong Kong Shanghai Banking Corporation (HSBC) headquarters and the British Consulate (BC), killing 33 and injuring an estimated additional 450. Victims were maldistributed to 16 medical facilities. For example, TERSH, located 18 km from the HSBC site and 2 km from the the BC received 184 injured survivors, of which 93% had secondary blast injuries and 15% were hospitalized. The AH, located 9 km from the HSBC site and 6 km from the BC, received 16 victims.Conclusion:The twin suicide truck bombings on 15 and 20 November 2003 were the two largest terrorist attacks in modern Turkish history, collectively killing 63 persons and injuring an estimated 750 others. The vast majority of victims had secondary blast injuries, which did not require hospitalization. Factors associated with the maldistribution of casualties to medical facilities appeared to include the distance from each bombing site, the type of medical facility, and the personal preference of injured survivors.

Cognitive sequelae of blast-related versus other mechanisms of brain trauma

2009 ◽  
Vol 15 (1) ◽  
pp. 1-8 ◽  
Author(s):  
HEATHER G. BELANGER ◽  
TRACY KRETZMER ◽  
RUTH YOASH-GANTZ ◽  
TREVEN PICKETT ◽  
LARRY A. TUPLER
Keyword(s):  
Visual Memory ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Analysis Of Covariance ◽  
Neuropsychological Measures ◽  
Severity Of Injury ◽  
Cognitive Sequelae ◽  
Improvised Explosive ◽  
Explosive Devices

AbstractThe use of improvised explosive devices has become the hallmark of modern warfare and has resulted in an ever-increasing number of blast-related traumatic brain injuries (TBIs). Despite this fact, very little is actually known about the cognitive sequelae of blast-related TBIs. The purpose of the current study was to compare patterns of performance on neuropsychological measures in subjects who have sustained TBIs as a result of blast (or explosion) with those who have sustained TBIs from non-blast or blunt force trauma (motor vehicle accident, fall, assault, etc.). Participants were categorized as blast-related TBI or non-blast-related TBI and according to severity of injury (mild or moderate-to-severe). No main effects were observed in analysis of covariance between blast-related TBI participants and non-blast-related TBI participants across any of the neuropsychological variables, although an interaction was observed on a visual memory test showing stronger performance for mild blast-related and poorer performance for moderate-to-severe blast-related participants compared with both non-blast groups. Overall, the results do not provide any strong evidence that blast is categorically different from other TBI mechanisms, at least with regard to cognitive sequelae on select measures. Additional findings included a marginally increased incidence of reported posttraumatic stress disorder symptoms among blast-injured participants. (JINS, 2009, 15, 1–8.)

Peacekeepers suffered combat-related injuries in Mali: a retrospective, descriptive study

2018 ◽  
Vol 166 (3) ◽  
pp. 161-166
Author(s):  
Zhao Yongqiang ◽  
H Dousheng ◽  
L Yanning ◽  
M Xin ◽  
W Kunping
Keyword(s):  
Damage Control ◽  
Damage Control Surgery ◽  
Descriptive Study ◽  
Body Parts ◽  
Medical Treatment Facility ◽  
Chinese Military ◽  
Overseas Operations ◽  
Minor Injuries ◽  
Improvised Explosive ◽  
Explosive Devices

PurposeTo describe the combat-related injuries cured by Chinese Level 2 medical treatment facility (CHN L2) in Mali from 1 March 2016 to 1 March 2018, including type of weapon, mortality, nature of injuries, degree and location of injuries and surgical procedures.Methods A retrospective, descriptive study of 176 injured cases that met the terrorist attacks was conducted. The medical data were collected by an electronic database system. All collected data were entered into an Excel spreadsheet for calculation.ResultsWe found that improvised explosive devices (114/176, 65%) were the most commonly used weapons of attack in Mali. 68.75% of the injuries (121/176) were classified as 'minor injuries according to Abbreviated Injury Scale score. As one patient may suffer multiple injuries, each location and nature of injuries was counted separately. Surface injuries were the top (116/197, 58.88%), followed by orthopaedic injuries (52/197, 26.39%) and internal injuries (29/197, 14.72%). The extremities were the most frequently injured body parts (144/197, 73.09%). We operated 175 surgeries to deal with the 176 combat-related injuries, which accounted for 40.05% of all 437 surgeries. The surgical debridement to remove fragments of explosive was the most frequently performed surgery. We also admitted 20 cases (18/176, 34%) into intensive care unit and transferred 40 cases to Level 3 medical facility.Conclusion Peacekeepers taking protective measures for head and trunk frequently got surface injuries. And their unprotected extremities often got injured. The fragment removal was the top surgery and the damage control surgery was the highly technical nature surgery we performed. Chinese military should offer advanced surgical training course to military surgeons who carry out overseas operations.

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