scholarly journals Military thoracic gunshot wounds: A systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Amy Pullen ◽  
David Kieser ◽  
Gary Hooper
Keyword(s):  
Systematic Review ◽  
Gunshot Wounds ◽  
Medical Personnel ◽  
Electronic Database Search ◽  
Life Threatening ◽  
Meta Analyses ◽  
Combat Casualties ◽  
Improvised Explosive ◽  
Explosive Devices ◽  
Conference Papers

Abstract A systematic review of the literature was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to investigate the frequency of military thoracic gunshot wounds (GSWs) and deaths in combat theatres since World War Two (WW2). An electronic database search of World of Science, Scopus, Science Direct, PubMed and Microsoft Academic was conducted using the keywords ‘combat, casualties, thorax, gunshot, and military’ to identify peer-reviewed journals and conference papers on the topic. Twenty-three sources relevant to this review were identified and covered multiple theatres of operation. While there is a downward trend in the frequency of thoracic GSWs and fatalities likely due to the improvement of body armour, the improvement in medical treatment and increased frequency of improvised explosive devices (IEDs), the review shows that the advancement has not removed the likelihood of thoracic GSWs, which still accounted for approximately 15% of all thoracic injuries in the most recent combat theatres. The systematic review identifies that GSWs of the thorax continue to be a risk in military theatres and therefore, medical personnel should be aware of the frequency and severity of thoracic GSWs and should be prepared to treat these life-threatening injuries, as timely intervention is essential.

A Finite Element Study of Blast Overpressure on the Skull With and Without Helmet

2010 ◽  
Author(s):  
Jiangyue Zhang ◽  
Frank A. Pintar
Keyword(s):  
Armed Forces ◽  
Human Head ◽  
Gunshot Wounds ◽  
Blast Overpressure ◽  
Blunt Impact ◽  
Close Proximity ◽  
Life Threatening ◽  
Reflecting Surface ◽  
Improvised Explosive ◽  
Explosive Devices

The use of advanced personal armor, especially the helmet, during combat has significantly reduced the incidence and severity of life threatening penetrating injuries from gunshot and blast shrapnel to the head and improved the overall survival rate of soldiers in combat [1]. On the other hand, the number of blast related injuries (68%) has increased to more than 4 times that of gunshot wounds (15%) and other injuries (17%), among which blast-induced traumatic brain injury (bTBI) has became the signature wound of the U.S. armed forces in Iraq and Afghanistan due to increased use of improvised explosive devices (IED) and rocket-propelled grenades (RPG) by the insurgents [2–4]. It is well known in detonation physics that the presence of a close proximity surface will increase the overpressure on the target due to blast wave reflection [5, 6]. The helmet, which has saved many lives from otherwise fatal penetration and blunt impact injuries, may unfortunately also serve as a reflecting surface and pose increased blast injury threat to the head. Consequently, the current study was designed to compare blast overpressures on the skull with and without helmet using a human head computational model.

scholarly journals Machine Learning Algorithms in Cardiology Domain: A Systematic Review (Preprint)

2019 ◽  
Author(s):  
Georgy Kopanitsa ◽  
Aleksei Dudchenko ◽  
Matthias Ganzinger
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Search Strategy ◽  
Learning Algorithms ◽  
Machine Learning Algorithms ◽  
Learning System ◽  
Prisma Statement ◽  
Meta Analyses ◽  
Conference Papers ◽  
Huge Variety

BACKGROUND It has been shown in previous decades, that Machine Learning (ML) has a huge variety of possible implementations in medicine and can be very helpful. Neretheless, cardiovascular diseases causes about third of of all global death. Does ML work in cardiology domain and what is current progress in that regard? OBJECTIVE The review aims at (1) identifying studies where machine-learning algorithms were applied in the cardiology domain; (2) providing an overview based on identified literature of the state of the art of the ML algorithm applying in cardiology. METHODS For organizing this review, we have employed PRISMA statement. PRISMA is a set of items for reporting in systematic reviews and meta-analyses, focused on the reporting of reviews evaluating randomized trials, but can also be used as a basis for reporting systematic review. For the review, we have adopted PRISMA statement and have identified the following items: review questions, information sources, search strategy, selection criteria. RESULTS In total 27 scientific articles or conference papers written in English and reporting about implementation of an ML-method or algorithm in cardiology domain were included in this review. We have examined four aspects: aims of ML-systems, methods, datasets and evaluation metrics. CONCLUSIONS We suppose, this systematic review will be helpful for researchers developing machine-learning system for a medical domain and in particular for cardiology.

Iatrogenic Injuries in Manual and Mechanical Cardiopulmonary Resuscitation

2021 ◽  
pp. 000313482110475
Author(s):  
Magnus J. Chun ◽  
Yichi Zhang ◽  
Eman A. Toraih ◽  
Patrick R. McGrew
Keyword(s):  
Systematic Review ◽  
Chest Compression ◽  
Meta Analysis ◽  
Sternal Fracture ◽  
Iatrogenic Injuries ◽  
Mechanical Chest Compression ◽  
Manual Chest Compression ◽  
Significant Life ◽  
Life Threatening ◽  
Meta Analyses

Purpose Mechanical chest compression has been shown to be equivalent to manual chest compression in providing survival benefits to patients experiencing cardiac arrest. There has been a growing need for a contemporary review of iatrogenic injuries caused by mechanical in comparison with manual chest compression. Our study aims to analyze the studies that document significant life-threatening iatrogenic injuries caused by mechanical and manual chest compression. Methods A systematic review of PubMed and Embase was performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. All studies published after January 1st, 2000 were reviewed using inclusion/exclusion criteria and completed by May 2020. A total of 7202 patients enrolled in 15 studies were included in our meta-analysis. Results Significant life-threatening iatrogenic injuries had higher odds of occurring when mechanical chest compression was used compared to manual chest compression, especially for hemothorax and liver lacerations. Mechanical chest compression involves consistently deeper compression depths compared to manual chest compression, potentially resulting in more injuries. In the mechanical chest compression cohort, chest wall fractures had the highest incidence rate (55.7%), followed by sternal fracture (28.3%), lung injuries (3.7%), liver (1.0%), and diaphragm (.2%) lacerations. Conclusions Mechanical chest compression was associated with more iatrogenic injuries as compared to manual chest compression. Further research is needed to define the appropriate application of mechanical in comparison with manual chest compression in different scenarios. Levels of provider training, different mechanical chest compression device types, patient demographics, and compression duration/depth may all play roles in influencing outcomes.

Pictorial Review of Radiographic Patterns of Injury in Modern Warfare: Imaging the Conflict in Afghanistan

2011 ◽  
Vol 62 (2) ◽  
pp. 90-106 ◽  
Author(s):  
Ed R. Peramaki
Keyword(s):  
Medical Personnel ◽  
Organ Injury ◽  
War Wounds ◽  
Pictorial Review ◽  
Combat Injuries ◽  
Asymmetric Conflicts ◽  
Patterns Of Injury ◽  
Improvised Explosive ◽  
Injured Patients ◽  
Explosive Devices

Radiographic assessment of combat injuries has been an important component of casualty care in every major conflict of the 20th and 21st centuries. The advent of multislice computed tomography scanners has provided physicians with the ability to visualize organ injury at submillimetre resolution, changing the way war wounds are treated. Modern wars are, for the most part, asymmetric conflicts where improvised explosive devices have replaced artillery as a major cause of casualties. Both bullets and explosive devices wreak distinctive patterns of injury on the human body. Being able to recognize these patterns and their potential associated morbidities will allow medical personnel to provide expert and timely care to some of the most severely injured patients on earth. This series of pictorial essays will review the radiographic patterns of combat-related injury encountered in southern Afghanistan in 2008–2009.

Qualitative online research in tourism – a systematic review of the literature

2019 ◽  
Vol 75 (2) ◽  
pp. 448-465 ◽  
Author(s):  
Saeed Pahlevan-Sharif ◽  
Paolo Mura ◽  
Sarah N.R. Wijesinghe
Keyword(s):  
Systematic Review ◽  
Epistemological Beliefs ◽  
Online Research ◽  
Content Type ◽  
Qualitative Approaches ◽  
Meta Analyses ◽  
Online Methods ◽  
Conference Papers ◽  
Virtual Interactions

Purpose This paper aims to present a systematic review of tourism articles using qualitative online methods. By focussing on tourism journals, this work explores the paradigmatic beliefs, methodological approaches and methods underpinning tourism qualitative online research. Design/methodology/approach This review was conducted systematically by following the reporting checklist of the preferred reporting items for systematic reviews and meta-analyses by the Centre for Reviews and Dissemination. Findings Overall, this systematic review indicates that the ontological and epistemological beliefs guiding online research are not clearly expressed by tourism scholars. It also shows that the possibility of using the internet for more interactive and participatory forms of research has not been fully explored by tourism scholars. Research limitations/implications This paper expands tourism scholars’ awareness of the range of qualitative approaches/methods available by suggesting additional research instruments that could replace or complement the traditional ones. However, by selecting only indexed journal papers, other sources of publications, such as papers published in non-Scopus and non-Web-of-Science journals, books, book chapters and conference papers, were not included in the current review. Originality/value This work emphasizes the important role of cyberspace in facilitating virtual interactions between researchers and participants in the co-construction of qualitative empirical material.

scholarly journals The Approach of Pregnant Women to Vaccination Based on a COVID-19 Systematic Review

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 977
Author(s):  
Sławomir M. Januszek ◽  
Anna Faryniak-Zuzak ◽  
Edyta Barnaś ◽  
Tomasz Łoziński ◽  
Tomasz Góra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Public Awareness ◽  
Medical Personnel ◽  
Vaccine Safety ◽  
Health Science ◽  
South American ◽  
Factors Affecting ◽  
Public Health Agencies ◽  
Meta Analyses

Background and Objectives: Pregnant women are more likely to develop a more severe course of COVID-19 than their non-pregnant peers. There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnant women. The aim of this study is to conduct a systematic review concerning the approach of pregnant women towards vaccination against COVID-19, with particular regard to determinants of vaccination acceptance. Materials and Methods: Articles were reviewed in which the aim was to evaluate—via a survey or questionnaire—the acceptance and decision to undergo vaccination against COVID-19. The articles were subjected to review according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Results: In various studies, the percentage of pregnant women accepting the COVID-19 vaccine was between 29.7% and 77.4%. The strongest factors co-existing with the acceptance of the COVID-19 vaccination in pregnancy were trust in the importance and effectiveness of the vaccine, explicit communication about the safety of COVID-19 vaccines for pregnant women, acceptance of other vaccinations such as those for influenza, belief in the importance of vaccines/mass vaccination in one’s own country, anxiety about COVID-19, trust in public health agencies/health science, as well as compliance to mask guidelines. The remaining factors were older age, higher education, and socioeconomic status. Conclusions: This review allowed us to show that geographic factors (Asian, South American countries) and pandemic factors (different threats and risks from infection) significantly influence the acceptance of vaccines. The most significant factors affecting acceptance are those related to public awareness of the risk of infection, vaccine safety, and the way in which reliable information about the need and safety of vaccines is provided. Professional and reliable patient information by obstetricians and qualified medical personnel would significantly increase the level of confidence in vaccination against COVID-19.

scholarly journals Comparison of splint and conventional cast for treating wrist torus fractures in children (systematic review)

2017 ◽  
Vol 6 (4) ◽  
Author(s):  
Abdulrahman Alsawadi ◽  
Mustafa Abbas
Keyword(s):  
Systematic Review ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cost Effective ◽  
Easy Access ◽  
Fractures In Children ◽  
Cost Effective Treatment ◽  
Electronic Database Search ◽  
Randomised Controlled ◽  
Meta Analyses

<span>Wrist torus fractures in children are common. Although it might be simple and straightforward, the management of these injuries remains controversial and depends on the personal experience and preference of the treating physician. The consensus agreement, however, is that these fractures are inherently stable. Some authors argue that splints should replace the traditional method of cast immobilisation. The splints are viewed as easier to use, more convenient and do not require follow up clinics for removal. It has also been argued that splints are more cost-effective than casts. The aim of this systematic review is to examine the effectiveness and cost-effectiveness of removable splints versus casts in the treatment of torus wrist fractures of children in the current literature. This review followed the Systematic reviews and Meta-Analyses (PRISMA) statement for reporting. Comprehensive electronic database search and handsearch were conducted. Studies were considered for review if they were randomised or quasi-randomised controlled trial and compared removable splints and casts for treating torus fractures of distal radius and/or ulna in children. Four papers identified by two reviewers as potentially eligible for inclusion were appraised and two identified for inclusion were further assessed for any risk of bias. Data were narratively presented and discussed as meta-analysis would not have been possible for the identified studies. The limited available data favours the use of splint as a clinically effective and more cost-effective method of immobilisation. However, the findings of the systematic review are limited by the quality of the identified studies. It has been viewed that explanation to patients and parents and involving them in the decision, plus implementation of safety protocol to avoid under-treatment of misdiagnosed fractures and allow easy access of patients to the clinic, is an alternative way to provide safe, convenient and cost-effective treatment. </span>

scholarly journals Fluid Extravasation in Shoulder Arthroscopic Surgery: A Systematic Review

2018 ◽  
Vol 6 (5) ◽  
pp. 232596711877161 ◽  
Author(s):  
Muzammil Memon ◽  
Jeffrey Kay ◽  
Arian Gholami ◽  
Nicole Simunovic ◽  
Olufemi R. Ayeni
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Respiratory Compromise ◽  
Level Of Evidence ◽  
Fluid Extravasation ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Meta Analyses

Background: Arthroscopic surgery of the shoulder joint has become increasingly more common given its advantages over open surgery; however, one rare but potentially life-threatening complication is fluid extravasation into the surrounding tissues, causing edema, respiratory compromise, abnormal results on laboratory blood tests, and possibly death. Currently, no systematic review exists that summarizes the existing clinical research on this topic. Purpose: To perform a systematic review on fluid extravasation as a complication of shoulder arthroscopic surgery, specifically assessing clinical presentation, risk factors, management, and outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: Two reviewers independently searched 3 databases (PubMed, Ovid [MEDLINE], and Embase) from database inception until July 1, 2017. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guided the reporting and data abstraction. The methodological quality of these studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. The results are presented in a narrative summary fashion using descriptive statistics including ranges and agreement statistics. Results: A total of 26 studies (20 case reports, 4 case series, and 2 prospective comparative studies) encompassing 205 patients (mean age, 50.8 years [range, 15-83 years]) were included. The most common signs of fluid extravasation included chest wall swelling (n = 86) and neck swelling (n = 116). In 32 patients, observation alone was sufficient. Other patients required airway intubation (n = 16), diuretics (n = 7), steroids (n = 1), and percutaneous drainage of fluid (n = 1). Clinical edema resolved after 2 to 48 hours, and patients were discharged 1 to 20 days postoperatively. Serious complications included transfer to the intensive care unit (n = 14), anterior interosseous nerve palsy (n = 4), rhabdomyolysis (n = 1), and death (n = 1). Conclusion: Fluid extravasation has the potential to be a life-threatening complication of shoulder arthroscopic surgery; however, it is most commonly managed nonoperatively, and symptoms typically resolve with no evidence of long-term complications. Intraoperative surgical decisions, such as minimizing the surgical time and volume of irrigation fluid used, may limit fluid extravasation, while careful intraoperative monitoring may facilitate prompt diagnosis and management to optimize patient outcomes.

Civilian and Military Trauma: Does Civilian Training Prepare Surgeons for the Battlefield?

2011 ◽  
Vol 77 (1) ◽  
pp. 19-21 ◽  
Author(s):  
Michael S. Truitt ◽  
Van Johnson ◽  
Manuel Rivera ◽  
Alicia Mangram ◽  
Manuel Lorenzo ◽  
...  
Keyword(s):  
Gunshot Wounds ◽  
Resident Training ◽  
Domestic Terrorism ◽  
Trauma Patients ◽  
Civilian Trauma ◽  
Military Trauma ◽  
Extremity Injuries ◽  
Improvised Explosive ◽  
Explosive Devices ◽  
The Military

The management of trauma patients continues to be a major focus of resident training. The purpose of this review is to compare the mechanism and distribution of injuries in civilian and military trauma and to ascertain whether we are optimally preparing surgeons for the injuries seen on the battlefield. We performed a retrospective 5-year review of all trauma admissions to our urban trauma center (TC). We then compared this data with that recently acquired from Operation Iraqi Freedom (OIF). There were 7732 trauma patients seen during that time at our TC with 9.8 per cent sustaining gunshot wounds. Of those, 26 per cent sustained a gunshot wound to the thorax, and injuries to the abdomen and pelvis were sustained in 28.5 per cent. In total, truncal trauma accounted for 55 per cent of the injuries. Extremity injuries occurred in just 31 per cent. Data from OIF show the mechanism and distribution of injuries to be quite different. Improvised explosive devices accounted for greater than 50 per cent of the injuries in OIF. Truncal injuries accounted for just 14 per cent of the injuries seen and extremity injuries accounted for, a significant, 56 per cent of all the injuries observed. The civilian experience with gunshot wounds often focuses on truncal trauma, yet the military data show a need for knowledge of devastating injuries to the extremity. This divergent experience may be even more salient in the future as the battlefield is brought closer to home through domestic terrorism and the line is blurred between military and civilian trauma.

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