5,353 results match your criteria Blast Injuries


Local injection of a hexametaphosphate formulation reduces heterotopic ossification .

Mater Today Bio 2020 Jun 2;7:100059. Epub 2020 Jun 2.

Healthcare Technologies Institute, School of Chemical Engineering, University of Birmingham, Edgbaston, B15 2TT, UK.

Heterotopic ossification (HO), the pathological formation of ectopic bone, is a debilitating condition which can cause chronic pain, limit joint movement, and prevent prosthetic limb fitting. The prevalence of this condition has risen in the military population, due to increased survivorship following blast injuries. Current prophylaxes, which aim to target the complex upstream biological pathways, are inconsistently effective ​and have a range of side-effects that make them unsuitable for combat-injured personnel. Read More

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http://dx.doi.org/10.1016/j.mtbio.2020.100059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322360PMC

Blast-induced hearing impairment in rats is associated with structural and molecular changes of the inner ear.

Sci Rep 2020 Jun 30;10(1):10652. Epub 2020 Jun 30.

Blast-Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Bethesda, MD, USA.

Auditory dysfunction is the most prevalent injury associated with blast overpressure exposure (BOP) in Warfighters and civilians, yet little is known about the underlying pathophysiological mechanisms. To gain insights into these injuries, an advanced blast simulator was used to expose rats to BOP and assessments were made to identify structural and molecular changes in the middle/inner ears utilizing otoscopy, RNA sequencing (RNA-seq), and histopathological analysis. Deficits persisting up to 1 month after blast exposure were observed in the distortion product otoacoustic emissions (DPOAEs) and the auditory brainstem responses (ABRs) across the entire range of tested frequencies (4-40 kHz). Read More

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http://dx.doi.org/10.1038/s41598-020-67389-5DOI Listing

Tornadic Shear Stress Induces a Transient, Calcineurin-Dependent Hypervirulent Phenotype in Mucorales Molds.

mBio 2020 Jun 30;11(3). Epub 2020 Jun 30.

Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

Trauma-related necrotizing myocutaneous mucormycosis (NMM) has a high morbidity and mortality in victims of combat-related injuries, geometeorological disasters, and severe burns. Inspired by the observation that several recent clusters of NMM have been associated with extreme mechanical forces (e.g. Read More

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http://dx.doi.org/10.1128/mBio.01414-20DOI Listing

Assessment of computed tomography indications and computed tomography reports for usefulness in clinical presentation at postoperative follow-up of gunshot wound cases.

Ulus Travma Acil Cerrahi Derg 2020 Jun;26(4):613-619

Deparmant of General Surgery, University of Health Sciences Gülhane Training and Research Hospital, Ankara-Turkey.

Background: The present study aimed to evaluate the results of lower thoracic tomography (LTT) and upper abdominal tomography (UAT) of the patients who were treated and followed at our tertiary center due to gunshot wounds (GSWs).

Methods: The present research was designed as a retrospective descriptive study. All patients, who were admitted to our clinic due to GSW between January 2016 and April 2020, were retrospectively analyzed. Read More

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http://dx.doi.org/10.14744/tjtes.2020.26862DOI Listing

Postdeployment Fertility Challenges and Treatment in the Modern Era.

Semin Reprod Med 2020 Jun 25. Epub 2020 Jun 25.

Shady Grove Fertility Center, Annapolis, Maryland.

Current 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. Read More

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http://dx.doi.org/10.1055/s-0040-1713430DOI Listing

Cerebral perfusion is associated with blast exposure in military personnel without moderate or severe TBI.

J Cereb Blood Flow Metab 2020 Jun 24:271678X20935190. Epub 2020 Jun 24.

Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA.

Due to the use of improvised explosive devices, blast exposure and mild traumatic brain injury (mTBI) have become hallmark injuries of the Iraq and Afghanistan wars. Although the mechanisms of the effects of blast on human neurobiology remain active areas of investigation, research suggests that the cerebrovasculature may be particularly vulnerable to blast via molecular processes that impact cerebral blood flow. Given that recent work suggests that blast exposure, even without a subsequent TBI, may have negative consequences on brain structure and function, the current study sought to further understand the effects of blast exposure on perfusion. Read More

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http://dx.doi.org/10.1177/0271678X20935190DOI Listing

[Advances in research on changes of coagulation system after primary blast injury].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2020 May;32(5):632-635

Department of Emergency, the First Medical Center to Chinese People's Liberation Army General Hospital, Beijing 100853, China. Corresponding author: Li Tanshi, Email:

Blast injury is the main cause of injury in the battlefield, which also occurs frequently in the civil field and modern society. The damage caused by blast is more complicated than other types of trauma. Primary blast injury is a common type of blast injury, which can cause multiple organ damage with complex mechanism. Read More

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http://dx.doi.org/10.3760/cma.j.cn121430-20200106-00091DOI Listing

Effects of Blast Wave-induced Biomechanical Changes on Lung Injury in Rats.

Biomed Environ Sci 2020 May;33(5):338-349

Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China.

Objective: To observe the dynamic impacts of shock waves on the severity of lung injury in rats with different injury distances.

Methods: Simulate open-field shock waves; detect the biomechanical effects of explosion sources at distances of 40, 44, and 48 cm from rats; and examine the changes in the gross anatomy of the lungs, lung wet/dry weight ratio, hemoglobin concentration, blood gas analysis, and pathology.

Results: Biomechanical parameters such as the overpressure peak and impulse were gradually attenuated with an increase in the injury distance. Read More

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http://dx.doi.org/10.3967/bes2020.046DOI Listing

Risk of Acute Kidney Injury in Combat-Injured Patients Associated With Concomitant Vancomycin and Extended-Spectrum β-Lactam Antibiotic Use.

J Intensive Care Med 2020 Jun 8:885066620930994. Epub 2020 Jun 8.

Brooke Army Medical Center, JBSA, Fort Sam Houston, TX, USA.

Background: Multidrug-resistant infections complicating combat-related trauma necessitate the use of broad-spectrum antimicrobials. Recent literature posits an association between vancomycin (VANC) and piperacillin-tazobactam (VPT) combination therapy and acute kidney injury (AKI). We examined whether therapy with VPT was associated with an increased risk of AKI compared to VANC and other broad-spectrum β-lactam antibiotics (VBL) following combat-related injuries. Read More

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http://dx.doi.org/10.1177/0885066620930994DOI Listing

A prospective observational study of acute traumatic coagulopathy in traumatic bleeding from the battlefield.

Transfusion 2020 Jun 1;60 Suppl 3:S52-S61. Epub 2020 Jun 1.

St Thomas' Hospital, Thrombosis & Haemophilia Centre & Thrombosis and Vascular Biology Group, London, UK.

Background: Acute trauma coagulopathy (ATC) after military trauma has not been comprehensively studied. ATC is defined as a prolonged prothrombin time ratio (PTr) or reduced clot amplitude (A5) in viscoelastic testing. Compared to civilian trauma, military trauma has more injuries from explosions and gunshot wounds (GSWs), potentially leading to a different pathophysiology for traumatic coagulopathy. Read More

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http://dx.doi.org/10.1111/trf.15658DOI Listing

Improvised Explosive Device Blast Injuries to the Craniofacial Region: Wound Characteristics and Management.

J Craniofac Surg 2020 May 28. Epub 2020 May 28.

Armed Forces, India.

Improvised explosive device blast injuries frequently report at our center and showed the maximum amount of contamination and damage, both in the facial soft tissues and the skeletal tissues with impregnation of splinters with size ranging from 2 mm to 10 mm. Should splinters be always explored is questionable and varies with every case. The reconstruction in such cases was done with titanium mini-plates along with extensive use of local vascular flaps for soft tissue repair in majority of the cases. Read More

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http://dx.doi.org/10.1097/SCS.0000000000006560DOI Listing
May 2020
0.676 Impact Factor

Ankara bombing: distribution of injury patterns with radiological imaging.

Pol J Radiol 2020 12;85:e90-e96. Epub 2020 Feb 12.

Ankara City Hospital, Ankara, Turkey.

Purpose: To describe and explain the blast injuries and imaging findings in the Ankara terrorist explosion that took place on October 10, 2015.

Material And Methods: A total of 77 patients who underwent radiologic imaging were classified as primary, secondary, tertiary, and quaternary, according to the injury type. The patients were evaluated based on body regions, such as head and neck, thorax, abdomen, lower extremity, and upper extremity. Read More

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http://dx.doi.org/10.5114/pjr.2020.93394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247021PMC
February 2020

Blunderbuss: Ocular and Orbital Injuries Due to Muzzle-Loading Firearms.

Ophthalmic Plast Reconstr Surg 2020 May 26. Epub 2020 May 26.

Department of Ophthalmology & Visual Sciences, Vanderbilt Eye Institute, Vanderbilt University Medical Center.

Purpose: Injury to the eye and/or orbital and adnexal structures associated with antiquated muzzle-loading firearms has not, to our knowledge, been characterized with the exception of a single case report.

Methods: A retrospective chart review of 7 patients treated at Vanderbilt University Medical Center from 2003 to 2017 who sustained traumatic injuries to the ocular and/or orbital structures secondary to the discharge of muzzle-loading firearms. The study was approved by the Vanderbilt Institutional Review Board. Read More

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http://dx.doi.org/10.1097/IOP.0000000000001709DOI Listing

Spinal Immobilization in Disasters: A Systematic Review.

Prehosp Disaster Med 2020 May 29:1-6. Epub 2020 May 29.

CRIMEDIM, Università del Piemonte Orientale, Novara, Italy.

In response to the International Liaison Committee on Resuscitation (ILCOR; Niel, Belgium) release of an updated recommendation related to out-of-hospital spinal immobilization (SI) practice in 2015, a systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist of English-language studies published from January 2000 through July 2019 on the use of SI in resource-scarce environments (RSEs). Studies meeting the following criteria were included in the analysis: peer-reviewed statistical studies or reports detailing management of potential traumatic spinal injury in RSE, civilian, and military environments; as well as consensus clinical guidelines, academic center, or professional association protocols or policy statements detailing management of potential traumatic spinal injury in RSE, civilian, and military environments; statistical analysis; and subsequent management of spinal injuries after mass-casualty incidents, in complex humanitarian events or conflict zones, low-to middle-income countries, or prolonged transport times published by government and non-government organizations. Studies excluded from consideration were those not related to a patient with a potential traumatic spinal injury after a mass-casualty incident, in complex humanitarian event or conflict zones, in low-to middle-income countries, or with prolonged transport times. Read More

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http://dx.doi.org/10.1017/S1049023X20000680DOI Listing

The Ethical Triage and Management Guidelines of the Entrapped and Mangled Extremity in Resource Scarce Environments: A Systematic Literature Review.

Disaster Med Public Health Prep 2020 May 27:1-9. Epub 2020 May 27.

MS3 Medical University of South Carolina, Charleston, SC.

Objective: A systematic literature review (SLR) was performed to elucidate the current triage and treatment of an entrapped or mangled extremity in resource scarce environments (RSEs).

Methods: A lead researcher followed the search strategy following inclusion and exclusion criteria. A first reviewer (FR) was randomly assigned sources. Read More

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http://dx.doi.org/10.1017/dmp.2020.49DOI Listing

The Behavioral Neuroscience of Traumatic Brain Injury.

Psychiatr Clin North Am 2020 Jun;43(2):305-330

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Traumatic brain injury is a calamity of various causes, pathologies, and extremely varied and often complex clinical presentations. Because of its predilection for brain systems underlying cognitive and complex behavioral operations, it may cause chronic and severe psychiatric illness that requires expert management. This is more so for the modern epidemic of athletic and military brain injuries which are dominated by psychiatric symptoms. Read More

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http://dx.doi.org/10.1016/j.psc.2020.02.009DOI Listing

Comprehensive analysis of combat casualty outcomes in U.S. servicemembers from the beginning of World War II to the end of Operation Enduring Freedom.

J Trauma Acute Care Surg 2020 May 19. Epub 2020 May 19.

Division of Traumatology, Surgical Critical Care & Emergency Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Advances in combat casualty care have improved combat survivability over the past two decades. However, these outcomes remain incompletely framed in the broader context of combat casualty outcomes over the past eighty years. We hypothesized that starting with World War II, combat survival worsened at the beginning of each new conflict but then improved over time. Read More

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http://dx.doi.org/10.1097/TA.0000000000002789DOI Listing

Bomb Explosion: Ocular Effects of Primary, Secondary and Tertiary Mechanisms.

Clin Ophthalmol 2020 28;14:1145-1151. Epub 2020 Apr 28.

Somalia Mogadishu - Turkey Education and Research Hospital, Department of Radiology, Banadir, Mogadishu, Somalia.

Purpose: To report the type and severity of ocular injuries sustained by the survivors of a bomb-loaded explosion that occurred in Mogadishu, Somalia on December 28, 2019.

Patients And Methods: The recorded data included age, gender, wounded eye, initial examination of ocular injuries and associated systemic injuries, initial visual acuity, anterior and posterior segment examinations. The type of injury (open vs closed globe), the injured zone of the globe, and the presence of a relative afferent pupil defect were evaluated in all cases where possible. Read More

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http://dx.doi.org/10.2147/OPTH.S253438DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196204PMC

Outcomes of tranexamic acid administration in military trauma patients with intracranial hemorrhage: a cohort study.

BMC Emerg Med 2020 May 14;20(1):39. Epub 2020 May 14.

Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD, 20889, USA.

Background: Tranexamic acid (TXA) may be a useful adjunct for military patients with severe traumatic brain injury (TBI). These patients are often treated in austere settings without immediate access to neurosurgical intervention. The purpose of this study was to evaluate any association between TXA use and progression of intracranial hemorrhage (ICH), neurologic outcomes, and venous thromboembolism (VTE) in TBI. Read More

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http://dx.doi.org/10.1186/s12873-020-00335-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222426PMC

Characteristics and treatments of ocular blast injury in Tianjin explosion in China.

BMC Ophthalmol 2020 May 6;20(1):185. Epub 2020 May 6.

Department of Ophthalmology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Tianjin, 300052, China.

Background: To document characteristics and treatments of ocular blast injury from a fire and explosion.

Method: Authors retrospectively evaluated 116 patients with 166 eye injuries from six hospitals. Terminology of ocular injury referred to Birmingham Eye Trauma Terminology, and best-corrected visual acuity (BCVA) was categorized with the ocular trauma score (OTS) grading system. Read More

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http://dx.doi.org/10.1186/s12886-020-01448-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203803PMC
May 2020
1.075 Impact Factor

Physical effects of sound exposure from underwater explosions on Pacific sardines (Sardinops sagax).

J Acoust Soc Am 2020 Apr;147(4):2383

University of Maryland, College Park, Maryland 20742, USA.

Explosions from activities such as construction, demolition, and military activities are increasingly encountered in the underwater soundscape. However, there are few scientifically rigorous data on the effects of underwater explosions on aquatic animals, including fishes. Thus, there is a need for data on potential effects on fishes collected simultaneously with data on the received signal characteristics that result in those effects. Read More

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http://dx.doi.org/10.1121/10.0001064DOI Listing

Lateral External-fixation Adjacent to Radial Nerve.

Cureus 2020 Mar 27;12(3):e7435. Epub 2020 Mar 27.

Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, USA.

Introduction The aim of our study was to describe the injury pattern and outcomes of active-duty subjects that underwent humeral external fixation and to determine if the placement of external fixator pins outside of the radial nerve safe zones is correlated with injury to the radial nerve. Materials and methods We examined all US Service members treated with humeral external fixation at our facility from June 2005 through June 2015. The mechanism of injury, injury pattern, location of external fixation application, pre- and postoperative radial nerve function, presence or absence of radial nerve transection from injury or external fixation, anatomic location of pins in relation to the radial nerve safe zone, and final radial nerve outcomes were recorded. Read More

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http://dx.doi.org/10.7759/cureus.7435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186088PMC

Cranial Vault Defects and Deformities Resulting from Combat-Related Gunshot, Blast and Splinter Injuries: How Best to Deal with Them.

Authors:
Priya Jeyaraj

J Maxillofac Oral Surg 2020 Jun 12;19(2):184-207. Epub 2019 Jul 12.

Division of Oral and Maxillofacial Surgery, Military Dental Centre (Gough Lines), Secunderabad, India.

Combat-related gunshot and blast injuries of the craniomaxillofacial region present a unique and challenging situation for the maxillofacial and reconstructive surgeon. The devastating cosmetic deformities and severe functional debility ensuing as a result of extensive hard and soft tissue disruption caused by these highly complex injuries, can have disastrous consequences, unless managed in a swift and efficient manner, by a multidisciplinary team approach. Large calvarial defects and deformities are frequent sequelae of these injuries and could result from shattering of the cranial vault by the force of an exploding shell, mine or improvised explosive device, or due to penetration of the skull by the projectile, such as a bullet, flying splinters or shrapnel. Read More

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http://dx.doi.org/10.1007/s12663-019-01258-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7176805PMC

Terrorist attacks: common injuries and initial surgical management.

Eur J Trauma Emerg Surg 2020 Apr 27. Epub 2020 Apr 27.

Department of Trauma Surgery and Orthopaedics, Reconstructive and Septic Surgery, Sports Traumatology, German Armed Forces Hospital, Ulm, Germany.

Terrorism-related incidents and shootings that involve the use of war weapons and explosives are associated with gunshot and blast injuries. Despite the perceived threat of terrorism, these incidents and injuries are rare in Germany. For this reason, healthcare providers are unlikely to have a full understanding of the special aspects of managing these types of injuries. Read More

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http://dx.doi.org/10.1007/s00068-020-01342-zDOI Listing

Head and neck injuries after a bomb explosion: Diagnostic findings and treatment approaches.

Am J Otolaryngol 2020 Jul - Aug;41(4):102489. Epub 2020 Apr 17.

Department of Ophthalmology, University of Health Sciences-Somalia Turkey Recep Tayyip Erdogan Education and Research Hospital, Mogadishu, Somalia. Electronic address:

Objective: To identify the types and severity of head, face and neck (HFN) injuries, which occurred as a result of a bomb explosion and reached serious life-threatening levels, using radiological imaging methods, and to discuss the options of treatment at the time of presentation.

Methods: Of the 16 patients brought to the emergency department, 14 with HFN injuries were included in the study. Computed tomography (CT) and radiography scans were performed at the time of presentation in all patients, except for one. Read More

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http://dx.doi.org/10.1016/j.amjoto.2020.102489DOI Listing

Kinematic and Biomechanical Response of Post-Mortem Human Subjects Under Various Pre-Impact Postures to High-Rate Vertical Loading Conditions.

Stapp Car Crash J 2019 Nov;63:235-266

Emory University, Atlanta, GA.

Limited data exist on the injury tolerance and biomechanical response of humans to high-rate, under-body blast (UBB) loading conditions that are commonly seen in current military operations, and there are no data examining the influence of occupant posture on response. Additionally, no anthropomorphic test device (ATD) currently exists that can properly assess the response of humans to high-rate UBB loading. Therefore, the purpose of this research was to examine the response of post-mortem human surrogates (PMHS) in various seated postures to high-rate, vertical loading representative of those conditions seen in theater. Read More

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November 2019

A Shoulder Injury Criterion for the EuroSID-2re Applicable in a Large Loading Condition Spectrum of the Military Domain.

Stapp Car Crash J 2019 Nov;63:147-176

DGA TT (Bourges, France).

The EuroSID-2re (ES-2re) is an Anthropometric Test Device (ATD) from the automotive domain designed for lateral impact. Since the 2000's, it has also been used by NATO armies to assess the risk of injury to armored vehicles occupants submitted to an Improvised Explosive Device (IED) attack. The resulting loading conditions from an explosion can vary a lot in term of impact velocity and duration. Read More

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November 2019

Effect of sitting posture on pelvic injury risk under vertical loading.

J Mech Behav Biomed Mater 2020 Aug 17;108:103780. Epub 2020 Apr 17.

Department of Biomedical Engineering, The University of Melbourne, Australia. Electronic address:

Underbody blast (UBB) attacks on military vehicles can result in severe pelvic injuries to the vehicle occupants. The aim of this study was to evaluate the biomechanical responses of the pelvis to UBB-like vertical loading in different seated postures. High-rate axial loading were performed on six defleshed human cadaveric pelves, whilst a three-dimensional finite element model of a human pelvis was created and used to simulate the high-rate loading with the model responses validated against experimental measurements. Read More

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http://dx.doi.org/10.1016/j.jmbbm.2020.103780DOI Listing

Human lumbar spinal column injury criteria from vertical loading at the base: Applications to military environments.

J Mech Behav Biomed Mater 2020 May 13;105:103690. Epub 2020 Feb 13.

SURVICE Engineering Co, USA.

The objective of this study was to determine force-based lumbar spine injury criteria due to vertical impact using Post Mortem Human Surrogate (PMHS) experiments. Mounted personnel in military vehicles sustain loads from the pelvis in combat events such as underbody blast loadings. Forty-three post mortem human subject thoracolumbar spinal columns were obtained, screened for pre-existing trauma, bone mineral densities (BMDs) were determined, pre-test radiological images were taken, fixed at the ends in polymethylmethacrylate, load cells were attached to the ends of the fixation, positioned on custom vertical accelerator device based on a military-seating posture, and impacted at the base. Read More

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http://dx.doi.org/10.1016/j.jmbbm.2020.103690DOI Listing

United States Special Operations Command Fatality Study of Subcommands, Units, and Trends.

J Trauma Acute Care Surg 2020 Apr 6. Epub 2020 Apr 6.

Defense Health Agency, Joint Trauma System, Joint Base San Antonio-Fort Sam Houston, Texas.

Background: Death from injury occurs predominantly in prehospital settings. Injury prevention and prehospital care of military forces is the responsibility of combatant commanders. Medical examiner and trauma systems should routinely study fatalities and inform commanders of mortality trends. Read More

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http://dx.doi.org/10.1097/TA.0000000000002699DOI Listing

Gold panner blast hand.

Hand Surg Rehabil 2020 Mar 29. Epub 2020 Mar 29.

Sourou Sanou University Hospital, Sikasso Sira, Bobo-Dioulasso, Burkina Faso.

"Blast hand" is a traumatic hand injury related to an explosion. Artisanal gold miners use dynamite to excavate gold pits; such activities expose them to blast hand injuries. This work aims to study blast injuries to gold miners' hands. Read More

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http://dx.doi.org/10.1016/j.hansur.2020.03.001DOI Listing

Emergency first responder management of combat injuries to the torso in the military, remote and austere settings.

BMJ Mil Health 2020 Mar 29. Epub 2020 Mar 29.

Academic Department of Military Surgery and Trauma, Birmingham, UK

Traumatic injuries to the torso account for almost a quarter of all injuries seen in combat and are typically secondary to blast or gunshot wounds. Injuries due to road traffic collisions or violence are also relatively common during humanitarian and disaster relief efforts. There may also be multiple injured patients in these settings, and surgical care may be limited by a lack of facilities and resources in such a non-permissive environment. Read More

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http://dx.doi.org/10.1136/bmjmilitary-2020-001460DOI Listing

Fracture union rates across a century of war: a systematic review of the literature.

BMJ Mil Health 2020 Mar 26. Epub 2020 Mar 26.

The Royal British Legion Centre for Blast Injury Studies, Imperial College London, London, UK.

Introduction: Fractures have been a common denominator of the injury patterns observed over the past century of warfare. The fractures typified by the blast and ballistic injuries of war lead to high rates of bone loss, soft tissue injury and infection, greatly increasing the likelihood of non-union. Despite this, no reliable treatment strategy for non-union exists. Read More

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http://dx.doi.org/10.1136/bmjmilitary-2019-001375DOI Listing

The Face of War: Maxillofacial Patients in the Syrian Civil War.

J Craniofac Surg 2020 Mar 23. Epub 2020 Mar 23.

Oral and Maxillofacial Surgery Department, Baruch Padeh Medical Center, Poriya.

The type of the armed conflict on the Syrian battle field acquired several types of injuries; including injuries that were caused by explosive, shrapnel and blast injuries.In the current study, the authors conducted an overview of maxillofacial patients, who mainly suffered from ballistic injuries in term of injuries, reconstruction, and management.Overall, 53 maxillofacial Syrian patients were treated. Read More

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http://dx.doi.org/10.1097/SCS.0000000000006321DOI Listing

Low-Level Blast Exposure in Humans A Systematic Review of Acute and Chronic Effects.

J Spec Oper Med 2020 ;20(1):87-93

There is growing concern that military breaching and training and firing artillery and mortars, grenades, and shoulder-fired weapons may have some type of cumulative deleterious effects. There are anecdotal reports of those with repetitive exposure to low-level blast complaining of various symptoms, as well as increasing empirical evidence. The purpose of this report is to provide a systematic review of the literature on repetitive lowlevel blast as it pertains to military and police training protocols. Read More

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Assessment of firearm injuries undergoing advanced airway management: Role II hospital experience.

Ulus Travma Acil Cerrahi Derg 2020 Mar;26(2):301-305

Department of Emergency Medicine, Kütahya University of Health Sciences Faculty of Medicine, Kütahya-Turkey.

Background: Airway problems are one of the most important factors affecting mortality in firearm injuries. The present study aims to examine the data of patients who underwent advanced airway support due to explosion and bullet injuries in a Role II hospital.

Methods: Ninety three patients who underwent advanced airway support due to gunshot wounds in a Role II hospital between January 2015 and September 2016 were included in this study. Read More

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http://dx.doi.org/10.14744/tjtes.2020.59956DOI Listing

Pelvic injury patterns in blast: Morbidity and mortality.

J Trauma Acute Care Surg 2020 Jun;88(6):832-838

From the The Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering (I.A.R., C.E.W., I.G., J.C.C., S.D.M.), Imperial College London, London; and Centre for Defence Radiology (I.G.), HMS Nelson, Portsmouth, United Kingdom.

Background: Pelvic trauma has emerged as one of the most severe injuries to be sustained by the victim of a blast insult. The incidence and mortality due to blast-related pelvic trauma is not known, and no data exist to assess the relative risk of clinical or radiological indicators of mortality.

Methods: The UK Joint Theater Trauma Registry was interrogated to identify those sustaining blast-mediated pelvic fractures during the conflicts in Iraq and Afghanistan, from 2003 to 2014, with subsequent computed tomography image analysis. Read More

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http://dx.doi.org/10.1097/TA.0000000000002659DOI Listing

Outpatient Pharmacy Prescriptions During the First Year Following Serious Combat Injury: A Retrospective Analysis.

Mil Med 2020 Mar 16. Epub 2020 Mar 16.

Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521.

Introduction: Limited research has analyzed the full range of outpatient medication prescription activity following serious combat injury. The objectives of this study were to describe (1) outpatient medication prescriptions and refills during the first 12 months after serious combat injury, (2) longitudinal changes in medication prescriptions during the first-year postinjury, and (3) patient characteristics associated with outpatient prescriptions.

Materials And Methods: This was a retrospective analysis of existing health and pharmacy data for a random sample of U. Read More

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http://dx.doi.org/10.1093/milmed/usaa038DOI Listing

Using Gas-Driven Shock Tubes to Produce Blast Wave Signatures.

Front Neurol 2020 21;11:90. Epub 2020 Feb 21.

The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States.

The increased incidence of improvised explosives in military conflicts has brought about an increase in the number of traumatic brain injuries (TBIs) observed. Although physical injuries are caused by shrapnel and the immediate blast, encountering the blast wave associated with improvised explosive devices (IEDs) may be the cause of traumatic brain injuries experienced by warfighters. Assessment of the effectiveness of personal protective equipment (PPE) to mitigate TBI requires understanding the interaction between blast waves and human bodies and the ability to replicate the pressure signatures caused by blast waves. Read More

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http://dx.doi.org/10.3389/fneur.2020.00090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047208PMC
February 2020

Prehospital Life-Saving Interventions Performed on Pediatric Patients in a Combat Zone: A Multicenter Prospective Study.

Pediatr Crit Care Med 2020 Mar 6. Epub 2020 Mar 6.

Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.

Objectives: We aimed to describe and evaluate prehospital life-saving interventions performed in a pediatric population in the Afghanistan theater of operations.

Design: Our study was a post hoc, subanalysis of a larger multicenter, prospective, observational study.

Setting: We evaluated casualties enrolled upon admission to one of the nine military medical facilities in Afghanistan between January 2009 and March 2014. Read More

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http://dx.doi.org/10.1097/PCC.0000000000002317DOI Listing

The Military Medical System and Wartime Injuries to the Spine.

Bull Hosp Jt Dis (2013) 2020 ;78(1):42-45

War has historically been a major catalyst for advancement in military medical care and medicine in general. In our current conflicts, advances in battlefield medicine, evacuation techniques, and personal protective equipment have improved survival rates among members of the armed services. With increased survival, there has been increased prevalence of serious but nonfatal injuries, particularly from blunt and penetrating trauma. Read More

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January 2020

Replicating landmine blast loading in cellular in Vitro models.

Phys Biol 2020 Mar 5. Epub 2020 Mar 5.

National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND.

Trauma arising from landmines and improvised explosive devices promotes heterotopic ossification, the formation of extra-skeletal bone in non-osseous tissue. To date, experimental platforms that can replicate the loading parameter space relevant to improvised explosive device and landmine blast wave exposure have not been available to study the effects of such non-physiological mechanical loading on cells. Here, we present the design and calibration of three distinct in vitro experimental loading platforms that allow us to replicate the spectrum of loading conditions recorded in near-field blast wave exposure. Read More

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http://dx.doi.org/10.1088/1478-3975/ab7d1cDOI Listing
March 2020
2.536 Impact Factor

Trends in microbial profile of burn patients following an event of dust explosion at a tertiary medical center.

BMC Infect Dis 2020 Mar 4;20(1):193. Epub 2020 Mar 4.

Department of Infection Control, Taipei Veterans General Hospital, Taipei, Taiwan.

Background: Microbial infection is the main cause of increased morbidity and mortality in burn patients, especially infections caused by multiple drug-resistant organisms (MDRO). The purpose of this study was to explore major microbial trends in burn patients.

Methods: This retrospective study was conducted at burn wards and intensive care units, where burn patients were admitted following an event of dust explosion. Read More

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http://dx.doi.org/10.1186/s12879-020-4920-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057658PMC

A Mysterious Case of an Infarcted Spleen due to Kissing Disease: A Rare Entity.

Cureus 2020 Jan 19;12(1):e6700. Epub 2020 Jan 19.

Internal Medicine, West Virginia University, Charelston, USA.

Viruses are long known to be leading causes of self-limiting infections. Infectious mononucleosis (IM) caused by the Epstein-Barr virus (EBV) is, however, no exception. The ailment is caused by a DNA virus belonging to the Herpesviridae family. Read More

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http://dx.doi.org/10.7759/cureus.6700DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029827PMC
January 2020

Syrian Civil War: a systematic review of trauma casualty epidemiology.

Authors:
Joshua McIntyre

BMJ Mil Health 2020 Feb 27. Epub 2020 Feb 27.

Army Medical Services Support Unit, Army Medical Services, Camberley, UK

Background: The Syrian Civil War has caused over 400 000 traumatic deaths. Understanding the nature of war casualties is crucial to deliver healthcare improvement. Historic regional conflicts and Syrian mortality data have been characterised by blast injuries. Read More

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http://dx.doi.org/10.1136/jramc-2019-001304DOI Listing
February 2020

Endovascular Management of Uncontrollable Orbital Hemorrhage Secondary to Blast Injury.

Cureus 2020 Jan 20;12(1):e6713. Epub 2020 Jan 20.

Neurosurgery, Advocate Christ Medical Center, Oak Lawn, USA.

Blast injuries to the face frequently involve vascular injury and have been reported in association with vehicles, including compressed air hoses and car battery explosions. While related to high-pressure releases, we present the first case of a car tire inflation resulting in tire explosion causing uncontrollable orbital hemorrhage, ocular damage, and the first case of endovascular intervention resulting in resolution of hemorrhage. A 63-year-old male presented after a tire explosion with evisceration of the right eye and uncontrollable hemorrhage from the orbit. Read More

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http://dx.doi.org/10.7759/cureus.6713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7032603PMC
January 2020

Epidemiology of Injuries Sustained by Civilians and Local Combatants in Contemporary Armed Conflict: An Appeal for a Shared Trauma Registry Among Humanitarian Actors.

World J Surg 2020 Jun;44(6):1863-1873

Stanford University School of Medicine, 291 Campus Drive, Stanford, CA, 94305, USA.

Background: Conflict-related injuries sustained by civilians and local combatants are poorly described, unlike injuries sustained by US, North Atlantic Treaty Organization, and coalition military personnel. An understanding of injury epidemiology in twenty-first century armed conflict is required to plan humanitarian trauma systems capable of responding to population needs.

Methods: We conducted a systematic search of databases (e. Read More

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http://dx.doi.org/10.1007/s00268-020-05428-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223167PMC

Identification of chronic brain protein changes and protein targets of serum auto-antibodies after blast-mediated traumatic brain injury.

Heliyon 2020 Feb 17;6(2):e03374. Epub 2020 Feb 17.

Pathovacs, Inc., Ames, IA, USA.

In addition to needing acute emergency management, blast-mediated traumatic brain injury (TBI) is also a chronic disorder with delayed-onset symptoms that manifest and progress over time. While the immediate consequences of acute blast injuries are readily apparent, chronic sequelae are harder to recognize. Indeed, the identification of individuals with mild-TBI or TBI-induced symptoms is greatly impaired in large part due to the lack of objective and robust biomarkers. Read More

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http://dx.doi.org/10.1016/j.heliyon.2020.e03374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029173PMC
February 2020

Blast injury of the hand related to warfare explosive devices: experience from the French Military Health Service.

BMJ Mil Health 2020 Feb 20. Epub 2020 Feb 20.

Department of Orthopaedic, Trauma and Reconstructive Surgery, Percy Military Hospital, Clamart, France.

Introduction: The objective was to report on the experience of the French Army Health Service in the management of blast injury of the hands related to warfare explosive devices.

Methods: A retrospective study was conducted in the Percy Military Hospital (role 4 medical treatment facility) among French soldiers who presented with a combat-related blast injury of the hand between 2002 and 2018. The functional result was assessed by the disabilities of the arm, shoulder and hand (DASH) and the Orthotics and Prosthetics User Survey (OPUS, upper extremity functional status) scores. Read More

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http://dx.doi.org/10.1136/jramc-2019-001326DOI Listing
February 2020

Modulation of in vitro Brain Endothelium by Mechanical Trauma: Structural and Functional Restoration by Poloxamer 188.

Sci Rep 2020 Feb 20;10(1):3054. Epub 2020 Feb 20.

Department of Bioengineering, University of Texas at Arlington, Arlington, TX, United States.

Brain injuries caused by an explosive blast or blunt force is typically presumed to associate with mechanical trauma to the brain tissue. Recent findings from our laboratory suggest that shockwaves produced by a blast can generate micron-sized bubbles in the tissue. The collapse of microbubbles (i. Read More

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http://dx.doi.org/10.1038/s41598-020-59888-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033190PMC
February 2020