Military medicine
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External cooling of ischemic limbs has been shown to have a significant protective benefit for durations up to 4 hours. ⋯ While external cooling during prolonged Zone 3 resuscitative endovascular balloon occlusion of the aorta appears to decrease ischemic muscle injury, this benefit appears to be time dependent. As the ischemic time approaches 8 hours, the benefit from hypothermia decreases.
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Blood is a precious commodity, with storage limited to 42 days under refrigeration. Degradative changes in red blood cells (RBCs) begin as early as 11-21 days after collection, and compromise their function. Materials that extend the life of RBCs will improve blood utilization in the field, as well as in hospital settings. Cerium oxide nanoparticles (CeONPs) are widely used in the materials industry to counteract oxidative stress and improve oxygen storage. We have previously shown that CeONPs extended the lifespan of cells in culture and counteract oxidative stress in vitro and in vivo. Here, we test the hypothesis that CeONPs extend the lifespan of RBCs in whole stored blood. ⋯ This work suggests that CeONPs may be a promising additive for extending storage and function of blood and blood products.
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Retracted Publication
PTSD Susceptibility and Challenges: Pathophysiological Consequences of Behavioral Symptoms.
Posttraumatic stress disorder (PTSD) can develop during the aftermath of traumatic events. Although many are impacted by several stressors, nearly 3.6% suffer from PTSD in the United States with higher incidence reported in military service personnel. Any injury to the blood-brain barrier can ignite an array of biological signaling molecules in the immune-privileged brain parenchyma, which can disrupt the synaptic neural network, resulting in altered behavior. ⋯ Identification of neural biomarkers is essential to understand the subclinical symptoms for the diagnosis PTSD, which may not be visible by magnetic resonance imaging (MRI/fMRI) and may take years to clinically manifest.
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Randomized Controlled Trial
Scrambler Therapy Treatment: The Importance of Examining Clinically Meaningful Improvements in Chronic Pain and Quality of Life.
Calmare Scrambler Therapy (ST) interferes with pain signal transmission by using nerve fibers to convey a message of normality to the central nervous system. This prospective, double-blinded, randomized trial had three aims. First, we tried to determine ST's effectiveness in reducing chronic neuropathic pain symptoms and analgesic medication use in military service members, when compared to sham treatment. Next, we examined its effect on reported mental and physical health-related quality of life. Finally, we sought to describe participant perceptions of treatment effectiveness. ⋯ ST is no better than sham treatment in decreasing pain. Yet, patient perceptions of treatment effectiveness are equally important in chronic pain treatment.
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We examined antibiotic management of combat-related extremity wound infections (CEWI) among wounded U.S. military personnel (2009-2012). ⋯ Substantial variation in antibiotic prescribing patterns related to CEWIs warrants development of combat-related clinical practice guidelines beyond infection prevention, to include strategies to reduce the use of unnecessary antibiotics and improve stewardship.