Military medicine
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Intraosseous (IO) access, enabling the rapid administration of epinephrine during cardiac arrest (CA), is crucial in promoting optimal postresuscitation outcomes in patients with poor vascular access. There is a question whether IO-administered epinephrine is equivalent to intravenously administered epinephrine during CA. ⋯ The clinician should consider using proximal IO infusion sites such as the sternum or humerus when administering advanced cardiac life support drugs to rapidly achieve maximal therapeutic concentrations. Further studies are needed to determine the differences seen when epinephrine is administered by these routes during CA.
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Review Case Reports
Sigmoid colon penetration by an intrauterine device: a case report and literature review.
The intrauterine device (IUD) is one of the most effective contraceptive methods available today. However, IUDs can cause some serious complications, such as bleeding, uterine perforation, and bowel perforation. Migration into bowel is a rare but serious complication that requires surgical attention. ⋯ The symptoms of IUD migration can be nonspecific, requiring a high degree of suspicion. Also, cross-sectional imaging studies are recommended to rule out adjacent organ involvement if IUD migration is suspected.
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Randomized Controlled Trial
Randomized controlled trial of accelerated resolution therapy (ART) for symptoms of combat-related post-traumatic stress disorder (PTSD).
Therapies for post-traumatic stress disorder (PTSD) endorsed by the Department of Defense and Veterans Administration are relatively lengthy, costly, and yield variable success. We evaluated Accelerated Resolution Therapy (ART) for the treatment of combat-related psychological trauma. ⋯ ART appears to be a safe and effective treatment for symptoms of combat-related PTSD, including refractory PTSD, and is delivered in significantly less time than therapies endorsed by the Department of Defense and Veterans Administration.
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Case Reports
Sprengel deformity presenting as a post-traumatic injury in an afghan boy: a case report.
Sprengel deformity is a rare congenital anomaly that involves the shoulder joint and scapula. We treated a young Afghan boy who was presented to the German Level II Provincial Reconstructive Team in Kunduz, Afghanistan, with the complaint of a shoulder deformity evolving after an accident that occurred several years before the presentation of the patient to clinic. Physicians maximized the available resources for the diagnostic workup by arranging for his computed tomography scan at the German Level III Hospital at Mazar-e-Sharif and then reviewing the study through teleradiology. The presence of a Coalition Surgical Team allowed the delivery of advanced surgical care by combining the specialized surgical skills of three upper extremity surgeons deployed to the area.
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Despite improved body armor, hemorrhage remains the leading cause of preventable death on the battlefield. Trauma to the junctional areas such as pelvis, groin, and axilla can be life threatening and difficult to manage. The Abdominal Aortic Tourniquet (AAT) is a prehospital device capable of preventing pelvic and proximal lower limb hemorrhage by means of external aortic compression. ⋯ Blood flow in the CFA was eliminated in 15 out of 16 participants. The one unsuccessful subject was above average height, weight, body mass index, and abdominal girth. This study shows the AAT to be effective in the control of blood flow in the pelvis and proximal lower limb and potentially lifesaving.