Military medicine
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In an attempt to determine whether selective, nonoperative management of hepatic trauma might be efficacious, a retrospective review of liver injuries was undertaken. Of the 48 patients with liver injuries identified, there were 34 men and 14 women with an average age of 28.5 years. Mechanism of injury consisted of blunt trauma in 23 patients, stab wounds in 14 patients, and 11 patients had gunshot wounds. ⋯ However, 17 of 25 patients with penetrating wounds had associated abdominal injuries which required operative treatment. Based on the information obtained in this review, it is recommended that stable patients with isolated hepatic injuries, secondary to blunt trauma confirmed by CT scan, may be managed nonoperatively. Due to the high frequency of associated injuries found in patients with penetrating trauma, nonoperative therapy is not advised.
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We followed 295 young infantry recruits during their first 14 weeks of basic training. The prevalence of smoking increased by 50%. About half of this increase was accounted for by ex-smokers, 57% of whom had resumed the habit. ⋯ These relationships were not demonstrated among resuming ex-smokers. The rise in the smoking rate accounts for most of the known rise during full military service. We suggest early preventive measures, especially for the two groups at risk.
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Over the past few years, the indications for resuscitative thoracotomy in civilian trauma have been refined. The use of this procedure for military casualities has received only brief mention. We have described our experience with 93 consecutive thoracotomies performed in a level I trauma center and have attempted to better define the indications for this procedure in military medicine.
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Among 118 young Hispanic (101 Puerto Rican) psychiatric inpatients, somatic complaints, violence, suicidal tendency, hallucinations, sudden onset of symptoms, and dissociative behavior each occurred in 46% or more of patients. There was no difference in clinical presentation between island Puerto Rican patients and Puerto Rican patients raised on the mainland. There was no relationship between these behaviors and any specific psychiatric disorder. Although there is a suggestion that more of these behaviors may occur among Puerto Rican Hispanics, further study with larger control groups is needed.
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The object of this study was to evaluate the effectiveness of five regimens in treating cyanide poisoning. A series of anesthetized adult beagle dogs were instrumented to record hemodynamic and respiratory function and given 2.5 mg/kg sodium cyanide intravenously. The 10 control animals given only cyanide died at from 5 to 7 minutes. ⋯ Results of these studies indicate that intravenous sodium nitrite, DMAP, and hydroxylamine hydrochloride, and amyl nitrite by inhalation, are all effective in reversing the lethal effects of cyanide poisoning. Only DMAP and hydroxylamine hydrochloride are effective when given by the intramuscular route. These results provide data to support an approach to therapy that is more practical and applicable where expert medical care may not be available following cyanide exposure.