2,253 results match your criteria: "US Army Institute of Surgical Research & Burn Center[Affiliation]"

Introduction: Hemorrhage remains the leading cause of preventable death on the battlefield. The most effective means to increase survivability is early hemorrhage control and fluid resuscitation. Unfortunately, fluid resuscitation requires constant adjustments to ensure casualty is properly managed, which is often not feasible in the pre-hospital setting.

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Article Synopsis
  • - The study explored the use of wrist-wearable devices to track heart rate variability (HRV) as potential biomarkers for recovery from adverse neuropsychiatric effects following traumatic events, specifically in a socioeconomically disadvantaged group.
  • - Researchers monitored participants within 72 hours of a traumatic event and over a course of 6 months, validating HRV characteristics linked to various posttraumatic symptoms, such as pain, re-experiencing, and anxiety.
  • - The findings indicate that changes in HRV could effectively predict improvements or worsening in symptoms, suggesting that these wearable technologies could serve as useful screening tools for identifying posttraumatic stress in high-risk populations.
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We performed a needs assessment to determine the essential elements for a curriculum teaching burn care during Large Scale Combat Operations against peer/near-peer adversaries within multi-domain contested combat environments. Virtual and face-to-face site visit meetings were conducted with 20 stakeholders at 3 levels: 1) Subject Matter Experts (SMEs) in military burn casualty care at the U.S.

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Design and validation of a preclinical model for oral commissure and lower eyelid thermal injury.

Burns

February 2025

Department of Otolaryngology - Head and Neck Surgery, Brooke Army Medical Center, JBSA Fort Sam Houston, TX, USA; United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, USA; Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, USA.

Article Synopsis
  • Oral commissure stenosis and lower eyelid ectropion from burns are difficult to treat due to a lack of preclinical models; this study describes a method for inducing controlled burns in swine to aid future research.
  • The experiment involved inducing burns of various durations (10 to 30 seconds) on swine and observing changes over time using techniques like laser speckle imaging for assessing tissue health and healing.
  • Results indicated that longer burn times led to more severe tissue damage and inflammation, but no significant functional impairments were noted, suggesting the need for further exploration of treatments with this new burn model.
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Phylogenetic evaluation and genotypic identification of burn-related Pseudomonas aeruginosa strains isolated from post-burn human infections during hospitalization.

Pathog Dis

February 2024

Division of Combat Wound Repair, U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Building 3610, JBSA Fort Sam Houston, San Antonio, TX 78234-7767, United States.

Cutaneous burn trauma, compromise of dermal layers and immune defense system is a physical and fiscal burden on healthcare systems. Burn-wound infections are a serious complication of thermal injury and contribute significantly to care burden. After burn-induced trauma, sepsis by Pseudomonas aeruginosa impairs patient recovery and contributes to mortality and morbidity.

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Spatial immunogenomic patterns associated with lymph node metastasis in lung adenocarcinoma.

Exp Hematol Oncol

October 2024

Department of Thoracic Surgery, Institution of Thoracic Oncology, Peking University People's Hospital, No.11 Xizhimen South Street, Beijing, 100044, Xicheng District, China.

Article Synopsis
  • This study investigates the immunogenomic characteristics of lung adenocarcinoma (LUAD) with lymph node (LN) metastasis, aiming to better understand its connection to poor patient prognosis.
  • Researchers utilized next-generation sequencing and multiplex immunohistochemistry on a large patient cohort to map genetic alterations and analyze the immune environment in LUAD tumors.
  • The findings highlight specific mutations and immune cell profiles linked to LN metastasis, allowing researchers to create a predictive model that could enhance personalized treatment strategies for patients who cannot undergo surgery.
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2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for the Management of Headache.

Ann Intern Med

December 2024

Aeromedical Consultation Service, U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Ohio; Wright State University Boonshoft School of Medicine, Dayton, Ohio; and Uniformed Services University F. Edward Hebert School of Medicine, Bethesda, Maryland (A.W.F.).

Description: Headache medicine and therapeutics evidence have been rapidly expanding and evolving since the 2020 U.S. Department of Veterans Affairs (VA) and U.

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Objectives: The effective control of dental plaque is crucial for oral health, given that pathogenic bacteria in plaque are the primary cause of dental caries. Current antimicrobial agents, although effective, disrupt the oral microbiome and lead to oral dysbiosis, hindering efforts to curb dental caries. Novel antimicrobial peptides offer a promising solution due to their selective bactericidal activity against cariogenic bacteria.

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Traumatic brain injuries (TBI) are common in dogs and cats that have sustained head trauma from a variety of causes. In moderate to severe TBI, damage from both the primary and secondary injuries can be life-threatening. TBI management may be further complicated by concurrent injuries in polytrauma patients.

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  • The study analyzed global, regional, and national trends in injury burden and identified risk factors contributing to injuries using data from the GBD 2019.
  • In 2019, there were approximately 713.9 million injury incidents and 4.3 million injury-related deaths globally, with low bone mineral density emerging as the leading risk factor.
  • The findings emphasize the need for effective global injury prevention policies by highlighting the persistent impact of injuries on global health.
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  • Extensive burn injuries need personalized fluid resuscitation protocols to prevent shock and reduce swelling, leading to efforts to improve treatment methods through mathematical modeling of burn physiology.
  • The research developed an advanced mathematical model that integrates cardiovascular, hormonal, and kidney function systems to enhance predictions about fluid regulation in burn patients.
  • The model was validated against experimental data from animals and clinical data from human burn patients, successfully predicting key health indicators like cardiac output and urinary output.
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A Description of the Dental Health and Treatment of Ukraine Military at U.S. Army Clinics in Germany.

Mil Med

October 2024

Craniofacial Health & Restorative Medicine, Naval Medical Research Unit San Antonio, JBSA Fort Sam Houston, TX 78234, USA.

Introduction: Since the start of the Russo-Ukrainian war, most reports have focused on trauma and combat conditions. Trauma care is essential; however, disease and nonbattle injuries (DNBIs) also burden armies and reduce combat effectiveness. Dental emergencies (DEs) account for a substantial portion of DNBI, but there is limited information on Ukrainian military dental readiness.

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Objective: To utilize sidestream dark field video microscopic technology to evaluate the endothelium in a canine hemorrhagic shock and resuscitation model.

Methods: 6 purpose-bred adult dogs were anesthetized, instrumented, and subjected to hemorrhagic shock from September 2021 through June 2022. Each dog was resuscitated with 5 resuscitation strategies in an experimental crossover design study: (1) lactated Ringer's solution (LRS) and hydroxyethyl starch (HES) solution; (2) canine chilled whole blood (CWB); (3) canine fresh frozen plasma (FFP) and packed RBCs (pRBC); (4) canine freeze-dried plasma (FDP) and hemoglobin-based oxygen carrier (HBOC); or (5) HBOC/FDP and canine lyophilized platelets.

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  • This study looked at how a special technique called the Panda Rope Bridge Technique (PRBT) can help heal injured Achilles tendons in rats.!
  • They divided the rats into three groups: one group healed naturally, one group used PRBT, and the last group had their ankles fixed to heal.!
  • The results showed that tendons treated with PRBT healed faster and stronger compared to the others, suggesting that PRBT could be a good way to treat tendon injuries in the future.!
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Epidemiology and timing of infectious complications from battlefield-related burn injuries.

Burns

December 2024

Infectious Disease Service, Brooke Army Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234, United States.

Article Synopsis
  • Infections are a major complication in burn patients, particularly among U.S. military personnel who sustained injuries in Iraq and Afghanistan from 2009 to 2014, with 18% of the studied patients developing infections.
  • The most common initial infection was pneumonia, occurring within four days post-injury, while those with infections had more severe burns, longer time before surgical treatment, and higher rates of inhalation injury.
  • The research indicates that military personnel with burn injuries face significant risks for serious infections, with a notable percentage suffering from multidrug-resistant Gram-negative bacteria and a concerning mortality rate among those with multiple infections.
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Unlabelled: To increase the achievement of negative R0 surgical margins and increase the low survival rates of pancreatic cancer, improvements in assessing tumor margins during surgical resections are needed. This can be accomplished by using pancreatic cancer-targeted fluorescence molecular imaging agents to intraoperatively detect tumor margins in real time. Because Toll-like receptor 2 (TLR2) is broadly expressed among many cancer types including pancreatic adenocarcinomas, a high-affinity TLR2-targeted fluorescence molecular imaging agent (TLR2L-800) was developed.

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  • Topical wound care after burns has changed how injuries are treated by using dressings that help prevent infections and promote healing while considering factors like pain and dressing change frequency.
  • This study looked at pain levels and opioid use related to different wound dressings, such as silver sulfadiazine, manuka honey, and negative-pressure wound therapy.
  • Results showed silver sulfadiazine typically resulted in lower pain scores and less opioid use compared to other dressings, suggesting the need for more detailed studies to better understand their impacts on pain management.
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Introduction: In prolonged care scenarios, where medical evacuations are significantly delayed, the treatment and transport of casualties with extremity musculoskeletal injuries will drain combat units' human resources. Developing enhanced splinting techniques to restore casualty mobility and function can alleviate this drain. To guide this development, a panel of tactical combat and wilderness medicine experts was assembled to determine which extremity musculoskeletal injuries had the greatest impact on unit capabilities, and the materials available for splinting these injuries.

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Definitions of adverse events associated with extracorporeal membrane oxygenation in children: results of an international Delphi process from the ECMO-CENTRAL ARC.

Lancet Child Adolesc Health

October 2024

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA; Susan B Meister Child Health Evaluation and Research Center, Division of General Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA. Electronic address:

Article Synopsis
  • ECMO is a complex and risky life support system that lacks standardized definitions for adverse outcomes, which hinders effective research and practices.
  • The ECMO-CENTRAL ARC was formed to create clear definitions for pediatric ECMO adverse events, using input from literature and a diverse expert panel.
  • After three rounds of surveys, 13 key adverse event definitions were established and unanimously agreed upon by the voting experts.
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Building on our strategic framework and operational model, we will discuss findings from our ethnographic study entitled, "The Impact of Catastrophic Injury Exposure on Resilience in Special Operations Surgical Teams (SOST)." Our goal is to establish that medical-martial creativity supports Special Operation Forces (SOF) medics' ability to fluidly modulate pressure amid real-time military medical decision-making in austere environments. We will use qualitative quotes to explore how SOST medics express medical-martial creativity in support of unconventional resilience.

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Introduction: Hemorrhage remains a leading cause of death in civilian and military trauma. Hemorrhages also extend to military working dogs, who can experience injuries similar to those of the humans they work alongside. Unfortunately, current physiological monitoring is often inadequate for early detection of hemorrhage.

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  • Cervical spondylosis is a prevalent issue among military personnel, often leading to serious career impacts, with the traditional treatment being anterior cervical discectomy and fusion (ACDF), while posterior cervical foraminotomy (PCF) offers a nonfusion alternative for certain conditions.
  • This study used a 3D finite element model to compare the biomechanical effects of ACDF and PCF on the cervical spine under military-specific loading scenarios, focusing on range of motion, disc pressure, and facet loads at the C5-C6 level.
  • Results indicated that ACDF reduced motion at the operated level but increased it at adjacent levels, whereas PCF allowed for increased motion at the index level and reduced it at adjacent levels,
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  • Combat casualties often undergo exploratory laparotomies in settings lacking modern imaging, with prior studies showing non-therapeutic laparotomy (NTL) rates as high as 32%.
  • An evaluation of military personnel from 2009 to 2014 revealed that 16.8% experienced NTLs, while 83.2% had therapeutic laparotomies for actual injuries.
  • Patients with NTLs had lower injury severity and were less likely to require intensive care or develop surgical site infections, indicating improvements in combat care and decision-making processes.
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Comparing the effects of various fluid resuscitative strategies on Glycocalyx damage in a canine hemorrhage model.

Vet J

October 2024

From the US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, United States; School of Veterinary Medicine, Texas A&M University,  College Station, TX, United States.

Hemorrhagic shock and subsequent resuscitation can cause significant dysregulation of critical systems, including the vascular endothelium. Following hemorrhage, the endothelial lining (glycocalyx) can shed, causing release of glycocalyx components, endothelial activation, and systemic inflammation. A canine model of hemorrhagic shock was used to evaluate five resuscitation fluids, including Lactated Ringers+Hetastarch, Whole Blood (WB), Fresh Frozen Plasma+packed Red Blood Cells (FFP+pRBC), and two hemoglobin-based oxygen carrier (HBOC) fluids, for their impact on glycocalyx shedding.

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