Journal of the Royal Army Medical Corps最新文献_第2页

Porphyria 卟啉症

Journal of the Royal Army Medical Corps Pub Date : 2020-02-08 DOI: 10.1136/jramc-109-01-52

I. Michie, M. Kelleher

引用次数: 1

Constitutional 宪法的

Journal of the Royal Army Medical Corps Pub Date : 2020-02-07 DOI: 10.1007/978-1-4020-6754-9_3553

Bruce Bannister, Nathan Ballentine, Mike Sottile, Gilda Cobb-Hunter, Kirkman Finlay, Garry Smith, J. Hayes, Bill Clyburn, Jimmy Bales, Todd S. Rutherford, H. Crawford, Dwight A. Loftis, Alan D. Clemmons, David Weeks, Adjutant

引用次数: 9

Case series of non-freezing cold injury: epidemiology and risk factors. 非冻害系列病例:流行病学及危险因素。

Journal of the Royal Army Medical Corps Pub Date : 2019-12-01 Epub Date: 2018-10-25 DOI: 10.1136/jramc-2018-000992

James A Kuht, D Woods, S Hollis

{"title":"Case series of non-freezing cold injury: epidemiology and risk factors.","authors":"James A Kuht, D Woods, S Hollis","doi":"10.1136/jramc-2018-000992","DOIUrl":"https://doi.org/10.1136/jramc-2018-000992","url":null,"abstract":"Background: Non-freezing cold injury (NFCI) occurs when the peripheral tissue is cooled sufficiently that damage occurs, but not to the point of tissue freezing. Historically, the phenotype of the injuries studied was often severe, and it is unclear whether knowledge gained from these cases is entirely relevant to the frequently subtle injuries seen today.Methods: We therefore sought to characterise a recent case series of 100 patients referred with suspected NFCI to a military UK NFCI clinic. Their demographics, medical history and situational risk factors leading to their injuries were analysed, and comparison was made between those subsequently diagnosed with NFCI (n=76) and those receiving alternate diagnoses (n=24).Results: Statistically significant predisposing factors for NFCI in the UK service personnel (SP) were being of African-Caribbean ethnicity and having a short duration of service in the Armed Forces. Past or current smoking was not identified as a risk factor. Injuries were almost always suffered on training exercises (most commonly in the UK); being generally cold and being on static duties were statistically significant situational risk factors. Non-significant trends of risk were also found for having wet clothing, wet boots and immersion. Self-reported dehydration was not found to be a risk factor for NFCI.Conclusions: Our demographic findings are in general agreement with those of previous studies. Our situational risk factor findings, however, highlight a pattern of NFCI risk factors to the modern UK SP: winter training exercises, when troops are generally cold and extremities often wet, with static duties frequently implicated in the disease mechanism.","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 6","pages":"400-404"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2018-000992","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36665619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Vacuum-assisted closure (VAC) for craniocerebral wounds in severely injured patients: technical note of a damage control procedure. 真空辅助封闭(VAC)在严重损伤患者的颅脑创伤:损害控制程序的技术说明。

Journal of the Royal Army Medical Corps Pub Date : 2019-12-01 Epub Date: 2019-04-16 DOI: 10.1136/jramc-2019-001201

Christophe Joubert, A Sellier, J-B Morvan, N Beucler, J Bordes, A Dagain

{"title":"Vacuum-assisted closure (VAC) for craniocerebral wounds in severely injured patients: technical note of a damage control procedure.","authors":"Christophe Joubert, A Sellier, J-B Morvan, N Beucler, J Bordes, A Dagain","doi":"10.1136/jramc-2019-001201","DOIUrl":"https://doi.org/10.1136/jramc-2019-001201","url":null,"abstract":"The management of a craniocerebral wound (CCW) remains challenging, particularly in a severely injured patient. Considering the complexity of the multilayer insult and damage control care in an unstable patient, every procedure performed should promptly benefit the patient. We report an illustrative case of a patient with a gunshot wound to the head that resulted in a CCW for which we applied vacuum-assisted closure (VAC) therapy according to damage control principles. We describe the technical approach and discuss the indications, results and technique by considering the literature available. VAC can be used for CCWs, particularly for large defects in selected patients according to clinical and CT evaluations following immediate resuscitation. In severely injured and unstable patients, VAC aims to delay definitive reconstructive and time-consuming treatment. Interestingly, it appears to be a safe treatment based on the previously described-but not exclusively trauma-cases with no secondary cerebrospinal fluid leakage encountered.","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 6","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2019-001201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37321935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Catastrophic haemorrhage in military major trauma patients: a retrospective database analysis of haemostatic agents used on the battlefield. 军事重大创伤患者的大出血:战场上使用的止血剂的回顾性数据库分析。

Journal of the Royal Army Medical Corps Pub Date : 2019-12-01 Epub Date: 2018-10-03 DOI: 10.1136/jramc-2018-001031

Mark Winstanley, J E Smith, C Wright

{"title":"Catastrophic haemorrhage in military major trauma patients: a retrospective database analysis of haemostatic agents used on the battlefield.","authors":"Mark Winstanley, J E Smith, C Wright","doi":"10.1136/jramc-2018-001031","DOIUrl":"https://doi.org/10.1136/jramc-2018-001031","url":null,"abstract":"Objectives Catastrophic haemorrhage is a leading cause of morbidity and mortality in trauma, in both military and civilian settings. There are numerous studies looking at the effectiveness of different haemostatic agents in the laboratory but few in a clinical setting. This study analyses the use of haemostatic dressings used in patients injured on the battlefield and their association with survival. Method A retrospective database review was undertaken using the UK Joint Theatre Trauma Registry from 2003 to 2014, during combat operations in Iraq and Afghanistan. Data included patient demographics, the use of haemostatic dressings, New Injury Severity Score (NISS) and patient outcome. Results Of 3792 cases, a haemostatic dressing was applied in 317 (either Celox, Hemcon or Quickclot). When comparing patients who had a haemostatic dressing applied versus no haemostatic agent, there was a 7% improvement in survival. Celox was the only individual haemostatic dressing that was associated with a statistically significant improvement in survival, which was most apparent in the more severely injured (NISS 36–75). Conclusion We have shown an association between use of haemostatic agents and improved survival, mostly in those with more severe injuries, which is particularly evident in those administered Celox. This supports the continued use of haemostatic agents as part of initial haemorrhage control for patients injured in conflict and suggests that civilian organisations that may need to deal with patients with similar injury patterns should consider their use and implementation.","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 6","pages":"405-409"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2018-001031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36601223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Health needs of ex-military personnel in the UK: a systematic review and qualitative synthesis. 英国前军事人员的健康需要：系统审查和定性综合。

Journal of the Royal Army Medical Corps Pub Date : 2019-12-01 Epub Date: 2018-12-09 DOI: 10.1136/jramc-2018-001101

Steven L Senior

{"title":"Health needs of ex-military personnel in the UK: a systematic review and qualitative synthesis.","authors":"Steven L Senior","doi":"10.1136/jramc-2018-001101","DOIUrl":"10.1136/jramc-2018-001101","url":null,"abstract":"Background: Despite all local authorities in England signing up to the Armed Forces Covenant, only a small proportion of Joint Strategic Needs Assessments (JSNAs) include detailed consideration of the health of the local ex-military population. This article supports improvements to JSNAs by systematically reviewing published research for evidence of differences in health between the ex-military population and the general public.Methods: Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology for qualitative synthesis of mixed study designs. SCOPUS, PubMed and Google Scholar were searched for published research on health outcomes among UK ex-military populations. All study designs were included.Results: 43 studies met the inclusion criteria. Rates of mental illness and hearing loss are higher among ex-military populations compared with the general public, while rates of cancer among ex-military personnel born after 1960 are lower. Despite high rates of hazardous drinking among serving personnel, rates of alcohol-related harm among ex-military populations are no higher than the general public. There is a subpopulation at increased risk of a range of adverse outcomes. This group is variously identified as younger, male, less educated, more likely to have served in a combat role and/or left service early.Conclusions: This review found evidence of areas of increased and reduced disease burden among ex-military populations. More detailed information on the make-up of the local ex-service population would support more meaningful needs assessments. The Ministry of Defence and local authorities and service providers should work together to support early identification and targeted support for those at the highest risk of adverse outcomes.","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 6","pages":"410-415"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36763516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rifled carotid: Internal carotid artery thrombosis from prolonged carrying of a military rifle. 颈动脉栓塞:长时间携带军用步枪造成的颈内动脉血栓。

Journal of the Royal Army Medical Corps Pub Date : 2019-12-01 Epub Date: 2019-05-27 DOI: 10.1136/jramc-2019-001225

Faiz Mh Ahmad, S K Nanda, S R, D S Grewal

{"title":"Rifled carotid: Internal carotid artery thrombosis from prolonged carrying of a military rifle.","authors":"Faiz Mh Ahmad, S K Nanda, S R, D S Grewal","doi":"10.1136/jramc-2019-001225","DOIUrl":"https://doi.org/10.1136/jramc-2019-001225","url":null,"abstract":"Background: Traumatic carotid artery thrombosis is uncommon and it usually results from penetrating injuries and less commonly secondary to blunt trauma. It can lead to delayed clinical presentation, which leads to delay in the diagnosis. Soldiers in combat scenario also can present with such an illness, which results from varied modes of injuries. Our case illustrates an unusual cause of carotid thrombosis.Case presentation: Our patient is a 37-year-old soldier who developed neck pain and headache following a 5 km training run with rifle on the shoulder and subsequently developed left upper limb weakness and evaluation revealed extracranial right internal carotid thrombosis. He was managed with anticoagulants and antiplatelets with complete resolution of the thrombosis and complete recovery of the weakness.Conclusion: Blunt trauma to the neck in the form of carrying a rifle for a prolonged duration can result in injury to the carotid vessels leading to delayed neurological presentation. Educating the troops regarding such a mode of illness will prevent such a catastrophic nature of vascular injury resulting in ischaemic stroke.","PeriodicalId":17327,"journal":{"name":"Journal of the Royal Army Medical Corps","volume":"165 6","pages":"e2"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jramc-2019-001225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37279278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Operation RUMAN and the Ministry of Defence response to Hurricane Irma. RUMAN行动和国防部对飓风Irma的反应。

Journal of the Royal Army Medical Corps Pub Date : 2019-12-01 Epub Date: 2019-06-27 DOI: 10.1136/jramc-2019-001259

Michael Connolly, J Breeze

引用次数: 1

Medical support to military training and operations. Starkey KJ, Lyon J, Sigman E, Pynn H, Nordman G. J R Army Med Corps 2018;(164):92-5. 为军事训练和行动提供医疗支持。Starkey KJ，Lyon J，Sigman E，Pynn H，Nordman G.J R Army Med Corps 2018；（164）：92-5。

Journal of the Royal Army Medical Corps Pub Date : 2019-12-01 Epub Date: 2018-11-14 DOI: 10.1136/jramc-2018-001086

Kerry Jo Starkey, H J Pynn, G Nordmann

引用次数: 0

Guerin's sign reflecting pterygoid plate dysjunction. 反映翼状板不接合的Guerin征。

Journal of the Royal Army Medical Corps Pub Date : 2019-12-01 Epub Date: 2019-01-03 DOI: 10.1136/jramc-2018-001125

Vaibhav Sahni

引用次数: 0