United States Department of the Army

About: United States Department of the Army is a government organization based out in Arlington, Virginia, United States. It is known for research contribution in the topics: Poison control & Population. The organization has 32668 authors who have published 42453 publications receiving 947075 citations. The organization is also known as: DA & U.S. Department of the Army.

COVID-19: Facts, Cultural Considerations, and Risk of Stigmatization.

Abstract: Data on COVID-19 supports targeted social distancing could be an effective way to reduce morbidity and mortality, but could inadvertently increase stigma for affected populations. As health care providers we must be aware of the facts of COVID-19, cultural implications, and potential for stigmatization of populations affected by COVID-2019. It is important to consider the real economic impact related to lost workdays due to quarantine and social isolation efforts as well as travel restrictions that may negatively impact access to care and ability to pay for care. Efforts geared towards general education about the disease and the rationale for quarantine and public health information provided to the general public can reduce stigmatization. Countries who are successful at aggressive screening, early identification, patient isolation, contact tracing, quarantine, and infection control methods should also address the risk of stigmatization among populations and the negative effects which could occur. The cases of COVID-19 will continue to rise and the virus will be sustainable for future infections. Timely and appropriate public health interventions addressing cultural impact and risk for stigmatization along with proper screening, treatment, and follow up for affected individuals and close contacts can reduce the number of infections, serious illness, and deaths.

Surgical tourniquets in orthopaedics.

Abstract: Higher levels of tourniquet pressure and higher pressure gradients beneath tourniquet cuffs are associated with a higher risk of nerve-related injury. Measurement of limb occlusion pressure can help to minimize tourniquet pressure levels and pressure gradients for individual patients and individual surgical procedures. Selective use of pneumatic, wider, and contoured tourniquet cuffs reduces tourniquet pressure levels and the applied pressure gradients.

Ten-Year Analysis of Transfusion in Operation Iraqi Freedom and Operation Enduring Freedom: Increased Plasma and Platelet Use Correlates with Improved Survival

Abstract: : BACKGROUND: The Joint Theater Trauma Registry database, begun early in Operation Iraqi Freedom and Operation Enduring Freedom, created a comprehensive repository of information that facilitated research efforts and produced rapid changes in clinical care. New clinical practice guidelines were adopted throughout the last decade. The damage-control resuscitation clinical practice guideline sought to provide high-quality blood products in support of tissue perfusion and hemostasis. The goal was to reduce death from hemorrhagic shock in patients with severe traumatic bleeding. This 10-year review of the Joint Theater Trauma Registry database reports the military s experience with resuscitation and coagulopathy, evaluates the effect of increased plasma and platelet (PLT) to red blood cell ratios, and analyzes other recent changes in practice. METHODS: Records of US active duty service members at least 18 years of age who were admitted to a military hospital from March 2003 to February 2012 were entered into a database. Those who received at least one blood product (n 3,632) were included in the analysis. Data were analyzed with respect to interactions within and between categories (demographics, admission characteristics, hospital course, and outcome). Transfusions were analyzed with respect to time, survival, and effect of increasing transfusion ratios. RESULTS: Coagulopathy was prevalent upon presentation (33% with international normalized ratio Q 1.5), correlated with increased mortality (fivefold higher), and was associated with the need for massive transfusion. High transfusion ratios of fresh frozen plasma and PLT to red blood cellswere correlated with higher survival but not decreased blood requirement. Survivalwas most correlated with PLT ratio, but high fresh frozen plasma ratio had an additive effect (PLT odds ratio, 0.22).

Ten years at war: comprehensive analysis of amputation trends.

Abstract: BACKGROUND: While multiple studies have examined amputations that have occurred during the current conflicts in Iraq and Afghanistan, none of these studies have provided an overarching characterization of all of these injuries. METHODS: A retrospective study of all major extremity amputations sustained by US Service Members from January 2001 through July 30, 2011, was performed. Data obtained from these amputees included amputation level(s), mechanism of injury, time to amputation, Injury Severity Score (ISS), age, rank, number of trauma admissions, and number of troops deployed. RESULTS: There were 1,221 amputees who met inclusion criteria. These amputees sustained a total of 1,631 amputations. The number of amputations performed each year has increased dramatically in 2010 (196) and the first half of 2011 (160) from 2008 (105) and 2009 (94). The number of amputations performed per every 100 traumatic admissions (3.5-14) and the number of amputations per 100,000 deployed troops (2-14) has also increased in 2010 and the first half of 2011. Most amputations occurred at the transtibial (683, 41.8%) and transfemoral (564, 34.5%) levels. Thirty percent of the amputees (366) sustained multiple amputations, and 14% of all amputations (228) performed involved the upper extremity. There were 127 amputees (10%) who underwent their amputation more than 90 days after the date of injury. CONCLUSION: The number of amputations occurring during the current Iraqi and Afghanistan conflicts has increased in 2010 and the first half of 2011. Most amputations involve the lower extremities, and there is a much higher percentage of amputees who have sustained multiple amputations during current operations than previous conflicts. LEVEL OF EVIDENCE: Epidemiologic study, level IV. Language: en