Ostra utrata krwi : co możemy zrobić w warunkach przedszpitalnych? Doświadczenia pola walki

Autorzy przedstawili praktyczne wnioski i zalecenia postępowania w przypadku wystąpienia krwotoków w warunkach pola walki. Ich stosowanie ma kluczowe znaczenie dla osiągnięcia sukcesu i przeżycia rannych w niesprzyjających warunkach środowiska taktycznego. Doświadczenia medycyny wojskowej i praktyczne rozwiązania w celu zapewnienia skutecznej hemostazy lub zachowania restrykcyjnej płynoterapii w przypadku krwotoków wewnętrznych mogą znaleźć zastosowanie również w cywilnej opiece przedszpitalnej.The authors presented the practical conclusions and therapeutic recommendations for the heavily bleeding patients, managed under combat conditions. Such therapy is vital for the wounded in the hostile tactical environment. The military medical solutions for assuring the effective hemostasis or applying the restrictive fluid therapy in internal bleeding cases may be useful also in civilian medicine

What changes occur in the brain of veteran? A magnetic resonance imaging and proton magnetic resonance spectroscopy study

The aims of this study were to assess the common anomalies in the MRI examinations of the heads of soldiers as well as to compare the relative concentration of magnetic resonance spectroscopy (MRS) metabolites in the brains of soldiers with those of healthy age-matched controls. Overall, 54 professional male soldiers were included in the study group and 46 healthy, age-matched males were in the control group. The relative values of N-acetylaspartate (NAA), choline (Cho), and myoinositol (mI) to creatine (Cr) were assessed. The mean relative concentrations of metabolites were compared between the study and the control group, separately for the frontal and occipital lobes, as well as between the right and left hemispheres within the study group only. The most frequent findings in the head MRI of the soldiers were: asymmetric lateral ventricles and dilated perivascular spaces, enlargement of the subarachnoid spaces, and the presence of cavum septum pellucidum and cavum vergae; the high frequency of sinus disease should also be noted. In the frontal lobes, the mI/Cr ratio was significantly higher (p = 0.005), while the NAA/Cr ratio was lower (p = 0.001), in the group of soldiers (vs. the study group). In the occipital lobes, the NAA/Cr ratio was significantly lower (p = 0.005) in the military personnel and there was a tendency to a higher mI/Cr ratio in the soldiers’ occipital lobes (p = 0.056) (vs. the study group). Comparing the metabolites between the left and right hemispheres in soldiers preferring a right shooting position, a significantly higher mI/Cr (p p = 0.003) in the right occipital lobe (vs. the left). These changes are associated with astrogliosis and neuronal loss, presumably secondary to repetitive mild traumatic brain injury

A massive bleeding : what can we do in prehospital tactical care? : combat lessons-learned

Autorzy przedstawili praktyczne wnioski i zalecenia postępowania w przypadku wystąpienia krwotoków w warunkach pola walki. Ich stosowanie ma kluczowe znaczenie dla osiągnięcia sukcesu i przeżycia rannych w niesprzyjających warunkach środowiska taktycznego. Doświadczenia medycyny wojskowej i praktyczne rozwiązania w celu zapewnienia skutecznej hemostazy lub zachowania restrykcyjnej płynoterapii w przypadku krwotoków wewnętrznych mogą znaleźć zastosowanie również w cywilnej opiece przedszpitalnej.The authors presented the practical conclusions and therapeutic recommendations for the heavily bleeding patients, managed under combat conditions. Such therapy is vital for the wounded in the hostile tactical environment. The military medical solutions for assuring the effective hemostasis or applying the restrictive fluid therapy in internal bleeding cases may be useful also in civilian medicine