Modeling Complex Orthopedic Trauma in Rodents: Bone, Muscle and Nerve Injury and Healing

Orthopedic injury can occur from a variety of causes including motor vehicle collision, battlefield injuries or even falls from standing. Persistent limb pain is common after orthopedic injury or surgery and presents a unique challenge, as the initiating event may result in polytrauma to bone, muscle, and peripheral nerves. It is imperative that we understand the tissue-specific and multicellular response to this unique type of injury in order to best develop targeted treatments that improve healing and regeneration. In this Mini Review we will first discuss current rodent models of orthopedic trauma/complex orthotrauma. In the second section, we will focus on bone-specific outcomes including imaging modalities, biomechanical testing and immunostaining for markers of bone healing/turnover. In the third section, we will discuss muscle-related pathology including outcome measures of fibrosis, muscle regeneration and tensile strength measurements. In the fourth section, we will discuss nervous system-related pathology including outcome measures of pain-like responses, both reflexive and non-reflexive. In all sections we will consider parallels between preclinical outcome measures and the functional and mechanistic findings of the human condition.

Zay Anna Herbáriuma és a XVIII. századi magyar gyógyszerészi szaknyelv

By the end of the 17th century, the Ottoman Empire power had been expelled out of Hungary. At the same time, the death of the King of Spain, forecast the end of the “Western” Habsburg Empire. Emerging economic nations England and the Netherlands wanted to create a new balance of power in which the Principality of Transylvania was also concerned. The Spanish War of Succession ended with the peace of Utrecht, which created a modern style of diplomacy. Ferenc Rákóczi II realized the chance of Hungary’s independence in a rearranging Europe, thus he started his war of independence. One of the spectacular social rise families of the era was the Vay family. Adam Vay wanted to be out of the war of independence. However, when the imperial troops burned down Gács Castle, he joined Rákóczi. Rising to the rank of general, Vay went to exile with his family in Poland after the peace of Szatmár (present-day Satu Mare, Romania). In exile, not only deprivation but also disease threatened them. Typical for the manorial courts of the era, scholar and lay healers worked together. His well-read wife, Anna Zay, began writing herbarium following this tradition. She tried most of the recipes he collected among the personnel of her house. Her work was circulated as a manuscript copy, which preserved the 16th – 17th-century Hungarian medical language. For the people of this era, above the battlefield injuries, the most feared disease was the plague. For Zay, prayer strengthened her endurance, helped her bearing much suffering and sorrow and provided hope to be freed from her exile. God speaks to man through the word, but prayers speak to God.

The use of Unmanned Aerial Vehicles for CASEVAC in the future urban and littoral environments

The recent development of Unmanned Aerial Vehicles (UAVs) and their potential use for casualty evacuation (CASEVAC) has exciting implications for the United Kingdom Defence Medical Services (DMS). When compared to existing technology, the unique attributes of small size, increased manoeuvrability and lack of a human pilot would be extremely useful in congested and hazardous settings. There are ethical and practical considerations to be taken into account, but harnessing the full potential of this technology may improve the chances of survival from some battlefield injuries.UAVs could be of most benefit in a congested and complex battlespace, allowing evacuation of casualties from high risk environments. In addition to CASEVAC, a UAV could be used for critical care transfers, Search and Rescue (SAR) and Humanitarian And Disaster Relief (HADR) operations. Given the vast array of potential applications and a lower risk profile compared with current CASEVAC platforms, the DMS should actively monitor the development of UAV technology and plan ahead for integration within current doctrine.

Elective neurosurgical humanitarian care in a deployed setting

OBJECTIVEActive-duty neurosurgical coverage has been provided at Bagram Air Force Base in Afghanistan since 2007. Early operative logs were reflective of a large number of surgical procedures performed to treat battlefield injuries. However, with maturation of the war effort, the number of operations for battlefield injuries has decreased with time. Consequently, procedures performed for elective neurosurgical humanitarian care (NHC) increased in number and complexity prior to closure of the Korean Hospital in 2015, which resulted in effective termination of NHC at Bagram. Monthly neurosurgical caseloads for deployed personnel have dropped precipitously since this time, renewing a debate as to whether the benefits of providing elective NHC in Afghanistan outweigh the costs of such a strategy. To date, there is a paucity of information in the literature discussing the overall context of such a determination.METHODSThe author retrospectively reviewed his personal database of all patients who underwent neurosurgical procedures at Bagram during his deployment there from April 17 to October 29, 2014. Standardized clinical parameters had been recorded in the ABNS NeuroLog system. All cases of nonelective surgical care for battlefield injuries were identified and excluded. Records of all other procedures, which represented elective NHC delivered during this period, were accessed to extract salient clinical and radiological data.RESULTSDuring the 6-month deployment, 49 patients (29 male and 20 female, age range 18 months to 63 years) were treated by the author in elective NHC. Procedures were performed for spinal degenerative disease (n = 28), cranial tumors (n = 11), pediatric conditions (n = 6), Pott’s disease (n = 2), peripheral nerve impingement (n = 1), and adult hydrocephalus (n = 1). The duration of follow-up ranged from 3 to 23 weeks. Complications referable to surgery included asymptomatic, unilateral lumbar screw fracture detected 3 months postoperatively and treated with revision of hardware (n = 1); wound infection requiring cranial flap explantation and staged cranioplasty (n = 1); and unanticipated return to the operating room for resection of residual tumor in a patient with a solitary metastatic lesion involving the mesial temporal lobe/ambient cistern (n = 1). There were no instances of postoperative neurological decline.CONCLUSIONSElective NHC can be safely and effectively implemented in the deployed setting. Benefits of a military strategy that supports humanitarian care include strengthening of the bond between the US/Afghan military communities and the local civilian population as well as maintenance of skills of the neurosurgical team during the sometimes-lengthy intervals between cases in which emergent neurosurgical care is provided for treatment of battlefield injuries.

Syntheses of Ketamine and Related Analogues: A Mini Review

Ketamine [2-(2-chlorophenyl)-2-(methylamino)cyclohexanone] is a dissociative anaesthetic, first developed in 1963 by Parke-Davis. It finds widespread application in the treatment of battlefield injuries, and in emergency departments for use in children. In recent times the clinical interest in ketamine has increased due to the positive impact it has in treating depression and the rapid onset of its antidepressant effect. This review covers the synthetic effort towards ketamine and related analogues over the past 60 years to give readers an overview of past, current, and future research outlook pertaining to ketamine-like molecules.1 Introduction2 Early Work3 Synthesis3.1 Ketamine3.2 Norketamine3.3 Ketamine Analogues4 Future Outlook and Conclusion

The Research of BDAR under Conditions of Informationalization

Effective implementation of BDAR(Battlefield Damage Assessment and Repair) can compensate equipment for battlefield losses, maintain combat effectiveness at the meantime. Under the conditions of modern information warfare, a variety of advanced reconnaissance, detection methods and widely used precision strike weapons, are making the battlefield highly transparent, however,the living environment of weaponry will become very seriously, more brutal battlefield injuries of weaponry will come up simultaneously. Equipment battlefield damage repair is facing new challenges,therefore,the BDAR military equipment which can maintain and enhance the combat capability has great practical significance under conditions of informationalization.