Health impacts of war: case studies of New Zealand veterans of the First World War.

AIM: Armed conflict remains a tragic feature of the modern world and so it is necessary to continue to study its health impacts. Even the study of historical conflicts is relevant given that certain health impacts are common to most wars e.g., post-traumatic stress disorder (PTSD). METHODS: This study built on a previous quantitative analysis of a randomly selected group of 200 New Zealand veterans from the First World War (WWI). From this sample we selected 10 cases that illustrated particular themes around morbidity impacts. RESULTS: The theme of severity of impacts was illustrated with a case who was severely wounded and died from suicide when back in New Zealand, and another case with severe PTSD. The theme of the high frequency of non-fatal conditions was revealed with cases illustrating new diagnoses (a case with n=8 diagnoses), hospitalisations for new conditions (n=6), non-fatal injury events (n=3) and for sexually transmitted infections (n=3). The theme of chronic debility as a consequence of various conditions was illustrated with cases who had suffered from being gassed or having gastroenteritis, malaria or pandemic influenza. CONCLUSION: These 10 selected cases reiterate how severe and extensive the morbidity burden for military personnel in WWI could be. Also illustrated is how the morbidity could contribute to adverse impacts on some of their lives after returning to New Zealand.

Frederic Lewy: how the two World Wars changed his life, work, and name.

In 1912, Friedrich Lewy described the inclusion bodies present in Parkinson disease and in Lewy body dementia. Throughout his life, Lewy fought in two wars - on opposite sides. He was born in Berlin in a Jewish family, and served in the German Army in World War I. In the following years, on many occasions he had to change his line of research due to Nazi persecution. Lewy became a naturalized American, changed his name to Frederic Henry Lewey, and served in the US Army as a lieutenant colonel. Lewy died in 1950 and never used the famous eponym in his papers.

Em 1912, Friedrich Lewy descreveu os corpos de inclusão presentes na doença de Parkinson e na demência com corpos de Lewy. Ao longo sua vida, Lewy lutou em duas guerras, em lados opostos. Ele nasceu em Berlin em uma família de origem judaica e serviu no Exército alemão na Primeira Guerra Mundial. Nos anos seguintes, passou muitas vezes teve de mudar sua linha de pesquisa devido à perseguição Nazista. Lewy naturalizou-se americano, mudou seu nome para Frederic Henry Lewey, e serviu no Exército americano como tenente-coronel. Lewy morreu em 1950 e nunca usou o famoso epônimo em seus artigos.

The unseen casualties of the First World War: insights from a randomly selected military sample.

AIMS: Studies of the morbidity burden of military personnel participating in the First World War (WWI) have tended to focus on specific outcomes (e.g., injuries). Therefore, we aimed for a more complete assessment. METHODS: From a random sample of active war service-exposed New Zealand WWI veterans used in previously published work, we examined a random subsample of 200 personnel. Data on diagnoses, hospitalisations and outcomes were extracted from the online archival military files. RESULTS: These personnel experienced a very high morbidity burden with 94% having at least one new condition diagnosed during their military service (mean: 2.4 per individual; range: 0 to 8). The relative severity of these conditions was reflected by the high level of hospitalisation (89% at least once; mean: 1.8 hospitalisations for new conditions per individual) and 59% of personnel being deemed no longer fit for military service at some stage. More of the new diagnoses were for infectious diseases than for conflict-related injuries (117 vs 50 cases per 100 personnel). Respiratory conditions such as influenza, pneumonia and tuberculosis affected 33% of personnel, and 14% were diagnosed with sexually transmitted infections. Diseases reflecting hazardous environmental conditions were relatively common e.g., for dysentery/gastroenteritis in 12% and scabies in 5% of personnel. Diagnoses suggestive of post-traumatic stress disorder (PTSD) were present in 10% and chemical warfare injuries in 6%. CONCLUSIONS: The overall morbidity burden of this military force in WWI was very high, and much higher than the previous official estimates.

THE HEALTH SYSTEM OF THE FIRST CZECHOSLOVAK REPUBLIC AND ITS ROLE IN COMBATING CONTAGIOUS DISEASES IMMEDIATELY AFTER THE FIRST WORLD WAR (THE 1920s)

A complex epidemiological situation marked the health system at the time of the establishment of the Czechoslovak Republic. Reducing the number of infectious diseases was an essential task of the State Administration of Health. It required new legislation and various steps directed at reducing infectious diseases. Serious infectious diseases, such as scarlet fever, diphtheria, typhoid, dysentery, smallpox, and malaria, were among the most significant health problems in Czechoslovakia. In 1920, Act No. 412 Coll. regarding compulsory smallpox vaccination was issued, as well as government Regulation No. 298, which describes vaccination obligations and stipulated proper isolation of patients with infectious diseases. Other steps that led to improvements included establishing the National Institute of Health and mobile disinfectant units. Conclusion: The systematic development of new legislation contributed to the new Republic's proficiency at the task and the gradual reduction in the number of infectious diseases.

OSTEOPOROSIS FROM YESTERDAY TO TODAY ­ A NARRATIVE REVIEW

Despite different lifestyles, humankind has suffered from osteoporosis for thousands of years. A literature review concerning the history of osteoporosis in the following databases: Index Medicus, Medline, PubMed, and PMC Citations was done. In the final analysis, 18 review articles and 31 original papers were included. The works were published during the period 1705-2020. Although there is evidence of the existence of osteoporosis for many centuries, it was first described as a disease at the beginning of the 18th century. It was first perceived as an unavoidable course of aging with no possibility to cure. This approach changed only in the 20th century thanks to sudden diagnostic and therapeutic progress. This paper presents the milestones and most important researchers in osteoporosis history. Rapid progress in diagnostic and therapeutic possibilities sheds new light on osteoporosis' nature. A comprehensive outlook on its history may help find answers for the still unsolved problems of this disease.

Technical conferences as a technique of internationalism.

This paper looks at a genre of meetings that, while neither purely 'scientific' nor 'diplomatic', drew on elements from both professional spheres and gained prominence in the interwar decades and during the Second World War. It proposes to make sense of 'technical conferences' as a phenomenon that was made by and through scientific experts and politicians championing the organizing power of rationality, science and liberal internationalism. Against the background of swelling ranks of state-employed scientists, this paper documents the emergence of technical conferences as the forums where they got down to work. To make this case the paper traces the influence of a new way of thinking about the function and organization of conferences, originating in the time around the First World War, on one international organization in particular: the United Nations Relief and Rehabilitation Administration (UNRRA), as a new hub of scientists and technicians.

History of Cranial Surgery in World War I: Experience on the Italian Front.

Since ancient history, men have been attempting to intervene when skull trauma occurs. The majority of traumas were always linked to war injuries, and in the modern era, the culprit was reached during World War I. Cranial traumas in wartime were very common, and consequently, physicians in wartime became particularly interested in the subject of cranial traumatology. In the following text, we want to bring to light the experience of some of the pioneers of cranial surgery in Italy during the First Great War. In fact before the war, very few medical officers had received training in central nervous system surgery. In addition, the surgical instruments for that clinical activity were inadequate and obsolete, but to deal with the medical emergency that had arisen on the front lines, the Italian government established Battlefield Medical Schools. And it is also from the reports and lectures of surgeons working on the front lines that the next generations of neurosurgeons were able to develop this surgical field into the complex and well-established surgical specialty that it is today.

[The significance of ideas and first experiences of A. A. Bogdanov for development of transfusiology in Russia].

The article considers the period of becoming of transfusiology in the USSR that fell on times of the First World War, the October Revolution, the Civil War and scrambling for power of various political forces. This scramble resulted in victory by forces that did not consider A. A. Bogdanov as an ideological enemy. It allowed him, already withdrew from political activity, to develop and to embody his concept of blood transfusion even in conditions of shortage of resources. The development of theory of A. A. Bogdanov from his early literary works to first experiments with blood transfusion is demonstrated. He carried out these experiments jointly with like-minded persons in conditions of the "underground" and active discussion at the highest state level necessity of establishing special Institute of blood transfusion in the country. Particular biographical information demonstrating ability of man to sacrifice oneself in searching the Truth are presented. The 2023 is the year of one hundred fiftieth birthday and the ninety fifth death anniversary (the death resulted from failed experience on oneself) of A. A. Malinovsky (Bogdanov) - the revolutionary, psychiatrist, politician, philosopher and man of letters.

Management of combat-sustained radial nerve injury during World War I: The case of Louis-Ferdinand Céline.

The radial nerve conveys sensory and motor information to and from the upper limb, and radial nerve injury can induce functional disability, as demonstrated by the case of the renowned French writer Louis-Ferdinand Céline (1894-1961), who sustained a gunshot injury to his right arm in October 1914. Radial nerve injuries treated during World War I inspired the publication of several medical handbooks and medical theses, such as that of the military surgeon Major Robert Bretton (1889-1956). The aim of this paper is, via Céline's injury, to explore the management of radial nerve injury during and since World War I. It is important to consider the historical perspective in order to improve radial nerve injury management so as to adapt to modern warfare.

Chemical 'canaries': Munitions workers in the First World War.

In the early twentieth century, scientific innovations permanently changed international warfare. As chemicals traveled out of laboratories into factories and military locations, war became waged at home as well as overseas. Large numbers of women were employed in munitions factories during the First World War, but their public memories have been overshadowed by men who died on battlefields abroad; they have also been ignored in traditional histories of chemistry that focus on laboratory-based research. Mostly young and poorly educated, but crucial for Britain's military success, these female workers were subjected to procedures of social regulation and consigned to carrying out dangerous chemical procedures causing chronic illness or death; in particular, when TNT died their skin yellow, they were colloquially known as 'canaries.'

Why Did Black Soldiers Historically Have More Pneumonia Than White Soldiers in the U.S. Army?

Black U.S. Army soldiers had four times as much bacterial pneumonia as White U.S. Army soldiers during both the U.S. Civil War and World War I (WWI). Pneumonia case fatality rates were a third greater in Black soldiers during the U.S. Civil War, but were the same between the racial groups by WWI. During WWII, the use of antibiotics decreased bacterial pneumonia mortality rates 100-fold and apparently erased racial differences. Similar differences in bacterial pneumonia rates by racial group were observed in African colonial soldiers of the French and British Armies during WWI. Pneumonia rates in Indian, Filipino, and Puerto Rican soldiers suggested that genetic polymorphisms were not a decisive factor determining Black pneumonia mortality. Postmeasles pneumonias did not suggest an immune deficit in Black soldiers. Geographic focus of pneumonia in Black soldiers from the southern U.S. states and other tropical regions raises the possibility that increased bacterial pneumonia rates were related indirectly to malaria infections. Malaria remains a difficult-to-measure but potentially important mortality risk factor in pneumonia.

[Beyond the trenches, two German pioneers of plastic surgery]. / Au-delà des tranchées, deux pionniers allemands de la chirurgie plastique.

Cosmetic and reconstructive surgery has existed in many forms since antiquity, but it was the impulse given by the Great War that gave birth to plastic and cosmetic surgery as we know it today. After the Great War, the names of the most famous pioneers of the allies' side are Sir Harold Gillies, Mac Indoe and also Hippolyte Morestin; however, the surgeons of the enemy axis, beyond the trenches, faced the same constraints with their own war casualties. We present the destinies of two great pioneers of plastic surgery within the beautiful German Bismarckian period: Professor Erich Lexer, and "non-professor" Jakob Joseph.

Neurosurgical management of penetrating brain injury during World War I: A historical cohort.

During World War I, 25% of penetrating injuries were in the cephalic region. Major Henri Brodier described his surgical techniques in a book in which he reported every consecutive penetrating brain injury (PBI) that he operated on from August 1914 to July 1916. The aim was to collate his data and discuss significant differences in management between soldiers who survived and those who died. We conducted a retrospective survey that included every consecutive PBI patient operated on by Henri Brodier from August 1914 to April 1916 and recorded in his book. We reported medical and surgical management. Seventy-seven patients underwent trepanation by Henri Brodier for PBI. Regarding injury mechanism, 66 procedures (86%) were for shrapnel injury. Regarding location, 21 (30%) involved the whole convexity. Intracranial venous sinus wound was diagnosed intraoperatively in 11 patients (14%). Postoperatively, 7 patients (9%) had seizures, 5 (6%) had cerebral herniation, 3 (4%) had cerebral abscess, and 5 (6%) had meningitis. No patients with abscess or meningitis survived. No significant intergroup differences were found for injury mechanism or wound location, including the venous sinus. Extensive initial surgery with debridement must be prioritized. Infectious complications must not be neglected. We should not forget the lessons of the past when managing casualties in present-day and future conflicts.

Surviving the Deluge: British servicemen in World War I.

We estimate the correlates of death and injury in action during the First World War for a sample of 2400 non-officer British servicemen who were born in the 1890s. Among these 13.1% were killed in action and another 23.5% were wounded. Not surprisingly we find that the probability of death or wounding increases with time in the army and was higher among infantrymen. For a serviceman who enlisted in the infantry at the beginning of the war and continued in service, the probability of being killed in action was 29% and the probability of being either killed or wounded in action was 64%. We examine, for ordinary soldiers, the hypothesis that death and injury was more likely for those from higher socioeconomic backgrounds as is suggested in the literature on the 'lost generation'. While such selectivity applies when comparing officers with other ranks it does not apply among the ordinary soldiers who comprised 95% of the army.

Getting Into One's Skin: The History of Skin Autografting.

Surgeons who treat and manage complex wounds rely on many techniques and modalities to properly close their wounds. In modern times, the concept of the reconstructive ladder helps practitioners make decisions on which method to employ to create the best result. Skin autografting is a part of that algorithm, but few know of the arduous history of this field. Dating back thousands of years ago, the history of skin autografting is complex and spans several continents and eras. This article discusses the history and nuance of a surgical technique that has had years of refinement. The discussion begins with ancient times and delves into how skin autografting made a resurgence during the renaissance and the late 1800s and the influence that World War I posed on the advancement of this surgical principle.

Mortality among those certified under lunacy legislation in Scotland during World War I.

Mortality in asylum populations increased during World War I. This paper seeks to analyse the mortality data from Scotland, where governmental statistics allow comparison between different lunacy institutions, poorhouses and prisons, as well as people certified under lunacy legislation but living in the community. Detailed study is made of two Lothian asylums, the Royal Edinburgh Asylum and the Midlothian and Peebles District Asylum, and the 1918 influenza pandemic is considered in the asylum context. Similarities and differences between the situation in Scotland and that in England and Wales are discussed, and parallels are drawn with the Covid-19 pandemic in Scotland.