RESUMEN
Military deployments to Afghanistan and Iraq have been associated with elevated prevalence of both posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) among combat veterans. The diagnosis and management of PTSD when a comorbid TBI may also exist presents a challenge to interdisciplinary care teams at Department of Veterans Affairs (VA) and civilian medical facilities, particularly when the patient reports a history of blast exposure. Treatment recommendations from VA and Department of Defense's (DOD) recently updated VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress are considered from the perspective of simultaneously managing comorbid TBI.
Asunto(s)
Lesiones Encefálicas/terapia , Psicoterapia/métodos , Psicotrópicos/uso terapéutico , Trastornos por Estrés Postraumático/terapia , Veteranos/psicología , Guerra , Campaña Afgana 2001- , Traumatismos por Explosión , Lesiones Encefálicas/diagnóstico , Lesiones Encefálicas/epidemiología , Lesiones Encefálicas/psicología , Humanos , Guerra de Irak 2003-2011 , Guías de Práctica Clínica como Asunto , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Trastornos Relacionados con Sustancias/epidemiología , Estados Unidos/epidemiología , United States Department of Veterans AffairsRESUMEN
OBJECTIVES: This paper quantifies pediatric thoracoabdominal response to belt loading to guide the scaling of existing adult response data and to assess the validity of a juvenile porcine abdominal model for application to the development of physical and computational models of the human child. METHODS: Table-top belt-loading experiments were performed on 6, 7, and 15 year-old pediatric post-mortem human subjects (PMHS). Response targets are reported for diagonal belt and distributed loading of the anterior thorax and for horizontal belt loading of the abdomen. RESULTS: The pediatric PMHS exhibited abdominal response similar to the swine, including the degree of rate sensitivity. The thoraces of the PMHS were as stiff as, or slightly more stiff than, published adult corridors. CONCLUSIONS: An assessment of age-related changes in thoracic stiffness suggests that the effective stiffness of the chest increases through the fourth decade of life and then decreases, resulting in stiffness values similar for children and elderly adults.
Asunto(s)
Abdomen/fisiología , Simulación por Computador , Modelos Biológicos , Cinturones de Seguridad , Tórax/fisiología , Adolescente , Animales , Fenómenos Biomecánicos , Niño , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , PorcinosRESUMEN
Barotrauma is common in modern warfare. We present the first description of sound induced vertigo caused by superior canal dehiscence (SCD) precipitated by blast exposure. Patients who complain of balance or visual changes after military or terrorist blast exposure should be evaluated for SCD.
