To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Improved understanding of the pattern of white matter changes in early and prodromal Alzheimer's disease (AD) states such as mild cognitive impairment (MCI) is necessary to support earlier preclinical detection of AD, and debate remains whether white matter changes in MCI are secondary to gray matter changes. We applied neuropsychologically based MCI criteria to a sample of normally aging older adults; 32 participants met criteria for MCI and 81 participants were classified as normal control (NC) subjects. Whole-head high resolution T1 and diffusion tensor imaging scans were completed. Tract-Based Spatial Statistics was applied and a priori selected regions of interest were extracted. Hippocampal volume and cortical thickness averaged across regions with known vulnerability to AD were derived. Controlling for cortical thickness, the MCI group showed decreased average fractional anisotropy (FA) and decreased FA in parietal white matter and in white matter underlying the entorhinal and posterior cingulate cortices relative to the NC group. Statistically controlling for cortical thickness, medial temporal FA was related to memory and parietal FA was related to executive functioning. These results provide further support for the potential role of white matter integrity as an early biomarker for individuals at risk for AD and highlight that changes in white matter may be independent of gray matter changes. (JINS, 2013, 19, 1–13)
Peter F. Mahoney, Military Critical Care, Royal Centre for Defence Medicine, Birmingham, United Kingdom,
Craig C. McFarland, Department of Anesthesiology, Uniformed Services, University of the Health Sciences, Bethesda, Maryland
Review the military environment and the constraints this imposes on resuscitation and anesthesia.
Review the issues in resuscitation of the ballistic casualty.
Discuss aspects of field anesthesia.
Injuries from modern military munitions can be complex and devastating. Their management demands particular anesthetic and surgical skill sets including an understanding of time-critical injury. In addition, casualty management in the deployed military setting is subject to a number of threats and constraints that influence how care can be delivered. This chapter will consider the types of casualties that may present to the military provider; how the care is influenced by situational constraints, and suggest some anesthetic techniques that are appropriate for use in the field.
Casualties presenting to the military anesthesiologist or anesthetist will broadly fall into a number of groups:
The ill, multiply injured casualty with time-critical injuries
The injured casualty needing surgery for wound care who is stable and can wait
Casualties needing follow-up procedures for wound and injury care
Routine problems such as appendectomies
Civilian patients (adult and child) falling into the above groups
All of these would have differing requirements in the setting of a large, well-resourced civilian hospital. The constraints of the military environment can mean they are managed very differently. This chapter is structured to try and separate the three chapter objectives, but in reality they are interwoven and some repetition is necessary between the different sections. The chapter starts with an overview of these constraints.
Email your librarian or administrator to recommend adding this to your organisation's collection.