Direct skeletal fixation: A new treatment option for Canadian war amputees
Abstract: Combat-related extremity amputations are common injuries during armed conflict. In recent years, improvised explosive devices have been responsible for massive trauma, including major amputations. Many war amputees have functional limitations that affect quality of life. Surgeons can now insert a metal implant directly in the residual bone to provide a stable anchor for the extremity prosthesis. This procedure improves the ability to walk but carries a high risk of infection. Veterans with serious functional limitations due to problems with socket fixation may consider this treatment option after consulting with a specialized team.
Abstract: Background: Individuals with pre-existing heavy alcohol use, prior traumatic exposures, and psychiatric disorders were considered an at-risk group for increased alcohol use and problems in the context of the COVID-19 pandemic. Objective: This study recruited from a multi-centre longitudinal cohort study of US military service members/veterans with combat exposure to examine the trajectories of alcohol use and problems in the context of a prolonged stressor. Methods: Individuals who endorsed heavy drinking and completed a measure of PTSD symptoms prior to the pandemic were invited to participate in a longitudinal survey study at three time points, three months apart, during the second year of the pandemic. Participants (N=44) completed surveys assessing alcohol consumption and alcohol-related problems (via the AUDIT), PTSD symptoms (via the PCL-5), and infection mitigation behaviours (via a COVID-19 specific survey). Random intercept models were fitted to the longitudinal data for each of these outcomes, covarying for demographics, pandemic quarantine/physical distancing experience, pre-pandemic baseline alcohol consumption and PTSD symptoms, and time-varying alcohol consumption and alcohol-related problems as well as PTSD symptoms. Results: We did not find an increase in alcohol consumption or problems over time. However, pre-pandemic alcohol consumption predicted alcohol consumption over time (B=0.52, SE=0.11, p