Traumatic brain injury induced by exposure to blast overpressure via ear canal

Availability of rehabilitation for victims of mine-explosive injury in the conditions of territorial community

OBJECTIVE

Aim: The aim of the study was to determine the needs for long-term rehabilitation of persons with damage as a result of a mine-explosive trauma and the availability of rehabilitation for these persons in the territorial community.

PATIENTS AND METHODS

Materials and Methods: Research materials included domestic and foreign scientific sources and normative legal acts on the topic. Research methods included the content analysis, bibliosemantic, data summarization, medical and statistical.

RESULTS

Results: The needs for long-term rehabilitation are determined by combined damage, among which damage to the limbs (34.78%-65.22%) [10], craniocerebral injuries (7.9%-12.7%) [11], the acoustic system (40.5%) [16], injuries of bones and soft tissues of the face (10.85%) [18]. Іn 2018, for the first time, 1.2 per 10,000 adult population of participants of the Anti-Terrorist Operation/Joint Forces Operation were recognized as persons with disabilities [7]. Permanent limitations of life activities were caused mainly by brain and limb injuries. In general, long-term rehabilitation is available to persons with injuries in the territorial community in accordance with European approaches. At the same time, the participation of the general practitioner-family doctor is limited by regulatory requirements only to refer the patient to rehabilitation specialists and other specialists.

CONCLUSION

Conclusions: High needs for long-term rehabilitation of persons brain and limb injuries as a result of mine-explosive trauma have been established. There is a need to expand the participation of general practitioners-family doctor in the organization and implementation of rehabilitation as a full-fledged member of a multidisciplinary rehabilitation team, which requires making appropriate changes to regulatory acts.

Limbic Responses Following Shock Wave Exposure in Male and Female Mice

Blast traumatic brain injury (bTBI) presents a serious threat to military personnel and often results in psychiatric conditions related to limbic system dysfunction. In this study, the functional outcomes for anxiety- and depressive-like behaviors and neuronal activation were evaluated in male and female mice after exposure to an Advanced Blast Simulator (ABS) shock wave. Mice were placed in a ventrally exposed orientation inside of the ABS test section and received primary and tertiary shock wave insults of approximately 15 psi peak pressure. Evans blue staining indicated cases of blood-brain barrier breach in the superficial cerebral cortex four, but not 24 h after blast, but the severity was variable. Behavioral testing with the elevated plus maze (EPM) or elevated zero maze (EZM), sucrose preference test (SPT), and tail suspension test (TST) or forced swim test (FST) were conducted 8 days–3.5 weeks after shock wave exposure. There was a sex difference, but no injury effect, for distance travelled in the EZM where female mice travelled significantly farther than males. The SPT and FST did not indicate group differences; however, injured mice were less immobile than sham mice during the TST; possibly indicating more agitated behavior. In a separate cohort of animals, the expression of the immediate early gene, c-Fos, was detected 4 h after undergoing bTBI or sham procedures. No differences in c-Fos expression were found in the cerebral cortex, but female mice in general displayed enhanced c-Fos activation in the paraventricular nucleus of the thalamus (PVT) compared to male mice. In the amygdala, more c-Fos-positive cells were observed in injured animals compared to sham mice. The observed sex differences in the PVT and c-Fos activation in the amygdala may correlate with the reported hyperactivity of females post-injury. This study demonstrates, albeit with mild effects, behavioral and neuronal activation correlates in female rodents after blast injury that could be relevant to the incidence of increased post-traumatic stress disorder in women.