Explosions and blast related injuries

August 05, 2008

There has been a rise in global terrorism against nonmilitary targets. Recent events in Oklahoma City, New York City, Madrid, London, and Mumbai have demonstrated that mass casualties are more likely from explosive devices than from biological, chemical, radioactive, or nuclear weapons. Editors Nabil M. Elsayed, James L. Atkins and Nikolai Gorbunov have assembled an impressive list of international experts in the mechanisms and treatment of blast related injuries in this timely book.

This authoritative text begins with a section on the epidemiology of blast and explosion injuries which details issues of triage, morbidity and mortality, as well as clinical experiences treating casualties at combat support hospitals. The next section covers the pathology and pathophysiology of blast injuries on the lungs and nervous system as well as quaternary blast effects resulting in burns. In a section devoted to primary research on the mechanisms of primary blast injuries, there are chapters devoted to computational modeling of lung blast injuries and the biochemical mechanisms primary blast injuries to include the role of free radicals and oxidative stress and the inflammatory response in primary blast injuries. The final section of the book relates global experiences of blast injuries and their mass casualty management.

Other than the physicians who have treated trauma victims in settings such as Iraq and Afghanistan, few physicians in the United States have been trained in the care of the injured blast victim or have taken care of patients who have sustained injuries from explosions. The assessment of acute injuries from blast is still poorly understood and no reliable prognosticators of blast injuries currently exist. While this text is not meant to serve as a text for the treatment of blast-related injuries, it is meant to provide a better understanding of explosion blast injury mechanism which will in turn help in the design of better protective armor and improve medical care.

Co-Editor Colonel (retired) James L. Atkins, M.D., PhD stated he was "thrilled we were able to assemble such a qualified international group of contributors for the book. This shows this is a worldwide problem, not just a military problem" Dr. Atkins also added that "These threats are constantly changing and it is important that medical professional recognize the patterns of blast related injuries and the inflammatory response precipitated by blast injuries that may take up to 48 hours to manifest." He hopes this book "helps clinicians and researchers understand what is already known about blast injuries" and that in turns "helps to guide the treatment of mass casualties resulting in blast related injuries".
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The authors are available for interview by calling (301) 319-9471, or via e-mail.

Dr. Nabil Elsayed is currently Senior Manager of Toxicology, Department of Early Drug Development with Celgene Corporation in Summit NJ. Dr. Elsayed received his Ph.D. from the School of Public Health, UCLA, Environmental Health and Toxicology and is a Fellow with the Academy of Toxicological Sciences. Dr. Elsayed received a Department of the Army Commendation for Special Services in 1988 for developing a new method for quantitative determination of Physostigmine in human blood. During his time with Walter Reed Army Institute of Research (WRAIR), Dr Elsayed served as Senior Toxicologist and Section Chief, Pulmonary Biochemistry Section, Department of Respiratory Research, Division of Medicine. While at WRAIR, Dr. Elsayed supervised and provided technical advice to civilian and military investigators in the areas of oxidative stress, chemical and biological warfare agents, toxic gases, ischemia/reperfusion injury, dietary and non-dietary antioxidant therapy, blast overpressure and non-lethal weapon injury assessment and treatment. Email: nelsayed@celgene.com

Dr. Atkins received his M.D. and Ph.D. from the University of Maryland and performed his post-doctoral work at NIH. Prior to his retirement from the Army in July of 2005, Colonel (ret) Atkins was the Director of the Division of Military Casualty Research at WRAIR and Task Area Manager for the Resuscitation program of the U.S. Army Medical Research and Materiel Command, Combat Casualty Care Research Program. In 2003 Dr. Atkins received a Lifetime Achievement Award at the Resuscitation Scientific Symposium of the American Heart Association. He received the U.S. Army Medical Research and Materiel Command, Combat Casualty Care Research Program Lifetime Achievement Award in 2005. Dr. Atkins has been studying the role of iron in blast related lung injury since 2004, under a grant from the Peer Reviewed Medical Research Program. He in now focusing his efforts on the emerging problem of blast induced brain injury and he was recently appointed as Director of the newly established Division of Brain Dysfunction and Blast Injury at WRAIR. Email: AtkinsJL@amedd.army.mil

Dr. Nikolai V. Gorbunov is currently Research Associate Professor with the Armed Forces Radiobiology Research Institute in Bethesda, Maryland. Dr. Gorbunov received his Ph.D. from the Russian Academy Sciences in St. Petersburg, Russia. He then completed a two-year postdoctoral training in Biomedicine at the Research Center of the Consorzio "Mario Negri" Sud (Italy) and a two-year DOE postdoctoral training program in Radiation Sciences at the University of Pittsburgh, Graduate School of Public Health. Pittsburgh, Pennsylvania. In 1994 and 2000 Dr. Gorbunov was a recipient of the National Research Council Fellowship Awards to pursue the NRC Senior Research Associateship at WRAIR. Working on models of blast-related injury he and co-authors have introduced a mechanism of the inflammatory response to shock wave induced pulmonary trauma and described the role of cell redox signaling in the related pulmonary microvascular remodeling. In this book, Dr. Gorbunov and Dr. Elsayed have presented the redox metabolic machinery balanced by antioxidants as an "interface module" which mediates systemic response to the blast-induced oxidative stress. Email: gorbunovNV@gmx.us

Explosions and Blast Related Injuries derive from the expertise of numerous international researchers and clinicians. It is available online at http://www.elsevier.com/wps/find/bookdescription.cws_home/714648/description#description through Academic Press (Elsevier) publishers.

Walter Reed Army Institute of Research

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