1. Jacobson, Joy managing editor
  2. Moffa, Christine MS, RN, clinical editor


Two soldiers injured in Iraq, several short- and long-term implications.


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Almost 15% of U.S. troops have suffered a mild traumatic brain injury in the war in Iraq, according to a survey of 2,525 returning soldiers by Hoge and colleagues that was published in the January 24 issue of the New England Journal of Medicine, and there appears to be a strong link between that injury and posttraumatic stress disorder (PTSD).1 As Martin and colleagues note in this issue (page 40), brain injuries can occur without a visible wound and may be missed when other injuries require immediate attention.


Physiologic processes possibly implicated in that link include the hypothalamic-pituitary-adrenal axis, write Hoge and colleagues, who gathered data from two U.S. Army brigades that had been engaged in high levels of combat for a year. "The strong associations," they say, "between mild traumatic brain injury, PTSD, depression, and physical health symptoms in combat veterans reinforce the need for a multidisciplinary approach centered in primary care."

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Army Staff Sergeant Robert Simonovich, seen below in a photograph by Michael Kamber, was temporarily blinded and suffered facial wounds and a burst eardrum after a "dismounted improvised explosive device"-a homemade land mine-exploded on May 22, 2007, in Mahmudiya, Iraq, according to the New York Times.2 Simonovich was 31 years old at the time. For an audio slide show of Kamber's work in Iraq, go to


Lieutenant Jordan Johnson, shown above at her San Antonio, Texas, home in a photograph by Nina Berman, spent seven days in a coma after a Humvee accident near Baghdad International Airport on July 20, 2003. She was 23 years old and since has suffered from short-term-memory loss and PTSD, as she and Berman said on the PBS television program NOW in 2005.3 Johnson is one of many injured soldiers featured in Berman's book Purple Hearts (go to

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Joy Jacobson, managing editor


Christine Moffa, MS, RN, clinical editor




1. Hoge CW, et al. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med 2008;358(5):453-63. [Context Link]


2. Cave D. As comrades search, fatal bomb wreaks havoc. The New York Times 2007 May 23. [Context Link]


3. PBS. NOW. May 13, 2005. [Context Link]