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Military Medicine

McKayla J Riggs, Naikeya H Coston, Nicholas R Teneyuque, Erin A Keyser
Subconjunctival hemorrhages are common in trauma and with increased intra-abdominal pressure. Despite the sustained pressure endured while pushing, they are rarely observed postpartum and can be an indicator of underlying ophthalmic disease. We present a case of a postpartum patient who developed bilateral subconjunctival hemorrhages with a retro-orbital hematoma. The patient is a 29-year-old gravida-1-para-0 at 41 weeks gestation who underwent an uncomplicated induction and delivery. She developed diplopia and orbital pain postpartum...
July 12, 2018: Military Medicine
Jennifer E Baker, Michael D Goodman, Amy T Makley, Sabre M Stevens-Topie, Rosalie A Veile, Eric J Mahoney, Judy R Heyl, Daniel B Cox, Timothy A Pritts, Krishna P Athota
Introduction: Acute hemorrhage remains the leading cause of death in potentially survivable injuries. The use of topical hemostatic agents has increased over the last two decades with the evolution of damage control surgery. By 2008, the military widely adopted Combat Gauze as the hemostatic dressing of choice for compressible hemorrhage. The goal of this study was to compare the performance of a novel fibrin sealant patch to Combat Gauze in two clinically relevant models of hemorrhage...
July 11, 2018: Military Medicine
Anita A Vashi, Farnoosh H Sheikhi, Lisa A Nashton, Jennifer Ellman, Priya Rajagopal, Steven M Asch
Introduction: We describe the use of Lean quality improvement methodologies at a Veterans Affairs (VA) medical facility to redesign Emergency Department (ED) front-end operations and improve ED flow, specifically to reduce time from Veteran arrival to provider evaluation. Materials and Methods: The intervention, a Rapid Process Improvement Workshop (RPIW), took place during January 2014 at the VA Palo Alto Health Care System (VAPAHCS). Key changes made as a result of the RPIW included standardizing and streamlining evaluation and hand-off processes, better-delineating roles for RNs and MDs, more efficiently utilizing beds and improving team communication...
July 11, 2018: Military Medicine
Selasi Attipoe, Liam Delahanty, Mark Stephens, Patricia A Deuster
Introduction: The use of energy drinks (ED) or shots (ES) is becoming increasingly popular in U.S. beverage market. In addition, young, physically active males, such as active-duty enlistees represent a prime target for the advertising of ED/ES; however, the exact mechanisms and safety of these products have come under scrutiny. This cross-sectional, exploratory, web-based survey among U.S. service members describes the prevalence of ED/ES use as well as common side effects and safety of these products among self-reported users...
July 11, 2018: Military Medicine
Rachel Sayko Adams, Cindy Parks Thomas, Grant A Ritter, Sue Lee, Mayada Saadoun, Thomas V Williams, Mary Jo Larson
Introduction: Little is known about long-term prescription opioid utilization in the Military Health System. The objectives of this study were to examine predictors of any prescription opioid receipt, and predictors of long-term opioid utilization among active duty soldiers in the year following deployment. Materials and Methods: The analytic sample consisted of Army active duty soldiers returning from deployment to Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn in fiscal years 2008-2014 (N = 540,738)...
July 11, 2018: Military Medicine
Christie Jackson, Brandon J Weiss, Marylene Cloitre
Introduction: Group Skills Training in Affective and Interpersonal Regulation (STAIR) is an evidence-based, manualized treatment for individuals with post-traumatic stress symptoms, that focuses on improving functioning through mood management (e.g., emotion regulation) and relationship skills development. To date, no study has evaluated the potential benefit of group STAIR among Veterans. Feasibility of delivering STAIR in a mixed-gender group format and the potential impact of gender on outcome were examined...
July 11, 2018: Military Medicine
Meital Zur, Racheli Magnezi, Shirley Portuguese, Inbal Reuveni, Ron Kedem, Eyal Fruchter
Introduction: Attention deficit hyperactive disorder (ADHD) is prevalent in 5.9-7.1% of children and adolescents, and 5% of adults. It results in poor academic, occupational, and social functioning. Pharmacotherapy improves core symptoms; however, average adherence levels are low and decrease at 16-17 years of age, just before the recruitment age to Israel Defense Forces (IDF). This study evaluated the effect of adherence to ADHD pharmacotherapy on occupational performance among soldiers...
July 11, 2018: Military Medicine
Bogdan Kovcan, Janez Vodicar, Jožef Šimenko, Mateja Videmšek, Primož Pori, Hadžiž Vedran
Introduction: Injury registration is an important first step of the musculoskeletal injury (MSI) prevention process that helps establish the magnitude of the problem and focus prevention on the body parts that are most frequently injured. However, an injury definition used in that process may influence the reported prevalence of MSI, causing some injuries to be under-reported which in turn alters the prevention efforts. The primary goal of our study was to identify the 10-year prevalence of MSI in members of the Slovenian Armed Forces (SAF), to help plan and implement preventive measures for the reduction of MSI...
July 3, 2018: Military Medicine
Kathleen M Poploski, Kelsey J Picha, Joshua D Winters, Scott D Royer, Nicholas R Heebner, Brad Lambert, John P Abt, Scott M Lephart
Introduction: Military personnel are at an increased risk of shoulder injuries due to training and deployment demands, however, there is a lack of information on the tactical athlete's upper extremity profile. Therefore, the purpose of this study was to examine shoulder musculoskeletal characteristics, including range of motion (ROM), strength, and function, and the relationships between these measures in Marine Corps Forces Special Operations Command (MARSOC) personnel without history of shoulder injury...
July 3, 2018: Military Medicine
Laura J Lutz, Erin Gaffney-Stomberg, J Philip Karl, Julie M Hughes, Katelyn I Guerriere, James P McClung
Introduction: The military dietary reference intakes (MDRIs), outlined in Army Regulation 40-25, OPNAVINST 10110.1/MCO10110.49, AFI 44-141, establish standards intended to meet the nutrient requirements of Warfighters. Therefore, the purpose of this study was to comprehensively compare the revised MDRIs, published in 2017, with estimated dietary intakes in U.S. military personnel. Materials and Methods: During this cross-sectional study, Block food frequency questionnaires were administered at the end of the 9-week basic combat training course to estimate dietary intake during basic combat training in male (n = 307) and female (n = 280) recruits...
July 3, 2018: Military Medicine
K Aaron Shaw, Edward Mottern, Stephen A Parada, Robert Burks, Guillaume Dumont, Brian R Waterman, Shane J Nho
Introduction: Femoral head avascular necrosis (AVN) is a debilitating disease with core decompression commonly performed for early stage disease. However, the ability to return to high-activity levels following treatment is largely unknown. Materials and Methods: Active military patients undergoing core decompression for femoral head AVN were reviewed. Demographic variables were identified and visual analog pain data was collected at a minimum of 2-year post-surgery or prior to total hip arthroplasty (THA)...
July 3, 2018: Military Medicine
James M Prieto, Kimberly A Thompson, Lyndsey Wessels, Hope N Moore, Matthew P Hannon, Romeo C Ignacio
Introduction: One of the most common emergent surgical diseases encountered within the active duty (AD) military population is acute appendicitis, yet the rate of perforation among military members is lower than age-matched civilians in the USA. Among all demographics, a delay in presentation to surgical care has been associated with an increase in perforation rates and postoperative complications. A subset of the U.S. military population, the Marine Corps recruits (MCRs), are subjected to a unique and vigorous training environment which may result in delayed medical care...
July 3, 2018: Military Medicine
Dario Torre, Deanna Schreiber-Gregory, John R Boulet, Ronald M Cervero, Paul Hemmer, Louis N Pangaro, Steven J Durning
Introduction: The education of health professionals and the assessment of their long-term goals are essential. Additionally, in the military health system (MHS), such programs also have the goals of improving readiness, providing high-quality care and meeting the needs and challenges of the MHS. The Uniformed Services University F. Edward Hebert School of Medicine (USUHS) has existed for over 40 years and the assessment of the longer term outcomes of its medical school graduates is an important endeavor...
June 27, 2018: Military Medicine
Simon A Sarkisian, Gregory Hand, Vanessa M Rivera, Meghan Smith, Joel A Miller
Myopericarditis following smallpox vaccination is a documented side effect with increasing incidence since reestablishing mandatory vaccination for deploying military personnel. After the ACAM2000 smallpox vaccine replaced the Dryvax smallpox vaccine, the rate of myopericarditis increased 50-fold.We describe six case reports of active duty soldiers who presented to the emergency department complaining of chest pain shortly after receiving routine pre-deployment vaccinations to include smallpox. All were hospitalized and became non-deployable after developing smallpox vaccination-associated myopericarditis...
June 27, 2018: Military Medicine
Margaret-Anne Mackintosh, Kim M Schaper, Emy A Willis, Steven Edland, Catherine Liu, Lon R White
Introduction: This study had two goals. First, we investigated how World War II (WW II) military service impacted marital stability during men's young and middle adulthood in a large community sample of American men of Japanese descent. Second, within a subgroup of WW II veterans, we assessed how the level of combat exposure affected marital stability. Material and Methods: The Honolulu Heart Program and later Honolulu-Asia Aging Project were longitudinal, community-based studies of Japanese-American men living in Hawai'i...
June 23, 2018: Military Medicine
Alan L Peterson, Monty T Baker, Cpt Brian A Moore, Willie J Hale, Jeremy S Joseph, Casey L Straud, Cynthia L Lancaster, Richard J McNally, William C Isler, Brett T Litz, Jim Mintz
Introduction: Limited research has been conducted on the impact of deployment-related trauma exposure on post-traumatic stress symptoms in military medical personnel. This study evaluated the association between exposure to both combat experiences and medical duty stressors and post-traumatic stress symptoms in deployed military medical personnel. Materials and Methods: U.S. military medical personnel (N = 1,138; 51% male) deployed to Iraq between 2004 and 2011 were surveyed about their exposure to combat stressors, healthcare stressors, and symptoms of post-traumatic stress disorder (PTSD)...
June 19, 2018: Military Medicine
Nicole T Lopez, Sean K McCoy, Christine Carroll, Ellen Jones, Joel A Miller
Background: Two studies by Bledsoe et al and Anand et al reported limited efficacy of the Supraglottic Airway Laryngeal Tube (SALT), which is a supraglottic airway (SGA) specifically designed for blind endotracheal intubation. Miller et al reported a 50% success rate using an Eschmann introducer as an adjunct for blind airway exchange via the laryngeal mask airway (LMA) classic. Another study by Ueki et al found that endotracheal tube (ETT) intubation was faster and less damaging to the airway when the Aintree intubating catheter was used in conjunction with a fiberoptic bronchoscope...
June 19, 2018: Military Medicine
Jean A Orman, Jacquelyn S Parker, Zsolt T Stockinger, Kevin W Nemelka
No abstract text is available yet for this article.
June 15, 2018: Military Medicine
Donna Ames, Zachary Erickson, Nagy A Youssef, Irina Arnold, Chaplain Sam Adamson, Alexander C Sones, Justin Yin, Kerry Haynes, Fred Volk, Ellen J Teng, John P Oliver, Harold G Koenig
Introduction: There is growing evidence that moral injury (MI) is related to greater suicide risk among Veterans and Active Duty Military (V/ADM). This study examines the relationship between MI and suicide risk and the moderating effect of religiosity on this relationship in V/ADM with post-traumatic stress disorder (PTSD) symptoms. Materials and Methods: This was a cross-sectional multi-site study involving 570 V/ADM from across the USA. Inclusion criteria were having served in a combat theater and the presence of PTSD symptoms...
June 15, 2018: Military Medicine
Matti Santtila, Kai Pihlainen, Harri Koski, Tommi Ojanen, Heikki Kyröläinen
Introduction: The physical fitness of male conscripts has decreased, and body mass increased during the last few decades, especially in Nordic countries. However, limited research-based reports are available concerning the physical fitness profiles of female recruits. Therefore, the purpose of this study was to investigate changes in physical fitness and body composition of female recruits entering voluntary Finnish military service between the years 2005 and 2015. Materials and methods: Data were collected from the initial fitness tests performed in military units during the first 2 weeks of military service...
June 13, 2018: Military Medicine
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