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Military Medicine

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https://www.readbyqxmd.com/read/29237022/life-in-the-emergency-department
#1
William Goldenberg
No abstract text is available yet for this article.
December 11, 2017: Military Medicine
https://www.readbyqxmd.com/read/29087892/ultrasonographic-evidence-of-persistent-synovitis-in-a-chikungunya-infected-service-member
#2
Arash Hassantoufighi, Ian Ward, Jay Higgs
Chikungunya virus (CHIKV) is an arthropod-borne alphavirus initially endemic to Central and East Africa but now spreading to Asia, Europe, and most recently the Western hemisphere. CHIKV infection initially presents as an acute, nonspecific febrile syndrome with rash and polyarthralgia, later leading to a chronic arthritis clinically similar to rheumatoid arthritis. We report a case of an active duty military member infected with CHIKV while deployed to Central America, who developed chronic arthritis. Active duty military members are at higher risk of contracting CHIKV because of deployment to countries with a high prevalence of this mosquito-borne illness...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087891/recurrent-priapism-in-a-military-veteran-receiving-treatment-for-ptsd
#3
Rachel A Mann, Arvin K George
INTRODUCTION: For veterans struggling with post-traumatic stress disorder (PTSD), symptomatic control often requires multiple psychotropic agents. We describe a case in which a young veteran experienced recurrent priapism while receiving treatment for PTSD with several medications, most notably trazodone and prazosin. CASE DESCRIPTION: Our patient presented to the emergency department with priapism, approximately 3 months after beginning a pharmacologic regimen of escitalopram, prazosin, trazodone, and methylphenidate for PTSD...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087890/a-case-report-of-acute-renal-failure-as-a-result-of-light-chain-mediated-acute-tubular-interstitial-nephritis-in-a-30-year-old-combat-veteran
#4
Benjamin M Forster, Adrian P Hinton, John S Thurlow
We present a 30-year-old combat veteran with an unclear exposure history, with multiple deployments who was later diagnosed with acute renal failure as a result of light-chain deposition disease. Despite a drastic decline in kappa light chains following chemotherapy; his renal function worsened, and he progressed to end-stage renal disease, requiring hemodialysis. Light-chain-mediated acute tubular interstitial nephritis is an uncommon type of monoclonal gammopathy of renal significance presenting with acute renal failure without significant glomerular disease...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087889/trainees-with-displaced-hip-fractures-present-to-physical-therapy-with-primary-complaint-of-knee-pain
#5
Scott D Carow, Jeremy D Houser
Stress fractures of the femoral neck are career-threatening and life-altering injuries that occur frequently in Initial Entry Training (IET) Soldiers. Because of the severity of these injuries, military clinics that serve IET Soldiers have implemented guidelines to direct providers in the management of Soldiers with signs of symptoms of stress fracture. These guidelines focus on Soldiers presenting with a primary complaint of hip pain. The cases described here show two Soldiers who had displaced hip fractures despite having primary complaints of knee pain and no self-reported hip pain...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087888/exertional-rhabdomyolysis-in-an-austere-deployed-setting
#6
Andrew Hall, Ryan Parks
INTRODUCTION: Exertional rhabdomyolysis is an, unfortunately, common disease process of military members undergoing strenuous activities. In an austere location, decisions on management and transfer to higher levels of care must be considered. This case series aims to discuss care in more austere locations. MATERIALS AND METHODS: A case series of 3 patients treated at Craig Joint Theater Hospital, Afghanistan. RESULTS: All patients were successfully treated with intravenous hydration and resumed normal military functions in theater rapidly...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087887/usefulness-of-a-risk-assessment-tool-to-risk-stratify-dietary-supplements
#7
Selasi Attipoe, Christopher Manganello, Jonathan M Scott, Patricia A Deuster
BACKGROUND: The use of dietary supplements (DSs) is widespread in the military. Service members use DS for any number of reasons, to include supporting general health, increasing energy levels, enhancing performance, and promoting gains in strength. However, some readily available DS products are potentially unsafe. Therefore, the purpose of this study is to assess the ability of military medical students to use the Operation Supplement Safety DS risk assessment tool. The Operation Supplement Safety risk assessment tool was developed to assist Service members in making decisions about safe DS use...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087886/does-mid-urethral-sling-surgery-in-the-treatment-of-stress-urinary-incontinence-affect-weight-changes-in-women-a-retrospective-cohort-study-using-internal-controls
#8
Alan P Gehrich, Jason Patzwald, Lauren Raby, Michael Lustik, Daniel Gruber, Hector Gonzalez
OBJECTIVE: Stress urinary incontinence (SUI) is a common disorder among women. This is particularly bothersome to physically active women, such as those who serve in the Armed Forces. With the documented success of the midurethral sling (MUS) in the treatment of SUI, more women are electing to undergo surgical treatment. Studies document that women have less inhibition about exercise as a result of decreased incontinence following MUS surgery. We sought to determine if MUS surgery is associated with a change in weight postoperatively resulting from increased levels of activity following surgery...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087885/mistrust-and-endorsement-of-human-immunodeficiency-virus-conspiracy-theories-among-human-immunodeficiency-virus-infected-african-american-veterans
#9
Kristin M Mattocks, Cynthia Gibert, David Fiellin, Lynn E Fiellin, Annah Jamison, Amber Brown, Amy C Justice
INTRODUCTION: Human immunodeficiency virus (HIV) has taken a disproportionate toll on the lives of African Americans, and many previous studies suggest HIV conspiracy beliefs and physician mistrust play important roles in this racial disparity. Because many HIV conspiracy theories tie government involvement with the origin and potential cure for HIV, an area for further examination is HIV+ African American veterans in Veterans Health Administration (VHA) care. In addition to HIV conspiracy beliefs, veterans may already be mistrustful of the VHA as a government healthcare provider...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087884/adenovirus-4-7-vaccine-s-effect-on-disease-rates-is-associated-with-disappearance-of-adenovirus-on-building-surfaces-at-a-military-recruit-base
#10
Michael Broderick, Christopher Myers, Melinda Balansay, Scott Vo, Angel Osuna, Kevin Russell
BACKGROUND: Febrile respiratory illness resulting from adenovirus types 4 and 7 (Ad4/7) was endemic at military training camps, but controlled by an Ad4/7 vaccine from the 1970s to 1999, the year it was discontinued. Thereafter, rates returned to prevaccine levels. Rates dropped after reintroduction of an Ad4/7 vaccine in 2011. METHODS: Surfaces of the barracks and medical clinic of a training camp were swabbed in 3 studies in 2004 and 1 study in 2007, and tested with culture and polymerase chain reaction (PCR)...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087883/occupational-outcomes-of-reconstructive-surgery-for-adult-acquired-flatfoot-deformity
#11
Michael Finnern, Paul Ryan, Claude Anderson
INTRODUCTION: Reconstruction of a symptomatic adult flatfoot is an involved operation with a long recovery period. No previous studies have looked at the occupational or functional results of athletically active patients who have undergone this surgery. In the U.S. Military, the rates of return to unrestricted active duty are unknown. MATERIALS AND METHODS: A retrospective review of all active duty military patients who underwent a reconstructive surgery for adult acquired flatfoot surgery at a single institution from January 2001 to 2015 was performed...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087882/retrospective-analysis-of-the-post-operative-changes-in-higher-order-aberrations-a-comparison-of-the-wavelight-ex500-to-the-visx-s4-laser-in-refractive-surgery
#12
Donovan S Reed, Douglas Apsey, Walter Steigleman, James Townley, Matthew Caldwell
INTRODUCTION: In an attempt to maximize treatment outcomes, refractive surgery techniques are being directed toward customized ablations to correct not only lower-order aberrations but also higher-order aberrations specific to the individual eye. Measurement of the entirety of ocular aberrations is the most definitive means to establish the true effect of refractive surgery on image quality and visual performance. Whether or not there is a statistically significant difference in induced higher-order corneal aberrations between the VISX Star S4 (Abbott Medical Optics, Santa Ana, California) and the WaveLight EX500 (Alcon, Fort Worth, Texas) lasers was examined...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087881/evaluation-of-miniature-dynamic-light-scattering-technology-for-the-assessment-of-hemodynamic-status-during-graded-hemorrhage-and-retransfusion-in-pigs
#13
Asaf Kerpel, Erez Ben-Menachem, Tal Mandelbaum, Elad Hofstetter, Sergei Preisman, Haim Berkenstadt
BACKGROUND: Hemorrhagic shock with occult hypoperfusion is a key challenge to prehospital staff during triage and transfer of patients, especially during mass casualty incidents. Recent advances in Dynamic Light Scattering (DLS), and miniaturization of this technology, has resulted in noninvasive sensors capable of continuously monitoring tissue perfusion. This study evaluated the ability of miniature DLS (mDLS) sensors to assess hemodynamic status in a porcine model of hemorrhage. METHODS: Following ethics committee approval, anesthetized and ventilated pigs underwent graded hemorrhage and then retransfusion...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087880/perioperative-gabapentin-improves-patient-centered-outcomes-after-inguinal-hernia-repair
#14
Jacob Quail, Dennis Spence, Matthew Hannon
INTRODUCTION: Over 5,300 inguinal hernia repairs (IHR) were performed in the Military Health System in 2015. Chronic pain can be a debilitating complication, occurring in up to 34% of patients after IHR and impacts mission readiness. Gabapentin has been shown to be effective for postoperative analgesia in a variety of operations. We evaluated the effect of a short course of perioperative gabapentin on chronic pain after IHR. METHODS: This was a double-blinded, randomized study involving male patients ≥18 years old with an initial inguinal hernia and no history of chronic pain or psychiatric disorder...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087879/hyperkalemia-in-combat-casualties-implications-for-delayed-evacuation
#15
Ian J Stewart, Brian D Snow, Michael S Clemens, Jonathan A Sosnov, James D Ross, Jeffrey T Howard, Kevin K Chung
OBJECTIVE: Fixed facilities and rapid global evacuation ensured that delayed complications of trauma, such as hyperkalemia, occurred late in the evacuation chain where renal replacement therapies were available. However, future conflicts or humanitarian disasters may involve prolonged evacuation times. We sought to quantify one potential risk of delayed evacuation by assessing hyperkalemia in combat casualties. METHODS: Retrospective study of military members admitted to intensive care units in Iraq and Afghanistan from February 1, 2002, to February 1, 2011...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087878/comparison-of-three-criteria-for-interpretation-of-electrocardiogram-in-the-military
#16
Hélder Dores, Paulo Dinis, Rita Fernandes, Sérgio Barra, Sara Ferreira, Maria Conceição Silveira, Evangelista Rocha, Joaquim Cardoso, José Monge
BACKGROUND: Screening of competitive athletes and other individuals exposed to regular and intense physical exercise, such as military personnel, can lead to an early and preclinical identification of cardiac conditions associated with a higher risk for sudden cardiac death. The electrocardiogram (ECG) has been recommended for the precompetitive screening, but its interpretation remains controversial. The aim of this study was to compare three different standardized criteria for interpretation of athletes' ECG applied in military...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087877/development-and-early-experience-of-the-first-joint-military-health-system-veterans-affairs-transcatheter-aortic-valve-replacement-program
#17
Luke Oakley, Wayne Pritchard, Joelle Colletta, William Penny, Steven Romero, Justin Cox, Gilbert Boswell, Joshua Kindelan, Daniel Gramins, Keshav Nayak
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a minimally invasive cardiac surgical procedure that has revolutionized the treatment of aortic stenosis. This is the most common valvular heart condition in developed countries, affecting 3.4% of those ages 75 and above. Because there is no medical therapy that can arrest progression of the disease, valve replacement forms the cornerstone of therapy. METHODS: Naval Medical Center San Diego and the VA San Diego Healthcare System have developed a unique collaborative TAVR program-a first in the Department of Defense-to offer this revolutionary procedure to their beneficiaries...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087876/management-of-cardiovascular-diseases-in-kabul-nato-role-3-hospital-a-15-week-long-experience
#18
Aurore Brondex
INTRODUCTION: Between 2009 and 2014, Kabul NATO role 3 hospital provided comprehensive medical services to NATO troops engaged in Afghanistan as well as care for Afghan national security forces and for Afghan and non-Afghan civilians. This study aims at describing the occurrence and the management of cardiovascular diseases in patients presenting to the emergency room or the outpatient clinic or hospitalized for a noncardiovascular reason over a 15-week-long period. MATERIALS AND METHODS: The patients for whom cardiologic advice was sought between June 16th and October 1st, 2012, were prospectively included...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087875/impact-of-minor-surgery-emergencies-in-isolated-sea-based-environment-the-french-navy-experience
#19
François Guénot, Simon Leigh-Smith, Christian Perrichot, Julien Pontis
INTRODUCTION: The aim of this article is to determine whether some of the urgent (<24 hours) medical evacuations (MEDEVACs) (from French Navy surface ships in isolated situations but with an embarked medical officer) of patients suffering from minor surgical emergencies could have been avoided, and if so, which ones. MATERIALS AND METHODS: This was a retrospective descriptive study of all MEDEVAC's performed between 2009 and 2014. This was done by an analysis of the records held at the French Naval Medical Headquarters that included both MEDEVAC signals and anonymized files called "Patient Movement Request...
November 2017: Military Medicine
https://www.readbyqxmd.com/read/29087874/follow-up-evaluation-of-the-u-s-army-institute-of-surgical-research-burn-flow-sheet-for-en-route-care-documentation-of-burned-combat-casualties
#20
Nicole W Caldwell, Maria L Serio-Melvin, Kevin K Chung, Jose Salinas, Michael E Shiels, Leopoldo C Cancio, Zsolt T Stockinger, Elizabeth A Mann-Salinas
INTRODUCTION: In 2006, burn clinical practice guidelines were developed to provide recommendations for optimal care of U.S. military and local national burn casualties. As part of that effort, a paper-based Burn Flow Sheet (BFS) was included to document the burn resuscitation of combat casualties with ≥20% total body surface area burns. The purpose of this study was to evaluate the BFS in terms of ongoing utilization, resuscitation management, and outcomes of patients transported. MATERIALS AND METHODS: A retrospective review was performed of hard-copy BFSs received from January 2007 to December 2013...
November 2017: Military Medicine
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