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Military Medicine

Asaf Weisman, Tomer Yona, Youssef Masharawi
No abstract text is available yet for this article.
September 12, 2018: Military Medicine
Tarja Nykänen, Kai Pihlainen, Matti Santtila, Tommi Vasankari, Mikael Fogelholm, Heikki Kyröläinen
Introduction: Optimal diet together with good physical fitness maintains readiness and military performance during longer deployments. The purpose of this study was to describe changes in dietary macronutrient and energy intake, total physical activity and body composition during a 6-month deployment in South Lebanon. Furthermore, associations of diet macronutrient intake and physical activity on body composition were also studied. Materials and Methods: Forty male soldiers kept a 3-day food diary and their body composition was measured via bioimpedance and ultrasonography...
September 12, 2018: Military Medicine
Joel M Guess, Cory G Madigan, Caleb B Hudspath, Jacob T Hurley, Shaun Martinho
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndromes, which has been gaining increased recognition with the routine use of coronary angiography and intravascular imaging techniques in patients presenting with ST-elevation myocardial infarction. Here we report the case of a healthy, 26-year-old active-duty male presented to Tripler Army Medical Center for evaluation of acute onset and worsening chest pain that occurred shortly after participating in an Army physical fitness test...
September 12, 2018: Military Medicine
Daniel Flood, Amanda Lezanski-Gujda, Nathanial R Miletta
Pemphigus foliaceus (PF) is an autoimmune dermatologic disease that typically presents with painful, superficial blisters that evolve into scaling erosions in a seborrheic distribution. This case study intends to demonstrate that due to the relative scarcity of the disease and its distribution on the body, PF can easily be misdiagnosed. We present a 43-year-old African American male that presented to the dermatology clinic with an 18-month history of non-pruritic, violaceous, scaling patches and plaques most prominent on the malar cheeks, upper chest and upper back...
September 12, 2018: Military Medicine
Anne L Malaktaris, Brian A Buzzella, Maya E Siegel, Ursula S Myers, Kendall C Browne, Sonya B Norman, Abigail C Angkaw
Introduction: Post-traumatic stress disorder (PTSD) has been linked to a variety of adverse mental and physical health outcomes including distressed relationships. Involving romantic partners in PTSD treatment appears to be a promising new avenue for PTSD treatment; however, additional research is necessary to clarify veteran preferences for inclusion of significant others in treatment and relationship characteristics that may influence such preferences. Accordingly, the present study was designed to evaluate Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans' desire to include romantic partners in trauma-focused care (n = 74) and to explore psychological and relationship variables associated with preference for partner inclusion in PTSD treatment...
September 12, 2018: Military Medicine
Caroline Brescon, Pierre-Yves Pegaz, Patrick Godet, Alexandra Malgoyre, Keyne Charlot
Introduction: Fighter jet pilots may adopt a voluntary hypohydration strategy hours before take-off to avoid urinating in flight. This may favor sortie-induced dehydration and potentially increase flying errors. Since 2015, French pilots have used a urinary sheath (US) that appears to have resolved this problem. However, its effect has never been assessed. Methods: Urine specific gravity (USG) before and after sorties, inflight intake (water and food) and loss (sweat and urine), and changes in bodyweight were measured during 44 long (~370 minutes) sorties (22 in 2015 without a US, No-US group, and 22 in 2017 with a US, US group)...
September 12, 2018: Military Medicine
Wesley M Hutto, Paul B Schroeder, Jeffery C Leggit
Chronic exertional compartment syndrome (CECS) is a debilitating condition that is not uncommon in athletes and military service members. The only curative treatment for this condition, surgical fascial release, was first described in 1956. In the ensuing 62 years, this has remained the standard therapy despite symptom recurrence in 45% of military service members who underwent surgery. In 2013, a case series introduced intracompartmental injections of botulinum toxin A as a non-surgical treatment option for CECS, which proved effective in 15 out of 16 patients...
September 12, 2018: Military Medicine
Kaitlin Harding, Melissa A Day, Dawn M Ehde, Amanda E Wood, Alisha McCall, Rhonda Williams
Introduction: The annual cost of treatment and lost productivity due to chronic pain is estimated to be $635 billion within the USA. Self-management treatments for chronic pain result in lower health care costs and lower utilization of provider-management treatments, such as hospitalization and medication use. The current study sought to identify and characterize patient factors and health conditions associated with chronic pain treatment utilization to inform ways to improve engagement in self-management pain treatment (e...
September 12, 2018: Military Medicine
Kimberly M Avallone, Erin R Smith, Sean Ma, Sean Gargan, Katherine E Porter, Caitlin C Authier, Brian Martis, Israel Liberzon, Sheila A M Rauch
Introduction: Traumatic brain injury (TBI), pain, and post-traumatic stress disorder (PTSD) commonly co-occur in Veteran populations, particularly among Veterans returning from the recent conflicts in Iraq and Afghanistan. Extant research indicates that both TBI and PTSD can negatively impact pain broadly; however, less is known about how these variables impact one another. The current study examines the impact of self-reported post-concussive symptoms on both pain severity and pain interference among Veterans with PTSD who screened positive for a possible TBI, and subsequently, evaluates the potential mediating role of PTSD in these relationships...
September 12, 2018: Military Medicine
Timothy P Plackett, Joel R Brockmeyer, Danielle B Holt, Robert M Rush, Joy Sarkar, Steven A Satterly, Jason M Seery, Bradley R Zagol
Introduction: Operative case volumes for military surgeons are reported to be significantly lower than civilian counterparts. Among the concern that this raises is an inability of military surgeons to achieve mastery of their craft. Material and Methods: Annual surgical case reports were obtained from seven Army military treatment facilities (MTF) for 2012-2016. Operative case volume and cumulative operative time were calculated for active duty general surgeons and for individual MTFs...
September 12, 2018: Military Medicine
Curtis Hardy, Jonathan Glass
Vaccines have a well-demonstrated therapeutic benefit. However, the spectrum of potential dermatologic vaccine side effects ranges from localized skin irritation to acute and delayed response. Currently, there are limited published data correlating dermatoses with alterations in the immune system following vaccination. The mechanism by which group A beta-hemolytic streptococci may precede the manifestation of guttate psoriasis is included as a mechanism foundation as we further describe the immunopathogenesis of immune-mediated linear dermatoses...
September 12, 2018: Military Medicine
Apollonia Fox, Drew Helmer, Chin-Lin Tseng, Kelly McCarron, Serena Satcher, Omowunmi Osinubi
Introduction: We characterized the presence of autonomic symptoms in a sample of Veterans with Gulf War Illness (GWI) using the Composite Autonomic Symptom Scale (COMPASS-31). In addition, we examined the report of autonomic symptoms across comorbid mental health conditions in this sample. Materials and Methods: Case-series follow-up of Gulf War veterans evaluated by the War Related Illness and Injury Study Center (WRIISC) between 2011 and 2016 (n = 153). Phone-based interview consisted of questionnaires designed to investigate autonomic symptoms, physical symptoms, mental health conditions, and GWI...
September 12, 2018: Military Medicine
Richard G Malish, Patrick D Sargent
No abstract text is available yet for this article.
September 12, 2018: Military Medicine
Guillaume L Hoareau, Carl A Beyer, Lauren E Walker, Kevin K Chung, Ian J Stewart
Trauma-induced acute kidney injury (AKI) has affected many U.S. warfighters throughout history. We seek to provide a historical review of the epidemiology of combat-acquired AKI and to highlight the importance of adapting current renal replacement therapy (RRT) capabilities to prepare for the next armed conflict. While severe AKI was rare in the recent conflicts in Iraq and Afghanistan, an analysis of prior wars suggests that it will be more common in future combat operations characterized by prolonged evacuation times, limited resuscitation capabilities, and delayed aeromedical evacuation...
September 12, 2018: Military Medicine
Andrew Timboe, Robert Lystrup, Christy J W Ledford, Paul Crawford
Introduction: The purpose of this study is to correlate HbA1c values with data points in the Air Force Physical Fitness Test (AFPT) in our active duty population. Materials and Methods: This study looks at 489 active duty U.S. Air Force members who performed the AFPT within 1 month of study participation at Nellis Air Force Base, Las Vegas, NV from July 2011 to August 2013. This cross-sectional study included a demographic survey, examination of AFPT results, and lab values, including Hemoglobin A1c and fasting lipid panel...
August 28, 2018: Military Medicine
Rohul Amin, Jessica Servey
Physicians operate in complex health care systems where leading change is an important competency, often practically implemented in process and quality improvements. This case describes a deployed junior officer leading change through a process improvement. It aligns the plan, do, study, act model with Kotter's model of leading organizational change.
August 28, 2018: Military Medicine
Joseph W Galvin, Joshua C Thompson, Amy M Thompson, Stephen A Parada, Josef K Eichinger, Jonathan F Dickens, Bruce L Gillingham
Introduction: With the continued rise in the cost of U.S. health care, there is an increased emphasis on value-based care methodologies. Value is defined as health outcomes achieved per dollar spent. Few studies have evaluated the role of value-based care in the Military Health System (MHS), especially in a format which physicians and providers can understand. The purpose of this article is to provide a guide to understanding current reimbursement systems and value-based care in the MHS and discuss potential strategies for improving value and military readiness...
August 28, 2018: Military Medicine
Robin L Toblin, Amanda L Adrian, Charles W Hoge, Amy B Adler
Introduction: Energy drink use has become widespread, particularly by service members, but its association with mental health problems and other behavioral and health problems such as aggression and fatigue is unclear. The present study examines the association between energy drink use and mental health problems, aggressive behaviors, and fatigue in a military population. Materials and Methods: At 7 months following a combat deployment, 627 male infantry soldiers were surveyed...
August 28, 2018: Military Medicine
Kristi M Wood, Carolyn Ellison, Everett F Magann
Introduction: This is a retrospective review of information collected during operation Continuing Promise 2017 from the Wayuu population in Colombia, South America. Materials and Methods: Team objective was to present an overview of women's health care needs in an isolated underserved population of Colombia by a humanitarian mission of health care providers from the U.S. Navy. We analyzed demographics, contraceptive selection, presenting complaint, diagnosis, and disposition of those female patients presenting for care...
August 28, 2018: Military Medicine
Anders Aandstad, Rune Hageberg
Introduction: The Norwegian armed forces reintroduced physical fitness testing of prospective conscript soldiers in 2011. Since then, a customized maximal treadmill test (MILMAX) has been used to screen aerobic fitness in 15-20,000 young Norwegian men and women annually. The aim of the current study was to investigate reliability and validity of the MILMAX test. Materials and methods: Sixty-seven young Army recruits (including 11 women) participated in this method comparison study...
August 21, 2018: Military Medicine
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