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Military Medicine

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https://www.readbyqxmd.com/read/27849513/venous-thoracic-outlet-syndrome-the-role-of-early-rib-resection
#1
Vienna G Katana, Jeffrey S Weiss
The upper extremity is an uncommon site for deep vein thrombosis and, although most of these thrombotic events are secondary to catheters or indwelling devices, venous thoracic outlet syndrome is an important cause of primary thrombosis. Young, active, otherwise healthy individuals that engage in repetitive upper extremity exercises, such as those required by a military vocation, may be at an increased risk. We present the case of a Naval Officer diagnosed with venous thoracic outlet syndrome whereby a multimodal approach with early surgical decompression was used...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849512/a-fatal-case-of-invasive-infection-caused-by-w135-neisseria-meningitidis-in-a-vaccinated-french-soldier
#2
Sandrine Duron, Christophe Martinaud, David Lacassagne, Jean-Louis Koeck
We report on the case of fatal "purpura fulminans" caused by Neisseria meningitidis W135 that occurred in a young French soldier vaccinated a few months earlier with the tetravalent conjugate vaccine ACYW135. Biological investigations revealed adequate titers of postvaccination antibodies against serogroups A, C, and W135 and led to the post-mortem diagnosis of a complete C7 complement deficiency. Late complement component deficiency is a well-known risk factor of meningococcal diseases, but usually exposes to recurrent mild infections, whereas severe invasive meningococcal diseases are more likely to occur among properdin-deficient patients...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849511/hiatal-hernia-as-the-cause-of-g-induced-abdominal-pain
#3
Scott B Hughey, Lauren H Mattingly
Sliding hiatal hernias are common and affect approximately 10% to 80% of the general population. The condition typically presents with reflux-type symptoms and is diagnosed either with imaging or endoscopy. In this case, the hernia presented as G-induced abdominal pain. The patient was an F-18 pilot who experienced worsening epigastric abdominal pain proportionate to the amount of accelerative force experienced. The pain would occur at approximately 3 Gs and increase beyond that. The patient was asymptomatic at rest and denied any dysphagia or reflux symptoms...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849510/g-induced-visual-symptoms-in-a-military-helicopter-pilot
#4
Terry W McMahon, David G Newman
INTRODUCTION: Military helicopters are increasingly agile and capable of producing significant G forces experienced in the longitudinal (z) axis of the body in a head-to-foot direction (+Gz). Dehydration and fatigue can adversely affect a pilot's +Gz tolerance, leading to +Gz-induced symptomatology occurring at lower +Gz levels than expected. The potential for adverse consequences of +Gz exposure to affect flight safety in military helicopter operations needs to be recognized. This case report describes a helicopter pilot who experienced +Gz-induced visual impairment during low-level flight...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849509/responding-to-trauma-at-sea-a-case-study-in-psychological-first-aid-unique-occupational-stressors-and-resiliency-self-care
#5
Jeffrey Millegan, Eileen M Delaney, Warren Klam
The U.S. Navy deploys Special Psychiatric Rapid Intervention Teams (SPRINT) to sites of military disasters to assist survivors and the command. SPRINT functions primarily as a consultant to help commands effectively respond to the mental health needs of their service members following a traumatic event. Utilizing the principles of psychological first aid, the overall goal of SPRINT is to mitigate long-term mental health dysfunction and facilitate recovery at both the individual and unit level. We present a case study of a SPRINT mission to a deployed U...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849508/rates-of-microbiologically-diagnosed-infection-and-pathogen-detection-in-hematopoietic-stem-cell-transplant-patients
#6
Lauren E Lee, Alice E Barsoumian, Alexander W Brown, Michael A Wiggins, John S Renshaw, Michael B Osswald, Clinton K Murray
Infections remain a significant cause of mortality in hematopoietic stem cell transplant patients. Evaluations of causes of infection are often unrevealing, and at some sites, increasing rates of antimicrobial resistance have been noticed. We performed a retrospective analysis of infection rates and microbiologic testing yield, or percent of tests ordered to diagnose an infection, in the first 100 days of 30 allogeneic and 56 autologous stem cell transplants performed at San Antonio Military Medical Center from July 2011 to April 2014...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849507/deployment-of-the-1st-area-medical-laboratory-in-a-split-based-configuration-during-the-largest-ebola-outbreak-in-history
#7
Anthony P Cardile, Christopher T Littell, Michael G Backlund, Richard A Heipertz, Jerod A Brammer, Sean M Palmer, Todd J Vento, Felix A Ortiz, William R Rosa, Michael J Major, Patrick M Garman
BACKGROUND: The U.S. Army 1(st) Area Medical Laboratory (1(st) AML) is currently the only deployable medical CBRNE (Chemical, Biological, Radiological, Nuclear, and Explosives) laboratory in the Army's Forces Command. In support of the United States Agency for International Development Ebola response, the U.S. military initiated Operation United Assistance (OUA), and deployed approximately 2,500 service members to support the Government of Liberia's Ebola control efforts. Due to its unique molecular diagnostic and expeditionary capabilities, the 1(st) AML was ordered to deploy in October of 2014 in support of OUA via establishment of Ebola testing laboratories...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849506/detection-of-diarrhea-etiology-among-u-s-military-personnel-during-exercise-balikatan-2014-philippines-using-taqman-array-cards
#8
Paphavee Lertsethtakarn, Kaewkanya Nakjarung, Sasikorn Silapong, Pimmnapar Neesanant, Pimmada Sakpaisal, Ladaporn Bodhidatta, Jie Liu, Eric Houpt, John Mark Velasco, Louis R Macareo, Brett E Swierczewski, Carl J Mason
BACKGROUND: Military personnel are vulnerable to diarrhea. Diarrheal disease is common when deployed for operations or exercise in developing countries. Although diarrheal disease is transient, cumulative time lost and medical asset can have a significant impact on military operations. Currently, diagnostics of diarrheal etiology typically relies on a mixture of conventional bacteriology, enzyme-linked immunosorbent assay, and polymerase chain reaction (PCR)-based methods including real-time PCR...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849505/a-prospective-observation-study-of-medical-toxicology-consultation-in-a-u-s-combat-theater
#9
Joseph K Maddry, Patrick C Ng, Daniel Sessions, Vikhyat S Bebarta
OBJECTIVES: Since 2001, U.S. military personnel and active duty, uniformed physicians providing medical support have been deployed to Afghanistan. Medical toxicologists are among the physicians deployed. There is a paucity of information present in the literature that has documented cases treated by toxicologists in theater. This prospective observational study describes 15 male patients treated in theater by a military medical toxicologist. METHODS: We performed a prospective observational study in which a medical toxicologist consulted and reported on deployed toxicology cases occurring during a 5-month deployment to Bagram, Afghanistan...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849504/return-to-duty-rates-following-meniscal-repair-surgery-in-an-active-duty-military-population
#10
Joseph W Galvin, Chase A Dukes, Jason A Grassbaugh, Bryant G Marchant, Edward D Arrington
Meniscal injury is a common knee injury in a young athletic population. Maintaining the integrity of the meniscus is critical to reducing contact pressures on the tibiofemoral articulation. The purpose of this study is to analyze the outcomes of meniscal repair in a young military population. We conducted a retrospective review of all meniscal repairs performed on active duty Army personnel at a Military Medical Center from January 2002 to December 2012. One hundred seventy-eight active duty patients, mean age 28 (19-48) years underwent 178 meniscal repairs...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849503/causes-of-primary-total-hip-arthroplasty-in-active-duty-soldiers-are-recurrent-medical-assessments-associated-with-reduced-rates-of-secondary-osteoarthritis-in-this-population
#11
Andreas Grözinger, Andreas Musa, Sascha Gravius, Thomas M Randau, Erwin Kollig
The purpose of this study was to analyze the different causes of symptomatic osteoarthritis (OA) of the hip joint in active duty soldiers requiring a total hip arthroplasty and the hypothesis that soldiers had a reduced prevalence of secondary OA as a result of a selection process that has taken place through multiple medical assessments during their military career. We analyzed patient records from 2006 to 2012 for male patients ≤60 years with OA of the hip and indication for total hip arthroplasty in a military hospital in which civilian patients are also treated...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849502/eating-behaviors-prevalence-psychiatric-comorbidity-and-associations-with-body-mass-index-among-male-and-female-iraq-and-afghanistan-veterans
#12
Jennifer D Slane, Michele D Levine, Sonya Borrero, Kristin M Mattocks, Amy D Ozier, Norman Silliker, Harini Bathulapalli, Cynthia Brandt, Sally G Haskell
OBJECTIVE: There is a dearth of research examining eating behaviors, such as binge eating, among male and female veterans. The present study evaluated the prevalence of self-reported eating problems as well as associations with body mass index and psychiatric disorders among male and female Iraq and Afghanistan veterans. METHODS: Participants were 298 male and 364 female veterans (M = 33.3 ± 10.6 years old) from the Women Veterans Cohort Study, a study of male and female veterans enrolled for Veterans Affairs care in New England or Indiana...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849501/danish-gulf-war-veterans-revisited-no-evidence-of-increased-sickness-absence-or-reduced-labor-market-outcome-after-deployment-to-the-persian-gulf
#13
Lars Ravnborg Nissen, Christian Stoltenberg, Anni B Sternhagen Nielsen, Mia S Vedtofte, Jacob L Marott, Finn Gyntelberg, Bernadette Guldager
OBJECTIVE: To examine the assumption that postdeployment incidence of sickness and other absence from work are higher among Gulf War Veterans compared with nonveterans. METHODS: A prospective registry study including a cohort of 721 Danish Gulf War Veterans and a control cohort of 3,629 nonveterans selected from the general Danish population. Outcome measures were up to 23 years postdeployment incidence of (1) long-term sickness absence and (2) long-term all types of absence from work...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849500/the-u-s-army-occupational-and-environmental-medicine-residency-at-aberdeen-proving-ground-maryland-1960-1996
#14
Joel C Gaydos, Timothy M Mallon, William A Rice
BACKGROUND: Reorganization of the Army and critical assessment of Army Graduate Medical Education programs prompted the Occupational and Environmental Medicine (OEM) Consultant to the Army Surgeon General to initiate a review of current Army OEM residency training. Available information indicated the Army OEM residency at Aberdeen Proving Ground, MD, was the first and longest operating Army OEM residency. Describing this residency was identified as the first step in the review, with the objectives of determining why the residency was started and sustained and its relevance to the needs of the Army...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849499/trauma-resuscitation-evaluation-times-and-correlating-human-patient-simulation-training-differences-what-is-the-standard
#15
Timothy J Bonjour, Grigory Charny, Robert E Thaxton
BACKGROUND: Rapid effective trauma resuscitations (TRs) decrease patient morbidity and mortality. Few studies have evaluated TR care times. Effective time goals and superior human patient simulator (HPS) training can improve patient survivability. OBJECTIVES: The purpose of this study was to compare live TR to HPS resuscitation times to determine mean incremental resuscitation times and ascertain if simulation was educationally equivalent. The study was conducted at San Antonio Military Medical Center, Department of Defense Level I trauma center...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849498/explaining-performance-on-military-tasks-in-the-canadian-armed-forces-the-importance-of-morphological-and-physical-fitness-characteristics
#16
Hans Christian Tingelstad, Daniel Theoret, Michael Spicovck, Francois Haman
Several occupations apply physical fitness tests to assess occupational physical performance to confirm that their employees meet minimum physical employment standards. Knowledge about factors affecting performance on these physical fitness tests could provide valuable information concerning mode of training. The main purpose of this study was to determine which morphological and/or physiological characteristics could explain overall performance outcome on six complex military tasks used to measure Canadian Armed Forces (CAF) members' occupational fitness...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849497/effect-of-lumbar-progressive-resistance-exercise-on-lumbar-muscular-strength-and-core-muscular-endurance-in-soldiers
#17
John M Mayer, John D Childs, Brett D Neilson, Henian Chen, Shane L Koppenhaver, William S Quillen
OBJECTIVES: Low back pain is common, costly, and disabling for active duty military personnel and veterans. The evidence is unclear on which management approaches are most effective. The purpose of this study was to assess the effectiveness of lumbar extensor high-intensity progressive resistance exercise (HIPRE) training versus control on improving lumbar extension muscular strength and core muscular endurance in soldiers. METHODS: A randomized controlled trial was conducted with active duty U...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849496/military-medics-insight-into-providing-women-s-health-care-in-deployed-settings
#18
Candy Wilson, Robert Corrigan, Sharon Reese, Angelica Almonte, Danielle Simpson, Amber Wilson
OBJECTIVES: To gain better understanding of the military medics' (Navy Independent Duty Corpsman, Air Force Independent Duty Medical Technician, and Army Health Care Specialist, experiences providing health care for women in the deployed or ship setting. METHODS: The researchers used an exploratory, descriptive design informed by ethnography. A total of 86 individuals participated in the focus group and individual interviews. RESULTS: Three themes were identified: Training Fidelity, Advocate Leader, and The Challenges of Providing Patient Care...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849495/cortisol-awakening-response-in-elite-military-men-summary-parameters-stability-measurement-and-effect-of-compliance
#19
Marcus K Taylor, Lisa M Hernández, Shiloah A Fuller, Paul Sargent, Genieleah A Padilla, Erica Harris
The cortisol awakening response (CAR) holds promise as a clinically important marker of health status. However, CAR research is routinely challenged by its innate complexity, sensitivity to confounds, and methodological inconsistencies. In this unprecedented characterization of CAR in elite military men (N = 58), we established summary parameters, evaluated sampling stability across two consecutive days, and explored the effect of subject compliance. Average salivary cortisol concentrations increased nearly 60% within 30 minutes of waking, followed by a swift recovery to waking values at 60 minutes...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849494/inpatient-trauma-focused-treatment-for-veterans-implementation-and-evaluation-of-patient-perceptions-and-outcomes-of-an-integrated-evidence-based-treatment-approach
#20
Deleene S Menefee, Wendy S Leopoulos, Jana K Tran, Ellen Teng, Jill Wanner, Elisabeth Wilde, Stephen McCauley, Susan X Day
BACKGROUND: Practice guidelines for post-traumatic stress disorder (PTSD) treatment suggest that inpatient care may be warranted when the severity of the clinical presentation is marred with significant concerns about suicidality and psychiatric comorbidity. Yet, limited guidance exists on conducting trauma-focused treatment in acute hospital settings beyond the traditional medical or stabilization model. OBJECTIVE: The purpose of this current article is to describe and evaluate the integration of evidence-based treatments (EBTs) for PTSD implemented in two gender-specific, Veterans Affairs inpatient programs...
November 2016: Military Medicine
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