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Military Medicine

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https://www.readbyqxmd.com/read/28051994/giant-anterior-tibial-artery-pseudoaneurysm-successfully-treated-on-the-usns-mercy
#1
Victoria S McDonald, Kimberly A Thompson, Kevin M Casey
The need for an experienced vascular surgeon in the combat setting is not questioned; however, there is a paucity of literature exploring the utility of vascular surgery during an elective humanitarian mission. We herein present a case of a post-traumatic pseudoaneurysm of the anterior tibial artery treated in the context of a humanitarian mission during Pacific Partnership 2015 aboard the United States Naval Ship Mercy. This case report demonstrates the necessity and unique opportunities for vascular surgeons to participate in humanitarian surgery...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051993/serotonergic-synergy-in-the-pharmacotherapy-of-acute-posttraumatic-stress-disorder-exacerbation-a-case-report
#2
J Gibson Pennington, Jeffrey Guina
OBJECTIVE: Posttraumatic stress disorder (PTSD) is often associated with acute panic, dissociation, suicidality, and aggression. However, pharmacologic interventions for such acute exacerbations are understudied. In this article, we report a case of combat-related PTSD with severe panic, suicidality, and agitation which responded favorably to a combination of ziprasidone, propranolol, and hydroxyzine. METHODS: An extensive literature search did not reveal any use of this combination, and there were few studies about each medication individually, with regard to PTSD...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051992/clostridium-sphenoides-chronic-osteomyelitis-diagnosed-via-matrix-assisted-laser-desorption-ionization-time-of-flight-mass-spectrometry-conflicting-with-16s-rrna-sequencing-but-confirmed-by-whole-genome-sequencing
#3
Matthew J Perkins, Erik Snesrud, Patrick McGann, Christopher A Duplessis
We report a case of successful treatment of chronic osteomyelitis (emanating from contaminated soil exposure) caused by Clostridium sphenoides, an organism infrequently identified as a cause of human infection and more saliently osteomyelitis (only 1 reported case in the literature). Additional impetus for reporting this case resides in the insights gained regarding pathogen identification exploiting sophisticated molecular platforms coupled to traditional microbial culture-based methods. The fastidious nature of cultivating anaerobic organisms required initial attempts at 16S rRNA sequencing to identify a Clostridium species (Clostridium celerecrescens)...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051991/cutaneous-coccidiomycosis-masquerading-as-an-epidermoid-cyst-case-report-and-review-of-the-literature
#4
Daniel H Russell, Ed Ager, Wendi Wohltman
OBJECTIVES: To present a challenging case of inoculatory fungal mycosis mimicking an epidermoid cyst, which may have been easily overlooked by the pathologist. METHODS: We present a case report of a 29-year-old male with a nodule on the right lower back, which was surgically excised and submitted to pathology as a ruptured epidermoid cyst. RESULTS: Histopathologic sections revealed detached soft tissue fragments containing polymorphic granulomas with abscess and suspicious-appearing spherical structures ranging in size from 50 to 200 μm...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051990/functional-capacity-evaluation-military-program-description-and-case-series
#5
Jill M Cancio, Robert A Oliver, Kathleen E Yancosek
A functional capacity evaluation (FCE) evaluates the ability of an individual to perform activities related to employment. There is no FCE specific to the military population; therefore, a FCE for the military population (FCE-M) was developed to evaluate an injured service member's (SM) ability to return to duty. The FCE-M is herein described along with descriptions of three active duty SMs who completed the evaluation. The three SMs completed all categories of the FCE-M with the first two cases achieving a work-level classification of Heavy-Very Heavy and the third a classification of Medium-Heavy...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051989/minute-ventilation-limitations-of-two-field-transport-ventilators
#6
Dale F Szpisjak, Gregory Horn, Samuel Shalov, Alvin Angelo Abes, Lauren Van Decar
Knowledge of transport ventilator performance impacts patient safety. This study compared minute ventilation (VE) of the MOVES and Uni-Vent 731 when ventilating the VentAid Training Test Lung with compliance (C) ranging from 0.02 to 0.10 L/cm H2O and three different airway resistances (R) (none, Rp5, or Rp20). Tidal volume (VT) was 800 ± 25 mL. Respiratory rate was increased to ventilator's maximum or until auto-PEEP > 5 cm H2O. Respiratory parameters were recorded with the RSS 100HR Research Pneumotach...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051988/ultraportable-oxygen-concentrator-use-in-u-s-army-special-operations-forward-area-surgery-a-proof-of-concept-in-multiple-environments
#7
Michael Rybak, Lynn C Huffman, Richard Nahouraii, John Loden, Marcos Gonzalez, Ramey Wilson, Paul D Danielson
INTRODUCTION: A limitation to surgical care in an austere environment is the supply of oxygen to support mechanical ventilation and general anesthesia. Portable oxygen concentrators (OCs) offer an alternative to traditional compressed oxygen tanks. OBJECTIVES: We set out to demonstrate that a low-pressure OC system could supply the mechanical ventilation needs in an austere operating environment. METHODS: An ultraportable OC (SAROS Model 3000, SeQual Technologies, Ball Ground, Georgia) was paired with an Impact 754 ventilator (Impact Instrumentation, West Caldwell, New Jersey) to evaluate the delivered fraction of inspired oxygen (FiO2) to a test lung across a range of minute ventilations and at altitudes of 1,200 and 6,500 feet above sea level...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051987/traumatic-hearing-loss-in-the-context-of-blast-related-tympanic-membrane-perforation
#8
Max D Pusz, Jon Robitschek
OBJECTIVE: Identify associated clinical factors and characterize the various forms of hearing loss in the context of blast-related traumatic tympanic membrane (TM) perforation sustained in the combat setting. METHODS: A prospective study of 41 patients who sustained a TM perforation secondary to blast injury between 2010 and 2012 while serving in combat. Clinical examinations and audiograms were obtained for all patients by a single-institution Otolaryngology service with comparative data generated from review of pre and post-trauma hearing screens...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051986/wavefront-guided-versus-wavefront-optimized-photorefractive-keratectomy-visual-and-military-task-performance
#9
Denise S Ryan, Rose K Sia, Richard D Stutzman, Joseph F Pasternak, Robin S Howard, Christopher L Howell, Tana Maurer, Mark F Torres, Kraig S Bower
PURPOSE: To compare visual performance, marksmanship performance, and threshold target identification following wavefront-guided (WFG) versus wavefront-optimized (WFO) photorefractive keratectomy (PRK). METHODS: In this prospective, randomized clinical trial, active duty U.S. military Soldiers, age 21 or over, electing to undergo PRK were randomized to undergo WFG (n = 27) or WFO (n = 27) PRK for myopia or myopic astigmatism. Binocular visual performance was assessed preoperatively and 1, 3, and 6 months postoperatively: Super Vision Test high contrast, Super Vision Test contrast sensitivity (CS), and 25% contrast acuity with night vision goggle filter...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051985/eye-care-productivity-and-access-in-the-veterans-affairs-health-care-system
#10
Mary G Lynch, April Maa, William Delaune, Joel Chasan, Glenn C Cockerham
OBJECTIVES: Eye care in the Veterans Affairs Health Care System is challenged with increasing demand and higher prevalence of patients with complex ocular conditions. Understanding factors that impact eye care productivity and access is necessary for appropriate allocation of resources. The purpose of this study was to determine the impact of various eye clinic personnel on eye care provider productivity and patient access. METHODS: Utilizing data from the Veterans Health Administration National Data Warehouse, workload and level of staffing were analyzed...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051984/implementing-an-electronic-patient-based-orthopaedic-outcomes-system-factors-affecting-patient-participation-compliance
#11
John M Tokish, Jaime N Chisholm, Craig R Bottoni, Adam T Groth, Weichin Chen, Joseph R Orchowski
INTRODUCTION: Few studies have reported on the optimization of patient compliance within outcome registries and no studies exist on orthopaedic outcome registries in the military to date. Our aim is to report on the compliance rate of an electronic, web-based, patient-reported outcomes program, with particular emphasis on the effect of variables in data acquisition on survey compliance at a single military installation. METHODS: 1,814 patients were entered into the database allowing patients to complete subjective preoperative validated scores...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051983/rapid-magnetic-resonance-imaging-evaluation-of-femoral-neck-stress-fractures-in-a-u-s-active-duty-military-population
#12
Lauren A May, Dillon C Chen, Liem T Bui-Mansfield, Seth D O'Brien
OBJECTIVES: Timely diagnosis of femoral neck stress fractures is important to prevent fracture completion and displacement. We hypothesize that an abbreviated magnetic resonance imaging (MRI) hip examination can diagnose femoral neck stress fractures and that femoral neck stress fractures are common in U.S. military recruits. METHODS: We retrospectively reviewed abbreviated hip MRI examinations performed on active duty patients from November 1, 2013, to August 5, 2014...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051982/single-neurosurgeon-operative-experience-at-craig-joint-theater-hospital-during-the-afghanistan-surge-november-2010-to-april-2011-part-ii-humanitarian-cases
#13
John Joseph Steele
BACKGROUND: The Afghanistan Surge saw NATO troops working with their Afghan partners to remove Taliban governance and replace it with a more democratic model. As part of this endeavor, medical support for both trauma and humanitarian cases was needed. OBJECTIVE: Identify and discuss disease trends to better prepare for future combat medical treatments. METHODS: Retrospective review of operative experience from a neurosurgeon from November 2010 to April 2011...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051981/single-neurosurgeon-operative-experience-at-craig-joint-theater-hospital-during-the-afghanistan-surge-november-2010-to-april-2011-part-i-neurotrauma-cases
#14
John Joseph Steele
BACKGROUND: The Afghanistan Surge saw NATO troops working with their Afghan partners to remove Taliban governance and replace it with a more democratic model. As part of this effort, medical support for both trauma and humanitarian cases was needed. OBJECTIVE: Identify and discuss disease trends to better prepare for future combat medical care. METHODS: Retrospective review of operative experience from a single neurosurgeon from November 2010 to April 2011...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051980/physical-performance-and-attrition-among-u-s-air-force-trainees-participating-in-the-basic-military-training-fueling-initiative
#15
Carrissa G Bartlett, Susan Stankorb
INTRODUCTION: Dietary intake of military initial entry trainees is often inadequate because of the structured food environment, lack of snacking, and limited time for meals. Inadequate intake during training increases risk for injury, poor performance, and attrition from training. A performance nutrition initiative was implemented at Joint Base San Antonio Lackland to mitigate this inadequacy in Air Force trainees and better reflect recommendations for active populations and mitigate nutritional inadequacy...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051979/barriers-and-health-beliefs-related-to-weight-management-among-veterans-with-human-immunodeficiency-virus
#16
Shannon Munro, Emily Dinatale, Sarah Hartley, Monica St Jacques, Kris Ann Oursler
INTRODUCTION: The success of antiretroviral therapy has led to dramatic changes in causes of morbidity and mortality among U.S. Veterans with human immunodeficiency virus (HIV). Among the 25,000 Veterans treated for HIV, 70% are over age 50 and the rate of obesity has doubled in this population. Veterans with HIV have a 50% increased risk of myocardial infarction yet have limited presence in prevention-related programs designed to lower cardiovascular disease risk. METHODS: This mixed methods study (focus groups, Schwarzer and Renner physical activity, and nutrition self-efficacy questionnaires) was used to explore factors related to health behavior and identify barriers that overweight Veterans with HIV face in enrolling in the MOVE weight management program...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051978/long-term-outcomes-after-residential-substance-use-treatment-relapse-morbidity-and-mortality
#17
Kathleen P Decker, Stephanie L Peglow, Carl R Samples, Tina D Cunningham
A cohort of 207 veterans admitted to a residential substance use treatment program was followed for 5 years following discharge to determine factors associated with reduced relapse or mortality following discharge. Subsequent utilization of medical and psychiatric hospitalization and emergency room utilization was also examined. Retrospective chart review was conducted using demographic, diagnostic, and prior treatment as independent variables. Dependent variables included aftercare compliance and subsequent morbidity as measured by relapse, emergency room visits, subsequent hospitalizations, and mortality...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051977/prevalence-of-psychotropic-medication-use-among-dutch-military-personnel-between-2003-and-2012-and-its-comparison-to-the-dutch-general-population
#18
Debbie G A Janssen, Eric Vermetten, Toine C G Egberts, Eibert R Heerdink
BACKGROUND: The armed forces work under high pressure and in stressful environments and it is well known that being in the military is a risk factor for psychiatric problems. However, it remains unknown how prevalent psychotropic medication use is in military personnel. OBJECTIVE: To assess prevalence of psychotropic medication use in Dutch military personnel and compare to the Dutch general population. METHODS: Data were obtained from the military pharmacy...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051976/military-mental-health-first-aid-development-and-preliminary-efficacy-of-a-community-training-for-improving-knowledge-attitudes-and-helping-behaviors
#19
Nathaniel Vincent Mohatt, Robert Boeckmann, Nicola Winkel, Dennis F Mohatt, Jay Shore
INTRODUCTION: Persistent stigma, lack of knowledge about mental health, and negative attitudes toward treatment are among the most significant barriers to military service members and veterans seeking behavioral health care. With the high rates of untreated behavioral health needs among service members and veterans, identifying effective programs for reducing barriers to care is a national priority. This study adapted Mental Health First Aid (MHFA), an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing laypeople's confidence in helping and frequency of referring people in need, for military and veteran populations and pilot tested the adapted training program with 4 Army National Guard armories...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28051975/intimate-partner-violence-in-the-canadian-armed-forces-psychological-distress-and-the-role-of-individual-factors-among-military-spouses
#20
Alla Skomorovsky, Manon Mireille LeBlanc
Unique military demands can have a significant impact upon family life. Although most Canadian Armed Forces (CAF) families are able to cope effectively with the stressors of military life, some may experience marital conflicts, contributing to spousal violence. Moreover, there is evidence that certain personal resources can buffer the impact of spousal violence on psychological distress. The present study examined the roles of spousal violence and personal resources, including coping, mastery, and social support, in the psychological distress of CAF members' spouses (N = 1,892)...
January 2017: Military Medicine
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