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Military Medicine

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https://www.readbyqxmd.com/read/28291503/regenerative-and-antibacterial-properties-of-acellular-fish-skin-grafts-and-human-amnion-chorion-membrane-implications-for-tissue-preservation-in-combat-casualty-care
#1
Skuli Magnusson, Baldur Tumi Baldursson, Hilmar Kjartansson, Ottar Rolfsson, Gudmundur Fertram Sigurjonsson
BACKGROUND: Improvised explosive devices and new directed energy weapons are changing warfare injuries from penetrating wounds to large surface area thermal and blast injuries. Acellular fish skin is used for tissue repair and during manufacturing subjected to gentle processing compared to biologic materials derived from mammals. This is due to the absence of viral and prion disease transmission risk, preserving natural structure and composition of the fish skin graft. OBJECTIVES: The aim of this study was to assess properties of acellular fish skin relevant for severe battlefield injuries and to compare those properties with those of dehydrated human amnion/chorion membrane...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291502/skin-regeneration-using-dermal-substrates-that-contain-autologous-cells-and-silver-nanoparticles-to-promote-antibacterial-activity-in-vitro-studies
#2
Michael A J Zieger, Manuel Ochoa, Rahim Rahimi, Gonzalo Campana, Sunil Tholpady, Babak Ziaie, Rajiv Sood
We hypothesized that the addition of silver nanoparticles (AgNP) to a dermal substrate would impart antibacterial properties without inhibiting the proliferation of contained cells. Our in vitro model was based on the commercial substrate, Integra. The substrate was prepared by simple immersion into 0 to 1% suspension of AgNP (75 or 200 nm diameter) followed by rinsing for 20 minutes and sterilization under an ultraviolet C lamp. A total of 10(7) human adipose stem cells per cubic centimeter were injected and after 1 hour, 6 × 10(5) keratinocytes/cm(2) were seeded and cultured for up to 14 days...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291501/lateral-flow-rapid-test-for-accurate-and-early-diagnosis-of-scrub-typhus-a-febrile-illness-of-historically-military-importance-in-the-pacific-rim
#3
Chien-Chung Chao, Zhiwen Zhangm, Giulia Weissenberger, Hua-Wei Chen, Wei-Mei Ching
Scrub typhus (ST) is an infection caused by Orientia tsutsugamushi. Historically, ST was ranked as the second most important arthropod-borne medical problem only behind malaria during World War II and the Vietnam War. The disease occurs mainly in Southeast Asia and has been shown to emerge and reemerge in new areas, implying the increased risk for U.S. military and civilian personnel deployed to these regions. ST can effectively be treated by doxycycline provided the diagnosis is made early, before the development of severe complications...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291500/comparative-susceptibility-of-different-mouse-strains-to-liver-stage-infection-with-plasmodium-berghei-sporozoites-assessed-using-in-vivo-imaging
#4
Qigui Li, Lisa Xie, Diana Caridha, Norma Roncal, Qiang Zeng, Jing Zhang, Ping Zhang, Mark Hickman, Lisa Read
BACKGROUND: The liver stages of Plasmodium parasites are important targets for the discovery and development of prophylactic drugs. METHODS: A real-time in vivo imaging system was used to determine the level of luminescence measured from firefly luciferase expression by sporozoites developing in hepatocytes in different strains of mice. RESULTS: The luminescence values (photon counts/sec) measured from the anatomical liver location in the untreated mice infected with 10,000 Plasmodium berghei sporozoites were 8...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291499/pertussis-outbreak-among-soldiers-during-basic-training-the-need-for-updated-protocols
#5
Basheer Halhal, Yuval Glick, Inbal Galor, Ankory Ran, David J Bacon, Elon Glassberg
Pertussis is a highly contagious, vaccine preventable upper respiratory disease. The incidence of the disease has been rising in the past few decades. During the winter of 2015, an upper respiratory outbreak occurred in one of Israel Defense Forces basic training bases in northern Israel. Following the detection of the first primary cases, a suspected outbreak investigation was initiated in conjunction with more rigorous clinical and laboratory testing efforts to include specific antibody enzyme-linked immunosorbent assay assays and polymerase chain reaction to diagnose pertussis...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291498/emergency-department-wounds-managed-by-combat-medics-a-case-series
#6
Steven G Schauer, James A Pfaff
BACKGROUND: Combat medics are an integral part of their unit helping to conserve the fighting strength. Minor wounds are a common problem in the deployed settings that affect a soldier's ability to partake in operations. While the medics often manage wound care, there is very little data on the outcomes. METHODS: Cases were acquired as part of a quality assurance project providing training feedback to medics on wound management. Laceration management is delegated to the medic at the direction of the provider...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291497/variation-in-postinjury-antibiotic-prophylaxis-patterns-over-five-years-in-a-combat-zone
#7
Bradley A Lloyd, Clinton K Murray, William Bradley, Faraz Shaikh, Deepak Aggarwal, M Leigh Carson, David R Tribble
In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among combat casualties and was later revised in 2011. We evaluated utilization of antimicrobials within 48 hours following injury in the combat zone over a 5-year period (June 2009 through May 2014) with regard to number of regimens, type of antimicrobial, and adherence to the 2011 CPG. The study population consisted of 5,196 wounded military personnel. Open fractures and skin and soft-tissue injuries were the most frequent injuries...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291496/public-health-surveillance-via-template-management-in-electronic-health-records-tri-service-workflow-s-rapid-response-to-an-infectious-disease-crisis
#8
Holly Berkley, Matthew Barnes, David Carnahan, Janet Hayhurst, Archie Bockhorst, James Neville
OBJECTIVE: To describe the use of template-based screening for risk of infectious disease exposure of patients presenting to primary care medical facilities during the 2014 West African Ebola virus outbreak. METHODS: The Military Health System implemented an Ebola risk-screening tool in primary care settings in order to create early notifications and early responses to potentially infected persons. Three time-sensitive, evidence-based screening questions were developed and posted to Tri-Service Workflow (TSWF) AHLTA templates in conjunction with appropriate training...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291495/an-assessment-of-national-emt-certification-among-enlisted-military-medics
#9
Stephen Harper, Remle Crowe, Melissa Bentley, Chetan Kharod, Benjamin Walrath
BACKGROUND: Navy Hospital Corpsmen (HMs) are the Navy equivalent to Emergency Medical Technicians (EMTs) both in-garrison and on the battlefield. In 2000, the Emergency Medical Services (EMS) Education Agenda for the Future highlighted the need for a single certification agency to provide consistent evaluation of entry level competence for each nationally recognized EMS provider level. Administered by the National Registry of EMTs (NREMT), National EMT Certification is currently utilized by 46 states, the District of Columbia, four territories, and six federal organizations as part of their processes for granting licensure...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291494/military-emergency-medical-service-system-assessment-application-of-the-national-park-service-needs-assessment-and-program-audit-to-objectively-evaluate-the-military-ems-system-of-okinawa-japan
#10
Elliot M Ross, Stephen A Harper, Cord Cunningham, Benjamin D Walrath, Gerard DeMers, Chetan U Kharod
INTRODUCTION: As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). METHODS: A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291493/empirical-study-on-the-impact-of-a-tactical-biosurveillance-information-visualization-on-users-situational-awareness
#11
Valeriya V Kettelhut, Trevor C Vanschooneveld, James C McClay, David F Mercer, Ann Fruhling, Jane L Meza
Decisions on antibiotic-resistant infection (ARI) prevention in dynamic health care settings should be agile and target the right process at the right time. Health information technologies can aid the recognition of high-risk situations for ARI transmission and timely facilitate operators' situational awareness (SA) in various military and civilian health care locations or transport platforms. High SA is one of the significant predictors of better performance. The objective of this study was to evaluate the impact of the developed health information visualization (VIZ) on the users' SA regarding situations when risks of ARI transmission and exposure are high...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291492/telesurgery-with-miniature-robots-to-leverage-surgical-expertise-in-distributed-expeditionary-environments
#12
Mark Reichenbach, Tom Frederick, Lou Cubrich, Walter Bircher, Nathan Bills, Marsha Morien, Shane Farritor, Dmitry Oleynikov
This study aimed to evaluate the capability of performing telesurgery via radio transmission for military arenas where wired internet connections may not be practical. Most existing robotic surgery systems are too large to effectively deploy with first responders. The miniature surgical platform in this study consists of a multifunctional robot suite that can fit easily into a briefcase. METHODS: The focus of this study is to explore the implications of radio control of the robot. The hypothesis is that an in vivo robot and its control boards can be controlled using off-the-shelf wireless components...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291491/an-augmented-reality-based-approach-for-surgical-telementoring-in-austere-environments
#13
Dan Andersen, Voicu Popescu, Maria Eugenia Cabrera, Aditya Shanghavi, Brian Mullis, Sherri Marley, Gerardo Gomez, Juan P Wachs
Telementoring can improve treatment of combat trauma injuries by connecting remote experienced surgeons with local less-experienced surgeons in an austere environment. Current surgical telementoring systems force the local surgeon to regularly shift focus away from the operating field to receive expert guidance, which can lead to surgery delays or even errors. The System for Telementoring with Augmented Reality (STAR) integrates expert-created annotations directly into the local surgeon's field of view. The local surgeon views the operating field by looking at a tablet display suspended between the patient and the surgeon that captures video of the surgical field...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291490/proposing-using-waist-to-height-ratio-as-the-initial-metric-for-body-fat-assessment-standards-in-the-u-s-army
#14
Stephen A Bernstein, Michael Lo, W Sumner Davis
OBJECTIVES: Soldiers failing to meet Army Regulation 600-9 (AR 600-9) for weight-to-height standards are required to undergo body fat taping assessment. This article describes a clinical performance improvement project in which battalion medical staff identified a simpler way to improve on meeting AR 600-9 standards with proposing to use the waist-to-height ratio (WtHR) in place of the current methodology. METHODS: During a yearlong combat deployment to Iraq from 2009 to 2010, 42 Soldiers (34 males, 8 females) were evaluated and monitored by battalion medical staff for weight and body fat loss...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291489/modeling-of-gender-differences-in-thermoregulation
#15
Anthony E Iyoho, Laurel J Ng, Lisa MacFadden
In January 2013, the Department of Defense lifted a ban that had prevented women from holding combat positions in the military. However, innate differences in physical traits and physiology between men and women likely will result in differences in physical performance. Sex differences in thermoregulation is a key area that needs to be examined due to the potential impact on physical performance. Therefore, we expanded our previously developed thermoregulation model (TRM) to include the effects of gender. Women have been found to have a lower sweat output in heat stress and lesser shivering in cold stress than men; therefore, the equations for sweat mass loss rate and shivering heat generation were modified for women accordingly...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291488/patient-litter-system-response-in-a-full-scale-ch-46-crash-test
#16
Charles A Weisenbach, Tyler Rooks, Troy Bowman, Vince Fralish, B Joseph McEntire
U.S. Military aeromedical patient litter systems are currently required to meet minimal static strength performance requirements at the component level. Operationally, these components must function as a system and are subjected to the dynamics of turbulent flight and potentially crash events. The first of two full-scale CH-46 crash tests was conducted at NASA's Langley Research Center and included an experiment to assess patient and litter system response during a severe but survivable crash event. A three-tiered strap and pole litter system was mounted into the airframe and occupied by three anthropomorphic test devices (ATDs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291487/physical-screening-predictors-for-success-in-completing-air-force-phase-ii-air-liaison-officer-aptitude-assessment
#17
John Christopher McGee, Eric Wilson, Haley Barela, Sharon Blum
OBJECTIVES: Air Liaison Officer Aptitude Assessment (AAA) attrition is often associated with a lack of candidate physical preparation. The Functional Movement Screen, Tactical Fitness Assessment, and fitness metrics were collected (n = 29 candidates) to determine what physical factors could predict a candidate s success in completing AAA. METHODS: Between-group comparisons were made between candidates completing AAA versus those who did not (p < 0.05). Upper 50% thresholds were established for all variables with R(2) < 0...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291486/a-randomized-controlled-trial-of-nurse-coaching-vs-herbal-supplementation-for-weight-reduction-in-soldiers
#18
Mary S McCarthy, Evelyn B Elshaw, Barbara M Szekely, Curtis Hobbs
The number of overweight and obese service members has tripled since the beginning of Overseas Contingency Operations.1 Overwhelming evidence suggesting links between obesity and increased risk for conditions such as musculoskeletal injuries, type II diabetes, and cardiovascular disease,2 poses a threat to the strength and performance of our current and future fighting force. OBJECTIVE: The purpose of the study was to test nurse health coaching (NHC) and/or herbal supplementation for weight reduction in Soldiers during a 12-week intervention...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291485/finding-their-way-back-in-family-reintegration-following-guard-deployment
#19
Deborah C Messecar
OBJECTIVE: The aim of this study was to describe deployed National Guard members' and their families' perceptions of their experience with family reintegration, and the causes and conditions of challenges reintegration presents after deployment. METHODS: A total of 26 National Guard members and 19 family members participated in individual (n = 22), couples (n = 6), or focus group (n = 17) interviews. In-depth interviews were used to assess needs and maximize input from military families regarding deployment-related experiences and reintegration issues...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291484/post-traumatic-stress-symptoms-in-united-states-air-force-aeromedical-evacuation-nurses-and-technicians
#20
Julie M Swearingen, Tanya M Goodman, Wayne L Chappelle, William T Thompson
Critical Care Air Transport Teams (CCATT) are specialized military medical personnel who provide high-acuity care in an aeromedical environment. The rate of post-traumatic stress disorder (PTSD) symptoms was assessed in CCATT personnel and their rates were compared to general aeromedical evacuation (AE) personnel. As part of a computer-based occupational stress survey, 188 crew members (138 AE nurses and technicians, 50 CCATT nurses and respiratory therapists) completed the PTSD Checklist - Military Version...
March 2017: Military Medicine
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