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Military Medicine

Allison Bush, Brett Sadowski, Dawn Torres
When the evaluation of newly elevated liver enzymes is unrevealing, a common diagnosis of exclusion is drug-induced liver injury. A 39-year-old active duty service member who presented with jaundice after returning from a mission in Thailand was found to have an acute hepatitis and developing acute liver failure. He was ultimately diagnosed with acute hepatitis E, but his diagnosis was initially confounded by multiple exposures to supplements known to cause drug-induced liver injury. This case illustrates the importance of broadened serologic testing in patients with acute liver injury returning from countries endemic with hepatitis E and also highlights the challenges in diagnosis of acute hepatitis E with currently available testing...
November 5, 2018: Military Medicine
Jose L Moreno, Paul S Nabity, Kathryn E Kanzler, Craig J Bryan, Cindy A McGeary, Donald D McGeary
Introduction: The objective was to explore how negative life events (NLEs, e.g., litigation related to pain and disability, failing most recent physical fitness test, and financial difficulties) are related to pain coping and psychological adjustment to pain in active duty military personnel. Materials and Methods: Data were gathered as part of the Evaluation of Suicidality, Cognitions, and Pain Experience study, a DoD-funded cross-sectional assessment of chronic pain and emotional coping among a cohort of military members...
November 5, 2018: Military Medicine
Sayed A Shinwari, Scott Zuerlein, Laura Singer, Josh Kumpf
No abstract text is available yet for this article.
November 5, 2018: Military Medicine
Edward Bae, Dominick Leone, Nellie Konnikov, Meera Mahalingam
Introduction: A recent study found that the incidence of melanoma and melanoma-related mortality was decreasing in residents of the New England region. However, it is unknown whether this trend is conserved in Veterans of New England who constitute more than 14% of the national Veteran population. Given this, our goal was to analyze the incidence of melanoma in patients of Veteran Integrated Service Network-1 (VISN-1) (geographically consisting of VA health care facilities in Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) and to calculate an incidence rate ratio (IRR) of melanoma in VISN-1 compared to the general population...
November 5, 2018: Military Medicine
Steven G Schauer, Jason F Naylor, Michael D April, Erick E Thronson, Joseph K Maddry, Tyson E Becker, Kirby R Gross
Introduction: U.S. military forces were redeployed in 2014 in support of Operation Inherent Resolve (OIR), operating in an austere theater without the benefit of an established medical system. We seek to describe the prehospital and hospital-based care delivered in this medically immature, non-doctrinal theater. Materials and Methods: We queried the Department of Defense Trauma Registry (DODTR) for all encounters associated with OIR from August 2014 through June 2017...
November 5, 2018: Military Medicine
Kath M Bogie
Background: Infected wounds are painful and cannot heal, with antibiotics showing reduced efficacy. Appropriate wound electrotherapy may limit incident planktonic and polymicrobial colonization, inhibit biofilm formation and accelerate healing. Methods: The Modular Adaptive Electrotherapy Delivery System (MAEDS) is a lightweight, flexible, battery-powered disposable bandage which delivers controlled reliable electrotherapy to the wound for up to 7 days. Large full-thickness excisional wounds (6 cm diameter) were created in a porcine model and freshly cultured 0...
November 5, 2018: Military Medicine
Geoffrey J Orme, E James Kehoe
Introduction: In integrating women into combat roles, one key question has been whether women will reduce the cohesion of small teams, which is their ability to stick together and perform well under pressure. Among other things, team cohesion protects the mental health of military personnel during initial training as well in operational zones. To provide new converging evidence on the cohesion of all-male versus mixed-gender recruit teams at the end of training, cohesion ratings were obtained from both recruits and their instructors...
November 5, 2018: Military Medicine
Karla E Adams, Kimberly S Johnson
Treatment of imported fire ant (IFA) hypersensitivity includes avoidance and venom immunotherapy (VIT) that reduces the risk of reactions to less than 5%. Previous studies have shown that rush immunotherapy (RIT) is safe and efficacious. It is unknown if multiple RIT procedures on individuals with breaks in VIT are safe and effective. This is a retrospective chart review of three patients who have undergone six IFA VIT rush protocols at our institution. Patients were all female with a median age of 27 years...
November 5, 2018: Military Medicine
Daniel Aedo-Martín, Ricardo Navarro-Suay, Rafael García-Cañas, Marcos Fernández-Gayol, Ricardo Vethencourt-Koifmann, Francisco Javier Areta-Jiménez
Compartment syndrome is defined as the pathology caused by the increase of pressure within a muscular compartment to the point where the vascular perfusion necessary for the viability of the tissues included therein is reduced. The diagnosis is established by clinical exam and pressure measurement. Measurement of intracompartmental pressure is an invasive method with no option of easy continuous monitoring.Continuous tissue oximetry, using near-infrared light spectroscopy, can estimate soft-tissue oxygenation several centimeters below the sensor placement...
October 27, 2018: Military Medicine
Susan L Eskridge, Owen T Hill, Mary C Clouser, Michael R Galarneau
Introduction: Despite medical interventions to preserve viability and functionality of injured limb(s) among combat-injured service members, delayed amputations may occur. The goal of this study was to determine whether specific lower extremity (LE) injuries were associated with delayed amputations. Methods: The Expeditionary Medical Encounter Database was queried for combat-related LE injuries between 2003 and 2015. The Abbreviated Injury Scale (AIS) was used to categorize LE injuries by severity...
October 27, 2018: Military Medicine
Paul Crawford, David A Moss, Amanda J Crawford, Danny J Sharon
Introduction: This study seeks to determine if modified Battlefield Acupuncture is more effective at relieving acute extremity pain, reducing medication use, and improving quality of life than placebo acupuncture or standard care after lower extremity surgery. Methods: We conducted a multi-site 3-arm randomized, double-blind controlled trial of standard care alone versus standard care + placebo auricular acupuncture with semi-permanent needles versus standard care + modified battlefield acupuncture with semi-permanent needles for lower extremity surgery at two Air Force hospitals...
October 27, 2018: Military Medicine
Guillaume L Hoareau, Timothy K Williams, Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, Lucas P Neff, J Kevin Grayson, Ian J Stewart, M Austin Johnson
Introduction: Low distal aortic flow via partial aortic occlusion (AO) may mitigate ischemia induced by resuscitative endovascular balloon occlusion of the aorta (REBOA). We compared endocrine effects of a novel simulated partial AO strategy, endovascular variable aortic control (EVAC), with simulated REBOA in a swine model. Materials and methods: Aortic flow in 20 swine was routed from the supraceliac aorta through an automated extracorporeal circuit. Following liver injury-induced hemorrhagic shock, animals were randomized to control (unregulated distal flow), simulated REBOA (no flow, complete AO), or simulated EVAC (distal flow of 100-300 mL/min after 20 minutes of complete AO)...
October 27, 2018: Military Medicine
Matthew R D'Angelo, Diane Seibert, Linda Wanzer, Heather Johnson, Katherine Alguire, Douglas Dillon, Matthew D Welder, Carol Romano
Introduction: The Global War on Terror and the ensuing Overseas Contingency Operations has rapidly transformed the U.S. military's strategic philosophy for warfare. The paradigm shift to unconventional warfare has forced military medicine to adapt with the rapidly evolving battle space. To this end, large fixed facility hospitals are being replaced with highly mobile and austere medical platforms that serve farther forward. The transition in operational health care has challenged the role of all health care team members...
October 27, 2018: Military Medicine
Charina Kullen, Tania Prvan, Helen O'Connor
Introduction: Military personnel require a high standard of health, nutrition, and physical fitness to perform their duties at optimal capacity. This study assessed the barriers and enablers for healthy eating in Australian Army (AA) personnel and identified their level of interest for future nutrition support. Methods: A convenience sample of AA completed a researcher-designed questionnaire assessing dietary, shopping and cooking practices, attitudes towards nutrition, barriers and enablers to healthy eating, and interest in future nutrition initiatives...
October 27, 2018: Military Medicine
Andrew R Wiesen, Rodd E Marcum, Michele A Soltis, Kris A Peterson
Introduction: Approximately, 320 physicians enter active duty in the U.S. Army each year, replacing a similar number separating from service. Despite the significant costs involved in educating and training physicians, factors associated with continued active service after completing obligations have not been well studied. Materials and Methods: A retrospective cohort study was conducted of all U.S. Army physicians who graduated medical school in 1987 or later and entered active physician service on or before December 31, 2015...
October 27, 2018: Military Medicine
Janet A Welsh, Jonathan R Olson, Daniel F Perkins
Introduction: With the changing roles of female military personnel, it is important to understand how wartime experiences and their impacts are similar and different for military men and women. This study examined gender differences in exposure to wartime events and post-deployment post-traumatic stress disorder (PTSD) and depressive symptoms, as well as mediators of these relations, in a large sample of male and female active duty Air Force personnel. Materials/Methods: The study included data from male (N = 21,879) and female (N = 3,741) active duty Air Force personnel who had experienced at least one deployment and completed the anonymous U...
October 27, 2018: Military Medicine
Tina L Palmieri, James H Holmes, Brett Arnoldo, Michael Peck, Amalia Cochran, Booker T King, William Dominic, Robert Cartotto, Dhaval Bhavsar, Edward Tredget, Francois Stapelberg, David Mozingo, Bruce Friedman, Soman Sen, Sandra L Taylor, Brad H Pollock
Objectives: Studies suggest that a restrictive transfusion strategy is safe in burns, yet the efficacy of a restrictive transfusion policy in massive burn injury is uncertain. Our objective: compare outcomes between massive burn (≥60% total body surface area (TBSA) burn) and major (20-59% TBSA) burn using a restrictive or a liberal blood transfusion strategy. Methods: Patients with burns ≥20% were block randomized by age and TBSA to a restrictive (transfuse hemoglobin <7 g/dL) or liberal (transfuse hemoglobin <10 g/dL) strategy throughout hospitalization...
October 27, 2018: Military Medicine
Noel Dickens, Humza Haider, Wen Lien, John Simecek, Jonathan Stahl
Introduction: Computer-aided design/computer-aided manufacturing (CAD/CAM) has gained increasing popularity since the first commercially viable dental system was introduced in the mid-1980s. Digitally milled dental restorations can be fabricated chairside in the course of one dental appointment, reducing time, cost, and manpower when compared with traditional laboratory-fabricated analog restorations. Clinical performance, physical properties, and esthetics of digital restorations have been shown to be comparable to traditional analog restorations...
October 27, 2018: Military Medicine
Charina Kullen, Tania Prvan, Helen O'Connor
Introduction: Military personnel are reported to use more dietary supplements (DS) than the general population. However, a comprehensive investigation of DS use in Australian Army personnel has not been conducted. This study investigated the prevalence and types of DS used by Australian Army personnel and examined the underpinning reasons and demographic factors influencing this use. Materials and Methods: A Convenience sample of Australian Army personnel from both Headquarter (desk-based) and Brigade (field-based) environments completed a researcher-designed DS questionnaire...
October 27, 2018: Military Medicine
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No abstract text is available yet for this article.
October 26, 2018: Military Medicine
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