U.S. Army Medical Department Journal

No abstract text is available yet for this article.

We report findings of field surveillance for disease vectors and the prevalence of Orientia tsutsugamushi, the causative agent for scrub typhus, and other Rickettsial species that cause murine typhus and spotted fever group rickettsioses, in chigger mites and small rodents; and Leptospira in rodent kidney, urine, and environmental water samples. The study sites included various Royal Thai Army military installations and other training sites, and surrounding areas where the multinational military training exercise Cobra Gold was conducted in Thailand in 2017 and 2018...

Aedes-vectored viruses are a major concern for active-duty military personnel working in South and Central America at certain times of the year. Knowledge about the seasonal changes of vector activity is important as it informs time-sensitive vector control, prophylaxis, and travel decisions. To assist in-country and extralimital efforts to anticipate when vector hazards and the risks of transmission are highest, we developed an Excel spreadsheet tool that uses published monthly habitat suitability models to display various aspects of average Aedes seasonality for user-defined second order administrative areas of Brazil...

With the continued increase in international travel and immigration to Georgia, the Department of Public Health (DPH) continued its mission to prevent and respond to Zika virus (ZIKV) transmission. METHODS: We analyzed surveillance data from the DPH to compare the geographical distribution of counties conducting surveillance, total number, and overall percentage of mosquito species collected in 2016 and 2017. Mosquito surveillance in 2017 was mapped by county and species using ArcMap 10...

Mosquito surveillance data can be used to develop bionomic profiles of vector species to inform abatement plans. Thus, surveillance was conducted in the months following Allied occupation of Japan at the conclusion of World War II. Mosquito surveillance in Nagasaki, Japan, began one month after the nuclear bomb destroyed much of the city. The resulting specimens housed within the US National mosquito collection are documented here for the first time. Specimen labels were digitized and specimens were photographed to record specimen condition as part of the process for making them readily available to researchers...

This is the first confirmed record of Aedes (Stegomyia) malayensis Colless from the Lao People's Democratic Republic. Its larvae were collected from rock pools and rock holes along the Nam Noy River in the Nakai Nam Theun National Protected Area, Khammuane Province. Larvae were reared in the laboratory and emerged adults were identified based on morphological characters and mitochondrial DNA analysis, using data from the mitochondrial cytochrome c oxidase subunit I. Detailed photographs of the morphological diagnostic characters and information on the bionomics of Ae...

As part of occupational health promotion in the Bundeswehr (military services of the Federal Republic of Germany), top-ranking executives were offered a medical examination and training program. The participants were subjected to retrospective evaluation. The aim of this study was to determine to what extent risk factors for the development of internal and orthopaedic conditions are present in military executives and how these factors affect physical fitness. To collect their medical history, a total of 122 male subjects answered a questionnaire aimed at evaluating private and occupational stress factors...

Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. MATERIAL AND METHODS: Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition...

The active battlefield is an environment of chaos and confusion. Depending on the scale of combat, the chaos and confusion often extend into the prehospital combat setting with multiple personnel and units involved in the chain of care of casualties. The chaos of the prehospital combat setting has led to limitations in the availability of data for performance improvement and research. The Department of Defense (DoD) Joint Trauma System (JTS) Prehospital Trauma Registry (PHTR) was developed in conjunction with the updated Tactical Combat Casualty Care (TCCC) card and a TCCC after action report (AAR), and currently serves as the prehospital repository and module of the DoD Trauma Registry (DoDTR)...

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The Army Physical Fitness Test (APFT) is a semiannual requirement. While conducting physical readiness training (PRT) is a requirement for all Soldiers, there is no requirement to train Soldiers on techniques that may help to optimize their performance on the APFT. A cohort of 34 officers that attended the Army Medical Department Basic Officer Leadership Course completed a technique-focused training program in conjunction with their required PRT program subsequent to failing one or more events on their initial APFT...

Heat strain is common in military working dogs (MWDs), but can be mitigated by limiting duration of activity to avoid overheating and allowing sufficient time for recovery. To determine work/rest times for MWDs, temperature responses during training must be characterized. This study measured body core temperature of 48 MWDs at Lackland Air Force Base, San Antonio, TX. Twenty-four MWDs in training for patrol and detection activities participated under a range of ambient temperatures in August (27°C-32°C), October (22°C-26°C) and March (approximately 13°C)...

No abstract text is available yet for this article.

Sandfly fever, sometimes known as pappataci fever or Phlebotomus fever, is a vector transmitted viral illness with a history of affecting naïve military formations that travel through or fight in areas in which the infection is endemic. We present a series of 4 hospitalized cases of sandfly fever (2 presumptive, 2 laboratory confirmed) that were admitted to a Role 3 hospital in Afghanistan for evaluation and treatment following medical evacuation from a forward area for marked fevers and malaise. Laboratory evaluation of these cases was significant for leukopenia and thrombocytopenia, consistent with historical descriptions of sandfly fever...

Insomnia disorder is a prevalent condition especially among the American military, affecting up to 50% of service members. It is shown to affect military performance. Guidelines recommend the use of nonpharmacologic approaches as initial treatment of insomnia. Cognitive behavioral therapy informed insomnia treatment (CBT-I) has the greatest evidence, however it requires specialized training. While deployed in the Middle East in support of US military operations, we faced a resource challenge while caring for service members with insomnia...

Military service members receive regular screenings for a variety of health conditions, but a field-expedient and military-specific screening tool that identifies an individual's risk for injury has not yet been identified. The purpose of this study is to describe the conduct of a novel musculoskeletal readiness screening tool (MRST) and evaluate the real-time interrater reliability of the MRST when scored by raters with differing levels of medical experience. MATERIALS/METHODS: This study included a convenience sample of 40 active duty military participants (30 male, 10 female, mean age 29...

BACKGROUND: Smoking rates are higher in the military population than in the civilian sector. Smoking is associated with poor prognosis for many musculoskeletal injuries. The purpose of this study was to investigate the effects of smoking on recovery from a shoulder injury in a prospective cohort seeking care at a military treatment facility. METHODS: Secondary analysis of 98 patients referred to physical therapy for unilateral shoulder pain. Patients received a corticosteroid injection or 6 sessions of physical therapy...

BACKGROUND: Neuropathy of the ulnar nerve at the elbow is one of a number of muscle-related and nerve-related disorders that affect people performing intensive work with their hands and upper extremities, and is the second most prevalent peripheral nerve mononeuropathy. There are several classification systems currently being used by the medical community for patients with neuropathy of the ulnar nerve at the elbow. However, few of these classification systems include the clinical electrophysiologic parameters nerve conduction (NCS) and electromyographic (EMG) studies...

BACKGROUND: Methylsulfonylmethane (MSM) is a naturally occurring sulfur containing substance that has been shown to have anti-inflammatory and antioxidative properties. Previous studies using MSM as an oral supplement to improve pain in those patients with knee osteoarthritis have shown superiority compared to placebo. However, these studies are not translatable to active individuals performing high impact activities and have not evaluated MSM as a preventative measure. METHODS: A total of 180 subjects ranging in age from 18 to 40 years were enrolled...

BACKGROUND: Preventing overuse of magnetic resonance imaging (MRI) for diagnosing ankle pathology was the goal of a process improvement project at a military treatment facility. METHODS: Ordering patterns for MRI of nonorthopaedic providers and orthopaedic surgeons were evaluated over 2 separate periods. An educational initiative on appropriate use of MRI in evaluating ankle complaints was conducted between the 2 periods. RESULTS: Between October 2009 and March 2010, 230 ankle MRIs were performed at our institution, compared to 347 ankle MRIs performed between December 2012 and August 2013...