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Kevin D Martin, Jeffrey Wake, Laura Dawson, J Preston Van Buren
Background: The prevalence of Achilles tendon (AT) pathology is common and can result in disability. Understanding normal AT properties can improve our ability to prevent AT injuries. We examined the cross-sectional area of the AT at multiple levels in an asymptomatic population of Army Rangers. Methods: This is a prospective cohort study composed of 41 voluntarily recruited United States Army Rangers deployed in a combat theater. All subjects were members of the Ranger Regiment participating in more than 20 h of intense bipedal non-sport weekly training with no history of AT pathology...
March 14, 2018: Military Medicine
Oren Schwartz, Itzik Malka, Cara H Olsen, Israel Dudkiewicz, Tarif Bader
Introduction: Integration of females in combat units poses a unique challenge for army commanders around the world. The purpose of this study is to provide a detailed up-to-date situation report regarding overuse injuries among combat female warriors in the IDF (Israeli Defense Forces) in order to enable evidence-based decision-making, prevention policy, and further research of this highly significant military public health issue. Methods: A cross-sectional descriptive study was conducted including 2,519 females recruited to combat duties during the year of 2013...
March 14, 2018: Military Medicine
Claire E Webster, Jon Clasper, Daniel J Stinner, Joseph Eliahoo, Spyros D Masouros
Background: Throughout history, traumatic amputation of the lower extremity has been a notable feature of all conflicts involving explosive incidents. Even at the close of the recent conflicts in Afghanistan, there were deaths that were deemed "potentially survivable." The purpose of this study is to characterize lower extremity blast injury and to determine if their amputation levels and associated injury characteristics correlate with a higher risk of mortality. Methods: the UK Joint Theatre Trauma Registry (JTTR) was interrogated to identify all lower extremity traumatic amputations sustained in both Iraq and Afghanistan between January 2003 and the end of UK operations in August 2014...
March 14, 2018: Military Medicine
Carla T Murray, Matthew Schmit
Introduction: We estimate the effect on health care spending of an option to change TRICARE. Under the option, which is based on a proposal made by the Military Compensation and Retirement Modernization Commission (MCRMC), most beneficiaries could choose from a range of commercial health networks instead of the current TRICARE plans. Military treatment facilities would become network providers under the commercial plans. Materials and Methods: We used data from the Department of Defense (DoD) to estimate the cost of providing the current health care benefit to working-age retirees and their dependents and survivors, and active duty family members...
March 14, 2018: Military Medicine
Luke Mease, Reema Sikka, Randall Rhees
Introduction: To analyze the effectiveness and suitability of pupillometer use in military and occupational medicine, specifically when pupil size is measured as part of medical surveillance. Pupil size is the most sensitive physical exam finding in vapor exposure to substances that inhibit acetylcholinesterase, such as nerve agent (chemical warfare) and organophosphates (used in agriculture). Pupillometer use permits real-time, accurate pupil measurements, which are of significant value in occupational setting where exposure to organophosphates is suspected and in dynamic military settings where it may be unclear if service members were exposed to nerve agent or not...
March 14, 2018: Military Medicine
Gordon G Wisbach, Joshua Peters, Jenise Leon Guerrero, Nelson Mozzini, Helen Metzger
Introduction: The obesity epidemic in the USA includes active duty service members in the military and effects physical readiness. At the Naval Medical Center San Diego command, the Health & Wellness Department is charged with administering the Weight Management Programs (WMP) for sailors in the San Diego area to ensure military physical readiness requirements. The optimal allocation of personnel and resources to manage these programs is paramount for mission success. We analyzed the cost and effectiveness of the WMPs for the active duty population stationed at Naval Medical Center San Diego (NMCSD) with the intent of offering potential recommendations for program optimization...
March 14, 2018: Military Medicine
Nathan H Johnson, Carol Vidal, Flavius R W Lilly
Background: Current prevalence estimates are 15% for depression and 20% for anxiety disorders among college students. These disorders are known to negatively impact academic achievement and persistence. It is important to understand the effects of parental military service on the mental health of children across development. The purpose of this study is to examine the influence of being raised in a military household on current and historical depression and anxiety disorders among college students...
March 14, 2018: Military Medicine
Krystin A Engelhardt, Elizabeth Hisle-Gorman, Gregory H Gorman, Nicole R Dobson
Background: The Military Health System (MHS) provides universal access to medical care to active duty service members, retirees, and their dependents. Observational data from small studies suggest lower preterm birth rates in the MHS compared with U.S. national averages. The objectives of this study are to determine the rate of preterm birth in the MHS from 2006 to 2012 compared with national rates and to analyze the impact of demographic factors on preterm birth in a universal access health care system...
March 14, 2018: Military Medicine
Matthew T Koroscil, Andrew Skabelund
Introduction: Blastomyces dermatitidis is a dimorphic fungus endemic to the Mississippi River valley. We describe a rare case of chronic pulmonary blastomycosis complicated by large pulmonary cavitation in a young service member who was misdiagnosed with active pulmonary tuberculosis. Case Presentation: A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL)...
March 14, 2018: Military Medicine
Eric B Elbogen, H Ryan Wagner, Mira Brancu, Nathan A Kimbrel, Jennifer C Naylor, Cindy M Swinkels, John A Fairbank
Introduction: In response to a strong focus on suicide prevention for all veterans, the Department of Veterans Affairs (VA) recently revised policy to provide emergency mental healthcare for veterans who received Other Than Honorable (OTH) discharges from the military. This current study takes a preliminary step toward identifying demographic, historic, military, clinical, and social characteristics of veterans with OTH discharges. Materials and Methods: N = 1,172 Iraq/Afghanistan-era veterans were evaluated between 2005 and 2016 in the multi-site VA Mid-Atlantic Mental Illness, Research, Education and Clinical Center (MIRECC) Study of Post-Deployment Mental Health (PDMH Study)...
March 14, 2018: Military Medicine
Sharon Reif, Rachel Sayko Adams, Grant A Ritter, Thomas V Williams, Mary Jo Larson
Introduction: Soldiers are at risk for acute and chronic pain due to the mental and physical challenges of military duties and ongoing training for force readiness. With the burden of pain on any individual attributable across pain sources, a broad perspective that goes beyond prior characterizations of pain is important. We aim to further the understanding of pain's effects among non-deployed active duty soldiers and the Military Health System (MHS), by describing prevalence of 10 painful conditions, reported pain levels, duration of pain and impact of pain on military duty limitations...
March 14, 2018: Military Medicine
Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Flavio Pereira, Roger de Moraes, Diogo Van Bavel, Andrea De Lorenzo, Eduardo Tibirica
Introduction: The main aim of the present study is to evaluate the effects of strenuous exercise, related to special military training for riot control, on systemic microvascular endothelial function and skin capillary density. Materials and Methods: Endothelium-dependent microvascular reactivity was evaluated in the forearm skin of healthy military trainees (age 23.4 ± 2.3 yr; n = 15) using laser speckle contrast imaging coupled with cutaneous acetylcholine (ACh) iontophoresis and post-occlusive reactive hyperemia (PORH)...
March 14, 2018: Military Medicine
Rachel A Hoopsick, D Lynn Homish, Paul T Bartone, Gregory G Homish
Background: Much research has focused on stress related to deployments; however, a substantial proportion of soldiers never deploy. In a study of 1.3 million veterans, suicide risk was higher among veterans who had never deployed. Thus, not being deployed may have an impact on soldiers' well-being; however, no measures exist to assess emotions regarding non-deployment. We aimed to develop and test an original measure of non-deployment emotions. Methods: We examined the Non-Deployment Emotions (NDE) questionnaire, a novel four-item measure of guilt, unit value, unit camaraderie, and unit connectedness in a sample of never-deployed male and female US Army Reserve/National Guard (USAR/NG) soldiers (N = 174)...
March 14, 2018: Military Medicine
Laura Miller, Gerardo J Pacheco, Jud C Janak, Rose C Grimm, Nicole A Dierschke, Janice Baker, Jean A Orman
Background: Military working dogs (MWDs) are a major asset in the theater of operations. Their unique abilities make them ideal for tasks such as tracking, patrol, and scent detection. MWDs deployed to a war zone are exposed to harsh environments and battlefield dangers that increase their risk of disease, injuries, and death. Although canines have been used extensively in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), no published studies have reported detailed causes of death among MWDs deployed to these conflicts...
March 14, 2018: Military Medicine
Hyungsub Park, Kwangmin Kim
The incidence of an isolated femoral vessel injury in the absence of fractures or other organ injury is extremely rare. A 20-yr-old male Korean soldier was taken to the hospital with a common femoral artery (CFA) obstruction. Injured CFA segment was resected and replaced by using 7-mm PTFE (polytetrafluoroethylene) graft. Two months after the surgical treatment, the patient discharged from the hospital without any complaints or postoperative complications. We report an unusual case of isolated femoral artery injury due to blunt trauma during military service with following review of literature...
March 14, 2018: Military Medicine
Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Laurent Mathieu, Michel Levadoux, Emmanuel Soucany de Landevoisin, Tarun J McBride Windsor, Sylvain Rigal
INTRODUCTION: Noncombat-related hand injuries are common in current theatres of operations. Crushing is one of the most frequent mechanisms that may cause traumatic amputations of digits. In the military setting, management of these digital amputations is challenging regarding limitation in microsurgical means in medical treatment facilities and aeromedical evacuation delays out of the combat zone. METHODS: Two cases of digital replantation performed in French forward surgical units are described...
2018: SICOT-J
James E McNicholas
No abstract text is available yet for this article.
March 13, 2018: Military Medicine
E A Smith, W S C Poston, C K Haddock, S A Jahnke, R E Malone
National military and veteran service organizations (MVSOs) have the potential to be advocates for stronger military tobacco control. This study consisted of qualitative analysis of interviews with 5 MVSO leaders (or their designees) and 6 focus groups conducted with veterans, to explore the opinions of MVSO leaders and veterans about military tobacco use and tobacco control policy, and to assess their current knowledge, attitudes, and likelihood of engaging with civilian tobacco control. Themes discussed include the impact of tobacco use on the military mission and on veterans; the possibility of stronger military tobacco control policies; and the idea that such policies would affect the rights of military personnel...
2018: Military Behavioral Health
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