Andexanet Alfa Use for Small Bowel Obstruction Patient With History of Sugiura Procedure
We present this surgical case as it required emergent reversal of the oral factor Xa inhibitor with andexanet alfa.PMID:33884426 | DOI:10.1093/milmed/usab151 (Source: Military Medicine)
Source: Military Medicine - April 22, 2021 Category: International Medicine & Public Health Authors: Adam K Brust Amarateedha P LeCourt Derek A Benham Jonathan R Gower Sean D Birmingham Source Type: research

Pattern of Cumulative Treatment Hours on Pain Impact and PROMIS Outcomes
CONCLUSIONS: A higher number of cumulative treatment hours was associated with improvement of pain impact, fatigue, and depression among military personnel receiving interdisciplinary pain treatment. At least 30 hours of sustained interdisciplinary treatment appears to be the threshold for improvement in pain impact and related outcomes.PMID:33885132 | DOI:10.1093/milmed/usab142 (Source: Military Medicine)
Source: Military Medicine - April 22, 2021 Category: International Medicine & Public Health Authors: Hongjin Li Diane M Flynn Krista B Highland Larisa A Burke Honor M Mcquinn Alana D Steffen Ardith Z Doorenbos Source Type: research

Preventing Surgical and Postpartum Hemorrhage in an Active Duty Patient With an Undiagnosed Coagulopathy at a Military Treatment Facility
We present a case of a young active duty female who had an undiagnosed FVII deficiency that became apparent during her expedited delivery for fetal distress. Our patient was admitted for delivery while undergoing a work up for an abnormal coagulation panel. Given high suspicion for FVII deficiency, anticipated hemorrhage, and need for cesarean delivery, she was treated with blood products containing FVII. Two days after delivery her diagnosis was confirmed. Available literature discusses the management of known FVII deficiency in pregnancy; however, to the best of our knowledge, there are no cases of an unknown bleeding di...
Source: Military Medicine - April 22, 2021 Category: International Medicine & Public Health Authors: Zachary A Kopelman Diana Villazana-Kretzer Meghan Yamasaki Source Type: research

Expanding Opportunities: An Evaluation of Uniformed Services University's Premedical Program for Enlisted Service Members
CONCLUSIONS: The EMDP2 appears to prepare medical students on a par with their non-EMDP2 peers. The EMDP2 contributes to USU's commitment to train physicians who represent the nation and its citizens by making medical education available to enlisted service members, a population that closely mirrors the diversity of the nation.PMID:33881150 | DOI:10.1093/milmed/usab125 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Althea Green Abigail Konopasky Ting Dong Aaron Saguil Dario Torre Steven J Durning Source Type: research

Injuries and Referral Patterns During Basic Combat Training: An Examination of Data From the Certified Athletic Trainer-Forward Program
Mil Med. 2021 Apr 21:usab156. doi: 10.1093/milmed/usab156. Online ahead of print.ABSTRACTINTRODUCTION: Injuries sustained during basic combat training (BCT) result in large economic costs to the U.S. Army. The inclusion of athletic trainers (ATs) in other military branches has reduced Troop Medical Clinic (TMC) referrals. However, the inclusion of ATs during BCT has yet to be studied. The purpose of this study was to describe the frequency and nature of sick call visits during BCT and determine how the presence of an AT affects referrals to the TMC.MATERIALS AND METHODS: A prospective cohort study was conducted at the Fort...
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Rebecca M Hirschhorn Susan W Yeargin James M Mensch Thomas P Dompier Source Type: research

Post-COVID Multisystem Inflammatory Syndrome in the Deployed Environment
This report describes the case of a soldier in the deployed setting with a benign initial clinical presentation who rapidly developed life-threatening MIS-A.PMID:33881152 | DOI:10.1093/milmed/usab159 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Faraz Ghoddusi David Garcia Teresa Harroun Source Type: research

Psychiatric Conditions During Pregnancy and Postpartum in a Universally Insured American Population
CONCLUSION: In a universally insured population, the incidences of psychiatric conditions in pregnancy and within a year of delivery were similar to the American population. Additionally, the development of psychiatric conditions in pregnancy and within a year of delivery may be associated with race, active duty status, and complicated births.PMID:33881522 | DOI:10.1093/milmed/usab154 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Tomas Andriotti Anju Ranjit Lynette Hamlin Tracey Koehlmoos Julian N Robinson Monica A Lutgendorf Source Type: research

Guillain-Barre Syndrome Associated With COVID-19 Pneumonia-The First Documented Case in a U.S. Military Intensive Care Unit
We describe the diagnostic process behind diagnosing GBS in an elderly male who developed acute-onset quadriparesis and respiratory muscle failure associated with severe COVID-19 pneumonia in a military ICU. A 69-year-old male was admitted to the ICU for acute hypoxemic respiratory failure due to COVID-19 pneumonia. He was subsequently intubated and treated with dexamethasone and remdesivir with improvement. On hospital day 32, the patient was extubated. Three days later, he developed acute, symmetric limb quadriparesis and respiratory muscle failure requiring reintubation. Analysis of his cerebrospinal fluid showed a cyto...
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Alvin C Yiu Ali Hussain Uzoagu A Okonkwo Rachel Villacorta-Lyew Michael J McMahon Matthew Blattner Source Type: research

Author's Response to Letter to the Editor "Direct Care Is an Important Component of Military Global Health Engagement"
Mil Med. 2021 Apr 21:usab153. doi: 10.1093/milmed/usab153. Online ahead of print.NO ABSTRACTPMID:33881534 | DOI:10.1093/milmed/usab153 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Robert P Callahan Source Type: research

Direct Care Is an Important Component of Military Global Health Engagement
Mil Med. 2021 Apr 21:usab152. doi: 10.1093/milmed/usab152. Online ahead of print.NO ABSTRACTPMID:33881538 | DOI:10.1093/milmed/usab152 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Robert P Lennon Source Type: research

Expanding Opportunities: An Evaluation of Uniformed Services University's Premedical Program for Enlisted Service Members
CONCLUSIONS: The EMDP2 appears to prepare medical students on a par with their non-EMDP2 peers. The EMDP2 contributes to USU's commitment to train physicians who represent the nation and its citizens by making medical education available to enlisted service members, a population that closely mirrors the diversity of the nation.PMID:33881150 | DOI:10.1093/milmed/usab125 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Althea Green Abigail Konopasky Ting Dong Aaron Saguil Dario Torre Steven J Durning Source Type: research

Injuries and Referral Patterns During Basic Combat Training: An Examination of Data From the Certified Athletic Trainer-Forward Program
Mil Med. 2021 Apr 21:usab156. doi: 10.1093/milmed/usab156. Online ahead of print.ABSTRACTINTRODUCTION: Injuries sustained during basic combat training (BCT) result in large economic costs to the U.S. Army. The inclusion of athletic trainers (ATs) in other military branches has reduced Troop Medical Clinic (TMC) referrals. However, the inclusion of ATs during BCT has yet to be studied. The purpose of this study was to describe the frequency and nature of sick call visits during BCT and determine how the presence of an AT affects referrals to the TMC.MATERIALS AND METHODS: A prospective cohort study was conducted at the Fort...
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Rebecca M Hirschhorn Susan W Yeargin James M Mensch Thomas P Dompier Source Type: research

Post-COVID Multisystem Inflammatory Syndrome in the Deployed Environment
This report describes the case of a soldier in the deployed setting with a benign initial clinical presentation who rapidly developed life-threatening MIS-A.PMID:33881152 | DOI:10.1093/milmed/usab159 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Faraz Ghoddusi David Garcia Teresa Harroun Source Type: research

Psychiatric Conditions During Pregnancy and Postpartum in a Universally Insured American Population
CONCLUSION: In a universally insured population, the incidences of psychiatric conditions in pregnancy and within a year of delivery were similar to the American population. Additionally, the development of psychiatric conditions in pregnancy and within a year of delivery may be associated with race, active duty status, and complicated births.PMID:33881522 | DOI:10.1093/milmed/usab154 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Tomas Andriotti Anju Ranjit Lynette Hamlin Tracey Koehlmoos Julian N Robinson Monica A Lutgendorf Source Type: research

Guillain-Barre Syndrome Associated With COVID-19 Pneumonia-The First Documented Case in a U.S. Military Intensive Care Unit
We describe the diagnostic process behind diagnosing GBS in an elderly male who developed acute-onset quadriparesis and respiratory muscle failure associated with severe COVID-19 pneumonia in a military ICU. A 69-year-old male was admitted to the ICU for acute hypoxemic respiratory failure due to COVID-19 pneumonia. He was subsequently intubated and treated with dexamethasone and remdesivir with improvement. On hospital day 32, the patient was extubated. Three days later, he developed acute, symmetric limb quadriparesis and respiratory muscle failure requiring reintubation. Analysis of his cerebrospinal fluid showed a cyto...
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Alvin C Yiu Ali Hussain Uzoagu A Okonkwo Rachel Villacorta-Lyew Michael J McMahon Matthew Blattner Source Type: research

Author's Response to Letter to the Editor "Direct Care Is an Important Component of Military Global Health Engagement"
Mil Med. 2021 Apr 21:usab153. doi: 10.1093/milmed/usab153. Online ahead of print.NO ABSTRACTPMID:33881534 | DOI:10.1093/milmed/usab153 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Robert P Callahan Source Type: research

Direct Care Is an Important Component of Military Global Health Engagement
Mil Med. 2021 Apr 21:usab152. doi: 10.1093/milmed/usab152. Online ahead of print.NO ABSTRACTPMID:33881538 | DOI:10.1093/milmed/usab152 (Source: Military Medicine)
Source: Military Medicine - April 21, 2021 Category: International Medicine & Public Health Authors: Robert P Lennon Source Type: research

The Effects of Exercise During a 10-Week Basic Military Training Program on the Physical Fitness and the Body Composition of the Greek Naval Cadets
Mil Med. 2021 Apr 20:usab146. doi: 10.1093/milmed/usab146. Online ahead of print.ABSTRACTINTRODUCTION: The period of basic military training (BMT) is a sudden change in the individual habits of the trainees and is characterized by significant improvements in body composition such as the percentage of body fat (%BF) and lean body mass (BM). Research has shown that physical activity during the period of BMT lasting 7-10 weeks has positive effects on the physical condition and BM of cadets. The purpose of this study was to examine the effects of training combining cardiovascular conditioning, circuit strength training, swimmi...
Source: Military Medicine - April 20, 2021 Category: International Medicine & Public Health Authors: Antonios Vantarakis Nikolaos Vezos Konstantinos Karakatsanis Gerasimos Grivas Theodosia Oikonomou Anna D Argyratou Sotirios A Vantarakis Stamatis Kalligeros Source Type: research

Physicians …Please Silence Your Pagers
Mil Med. 2021 Apr 20:usab148. doi: 10.1093/milmed/usab148. Online ahead of print.NO ABSTRACTPMID:33876236 | DOI:10.1093/milmed/usab148 (Source: Military Medicine)
Source: Military Medicine - April 20, 2021 Category: International Medicine & Public Health Authors: John A Hodgson Source Type: research

Atraumatic Vertebral Artery Dissection in a Patient With a Migraine Headache
Mil Med. 2021 Apr 20:usab135. doi: 10.1093/milmed/usab135. Online ahead of print.ABSTRACTThis case discusses a 34-year-old active duty male who presented to the emergency department with a 2-week persistent headache. His initial review of symptoms was reassuring until a detailed neurologic examination on his second visit revealed a visual deficit in the left upper quadrant. Additionally, he complained of intermittent tension headaches for the last several years but had no history of diagnosed migraines until he was seen 4 days prior for empiric migraine therapy in the same emergency department and left without improvement ...
Source: Military Medicine - April 20, 2021 Category: International Medicine & Public Health Authors: Michael L Lloyd Samuel Billingslea Richard Slama Source Type: research

Alleged Allergy to Penicillin and Isolation Issues: Toward New Practices for French Navy?
CONCLUSIONS: A study of medical records shows that the allergic risk is not anticipated for 74.5% of patients labeled allergic, despite the difficulties encountered at sea. Standardization of practices within the French Navy is necessary to avoid the prescription of second-line antibiotics, less effective and sometimes unavailable on board, and to improve patient safety in isolation situations. In agreement with French military allergists, we propose, in this article, guidelines for a systematic exploration of allegations of allergy to penicillin in the French Navy.PMID:33861325 | DOI:10.1093/milmed/usab141 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Cyprien Chartois Aude Valois Nicolas Paleiron Emilie Rivi ère Bertrand Elie Julien Pontis Source Type: research

The Successful Use of Left-Sided Stellate Ganglion Block in Patients That Fail to Respond to Right-Sided Stellate Ganglion Block for the Treatment of Post-Traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients
Mil Med. 2021 Apr 16:usab150. doi: 10.1093/milmed/usab150. Online ahead of print.NO ABSTRACTPMID:33861326 | DOI:10.1093/milmed/usab150 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Eugene Lipov Kenneth Candido Source Type: research

Energy Balance and Energy Availability During a Selection Course for Belgian Paratroopers
CONCLUSIONS: Energy intake is not optimal as indicated by the negative energy balance and the low energy availability, which means that the participants to this selection course had to perform in suboptimal conditions.PMID:33861342 | DOI:10.1093/milmed/usab140 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Patrick Mullie Pieter Maes Laurens van Veelen Damien Van Tiggelen Peter Clarys Source Type: research

Large Intra-Abdominal Desmoid Tumor in a Deployed Soldier Initially Presented With Chronic Diarrhea
We report the case of a young, healthy soldier with chronic diarrhea and progressively worsening abdominal distention that began during his deployment to Honduras who was subsequently found to have a large intra-abdominal desmoid tumor. Desmoid tumor is a rare and benign neoplasm that typically appears on the extremity, abdominal wall, intra-abdominal space, and occasionally in the chest wall. This tumor may be associated with abdominal distension and gastrointestinal complaints. A large tumor can compress organs, causing local tissue damage and, in rare cases, death.PMID:33861347 | DOI:10.1093/milmed/usab144 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Matthew J Perdue Mohamad Umar Jerimiah D Walker Martin Kelly Source Type: research

Leptospirosis and Rickettsial Diseases Sero-Conversion Surveillance Among U.S. Military Personnel in Honduras
CONCLUSIONS: Our results suggest a leptospirosis seroconversion rate of 7.3%, which is higher than the 0.9% and 3.9% seroconversion in Korea and Japan, respectively. The higher rate of seroconversion indicates potential risk of Leptospira exposure. Additional testing of water samples in the pools and pits around the training sites to locate the infected areas is important to eliminate or reduce future exposure to Leptospira during trainings. The rates of seroconversion for ST, MT, spotted fever Rickettsia, and QF were 4.3%, 1.9%, 3.9%, and 2.7%, respectively, indicating the potential exposure to a variety of rickettsial-re...
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Chien-Chung Chao Zhiwen Zhang Tatyana Belinskaya Hua-Wei Chen Wei-Mei Ching Source Type: research

Application of Damage Control Tactics and Transpapillary Biliary Decompression for Organ-Preserving Surgical Management of Liver Injury in Combat Patient
Mil Med. 2021 Apr 16:usab139. doi: 10.1093/milmed/usab139. Online ahead of print.ABSTRACTThe combat penetrating gunshot injury is frequently associated with damage to the liver. Bile leak and external biliary fistula (EBF) are common complications. Biliary decompression is commonly applied for the management of EBF. Also, little is known about the features of combat trauma and its management in ongoing hybrid warfare in East Ukraine. A 23-year-old male was diagnosed with thoracoabdominal penetrating gunshot wound (GSW) by a high-energy multiple metal projectile. Damage control tactics were applied at all four levels of mil...
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Igor Khomenko Ievgen Tsema Kostiantyn Humeniuk Heorhii Makarov Dmytro Rahushyn Yurii Yarynych Artur Sotnikov Viktor Slobodianyk Serhii Shypilov Dmytro Dubenko Olena Barabanchyk Andrii Dinets Source Type: research

Alleged Allergy to Penicillin and Isolation Issues: Toward New Practices for French Navy?
CONCLUSIONS: A study of medical records shows that the allergic risk is not anticipated for 74.5% of patients labeled allergic, despite the difficulties encountered at sea. Standardization of practices within the French Navy is necessary to avoid the prescription of second-line antibiotics, less effective and sometimes unavailable on board, and to improve patient safety in isolation situations. In agreement with French military allergists, we propose, in this article, guidelines for a systematic exploration of allegations of allergy to penicillin in the French Navy.PMID:33861325 | DOI:10.1093/milmed/usab141 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Cyprien Chartois Aude Valois Nicolas Paleiron Emilie Rivi ère Bertrand Elie Julien Pontis Source Type: research

The Successful Use of Left-Sided Stellate Ganglion Block in Patients That Fail to Respond to Right-Sided Stellate Ganglion Block for the Treatment of Post-Traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients
Mil Med. 2021 Apr 16:usab150. doi: 10.1093/milmed/usab150. Online ahead of print.NO ABSTRACTPMID:33861326 | DOI:10.1093/milmed/usab150 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Eugene Lipov Kenneth Candido Source Type: research

Energy Balance and Energy Availability During a Selection Course for Belgian Paratroopers
CONCLUSIONS: Energy intake is not optimal as indicated by the negative energy balance and the low energy availability, which means that the participants to this selection course had to perform in suboptimal conditions.PMID:33861342 | DOI:10.1093/milmed/usab140 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Patrick Mullie Pieter Maes Laurens van Veelen Damien Van Tiggelen Peter Clarys Source Type: research

Large Intra-Abdominal Desmoid Tumor in a Deployed Soldier Initially Presented With Chronic Diarrhea
We report the case of a young, healthy soldier with chronic diarrhea and progressively worsening abdominal distention that began during his deployment to Honduras who was subsequently found to have a large intra-abdominal desmoid tumor. Desmoid tumor is a rare and benign neoplasm that typically appears on the extremity, abdominal wall, intra-abdominal space, and occasionally in the chest wall. This tumor may be associated with abdominal distension and gastrointestinal complaints. A large tumor can compress organs, causing local tissue damage and, in rare cases, death.PMID:33861347 | DOI:10.1093/milmed/usab144 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Matthew J Perdue Mohamad Umar Jerimiah D Walker Martin Kelly Source Type: research

Leptospirosis and Rickettsial Diseases Sero-Conversion Surveillance Among U.S. Military Personnel in Honduras
CONCLUSIONS: Our results suggest a leptospirosis seroconversion rate of 7.3%, which is higher than the 0.9% and 3.9% seroconversion in Korea and Japan, respectively. The higher rate of seroconversion indicates potential risk of Leptospira exposure. Additional testing of water samples in the pools and pits around the training sites to locate the infected areas is important to eliminate or reduce future exposure to Leptospira during trainings. The rates of seroconversion for ST, MT, spotted fever Rickettsia, and QF were 4.3%, 1.9%, 3.9%, and 2.7%, respectively, indicating the potential exposure to a variety of rickettsial-re...
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Chien-Chung Chao Zhiwen Zhang Tatyana Belinskaya Hua-Wei Chen Wei-Mei Ching Source Type: research

Application of Damage Control Tactics and Transpapillary Biliary Decompression for Organ-Preserving Surgical Management of Liver Injury in Combat Patient
Mil Med. 2021 Apr 16:usab139. doi: 10.1093/milmed/usab139. Online ahead of print.ABSTRACTThe combat penetrating gunshot injury is frequently associated with damage to the liver. Bile leak and external biliary fistula (EBF) are common complications. Biliary decompression is commonly applied for the management of EBF. Also, little is known about the features of combat trauma and its management in ongoing hybrid warfare in East Ukraine. A 23-year-old male was diagnosed with thoracoabdominal penetrating gunshot wound (GSW) by a high-energy multiple metal projectile. Damage control tactics were applied at all four levels of mil...
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Igor Khomenko Ievgen Tsema Kostiantyn Humeniuk Heorhii Makarov Dmytro Rahushyn Yurii Yarynych Artur Sotnikov Viktor Slobodianyk Serhii Shypilov Dmytro Dubenko Olena Barabanchyk Andrii Dinets Source Type: research

Alleged Allergy to Penicillin and Isolation Issues: Toward New Practices for French Navy?
CONCLUSIONS: A study of medical records shows that the allergic risk is not anticipated for 74.5% of patients labeled allergic, despite the difficulties encountered at sea. Standardization of practices within the French Navy is necessary to avoid the prescription of second-line antibiotics, less effective and sometimes unavailable on board, and to improve patient safety in isolation situations. In agreement with French military allergists, we propose, in this article, guidelines for a systematic exploration of allegations of allergy to penicillin in the French Navy.PMID:33861325 | DOI:10.1093/milmed/usab141 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Cyprien Chartois Aude Valois Nicolas Paleiron Emilie Rivi ère Bertrand Elie Julien Pontis Source Type: research

The Successful Use of Left-Sided Stellate Ganglion Block in Patients That Fail to Respond to Right-Sided Stellate Ganglion Block for the Treatment of Post-Traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients
Mil Med. 2021 Apr 16:usab150. doi: 10.1093/milmed/usab150. Online ahead of print.NO ABSTRACTPMID:33861326 | DOI:10.1093/milmed/usab150 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Eugene Lipov Kenneth Candido Source Type: research

Energy Balance and Energy Availability During a Selection Course for Belgian Paratroopers
CONCLUSIONS: Energy intake is not optimal as indicated by the negative energy balance and the low energy availability, which means that the participants to this selection course had to perform in suboptimal conditions.PMID:33861342 | DOI:10.1093/milmed/usab140 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Patrick Mullie Pieter Maes Laurens van Veelen Damien Van Tiggelen Peter Clarys Source Type: research

Large Intra-Abdominal Desmoid Tumor in a Deployed Soldier Initially Presented With Chronic Diarrhea
We report the case of a young, healthy soldier with chronic diarrhea and progressively worsening abdominal distention that began during his deployment to Honduras who was subsequently found to have a large intra-abdominal desmoid tumor. Desmoid tumor is a rare and benign neoplasm that typically appears on the extremity, abdominal wall, intra-abdominal space, and occasionally in the chest wall. This tumor may be associated with abdominal distension and gastrointestinal complaints. A large tumor can compress organs, causing local tissue damage and, in rare cases, death.PMID:33861347 | DOI:10.1093/milmed/usab144 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Matthew J Perdue Mohamad Umar Jerimiah D Walker Martin Kelly Source Type: research

Leptospirosis and Rickettsial Diseases Sero-Conversion Surveillance Among U.S. Military Personnel in Honduras
CONCLUSIONS: Our results suggest a leptospirosis seroconversion rate of 7.3%, which is higher than the 0.9% and 3.9% seroconversion in Korea and Japan, respectively. The higher rate of seroconversion indicates potential risk of Leptospira exposure. Additional testing of water samples in the pools and pits around the training sites to locate the infected areas is important to eliminate or reduce future exposure to Leptospira during trainings. The rates of seroconversion for ST, MT, spotted fever Rickettsia, and QF were 4.3%, 1.9%, 3.9%, and 2.7%, respectively, indicating the potential exposure to a variety of rickettsial-re...
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Chien-Chung Chao Zhiwen Zhang Tatyana Belinskaya Hua-Wei Chen Wei-Mei Ching Source Type: research

Application of Damage Control Tactics and Transpapillary Biliary Decompression for Organ-Preserving Surgical Management of Liver Injury in Combat Patient
Mil Med. 2021 Apr 16:usab139. doi: 10.1093/milmed/usab139. Online ahead of print.ABSTRACTThe combat penetrating gunshot injury is frequently associated with damage to the liver. Bile leak and external biliary fistula (EBF) are common complications. Biliary decompression is commonly applied for the management of EBF. Also, little is known about the features of combat trauma and its management in ongoing hybrid warfare in East Ukraine. A 23-year-old male was diagnosed with thoracoabdominal penetrating gunshot wound (GSW) by a high-energy multiple metal projectile. Damage control tactics were applied at all four levels of mil...
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Igor Khomenko Ievgen Tsema Kostiantyn Humeniuk Heorhii Makarov Dmytro Rahushyn Yurii Yarynych Artur Sotnikov Viktor Slobodianyk Serhii Shypilov Dmytro Dubenko Olena Barabanchyk Andrii Dinets Source Type: research

Alleged Allergy to Penicillin and Isolation Issues: Toward New Practices for French Navy?
CONCLUSIONS: A study of medical records shows that the allergic risk is not anticipated for 74.5% of patients labeled allergic, despite the difficulties encountered at sea. Standardization of practices within the French Navy is necessary to avoid the prescription of second-line antibiotics, less effective and sometimes unavailable on board, and to improve patient safety in isolation situations. In agreement with French military allergists, we propose, in this article, guidelines for a systematic exploration of allegations of allergy to penicillin in the French Navy.PMID:33861325 | DOI:10.1093/milmed/usab141 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Cyprien Chartois Aude Valois Nicolas Paleiron Emilie Rivi ère Bertrand Elie Julien Pontis Source Type: research

The Successful Use of Left-Sided Stellate Ganglion Block in Patients That Fail to Respond to Right-Sided Stellate Ganglion Block for the Treatment of Post-Traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients
Mil Med. 2021 Apr 16:usab150. doi: 10.1093/milmed/usab150. Online ahead of print.NO ABSTRACTPMID:33861326 | DOI:10.1093/milmed/usab150 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Eugene Lipov Kenneth Candido Source Type: research

Energy Balance and Energy Availability During a Selection Course for Belgian Paratroopers
CONCLUSIONS: Energy intake is not optimal as indicated by the negative energy balance and the low energy availability, which means that the participants to this selection course had to perform in suboptimal conditions.PMID:33861342 | DOI:10.1093/milmed/usab140 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Patrick Mullie Pieter Maes Laurens van Veelen Damien Van Tiggelen Peter Clarys Source Type: research

Large Intra-Abdominal Desmoid Tumor in a Deployed Soldier Initially Presented With Chronic Diarrhea
We report the case of a young, healthy soldier with chronic diarrhea and progressively worsening abdominal distention that began during his deployment to Honduras who was subsequently found to have a large intra-abdominal desmoid tumor. Desmoid tumor is a rare and benign neoplasm that typically appears on the extremity, abdominal wall, intra-abdominal space, and occasionally in the chest wall. This tumor may be associated with abdominal distension and gastrointestinal complaints. A large tumor can compress organs, causing local tissue damage and, in rare cases, death.PMID:33861347 | DOI:10.1093/milmed/usab144 (Source: Military Medicine)
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Matthew J Perdue Mohamad Umar Jerimiah D Walker Martin Kelly Source Type: research

Leptospirosis and Rickettsial Diseases Sero-Conversion Surveillance Among U.S. Military Personnel in Honduras
CONCLUSIONS: Our results suggest a leptospirosis seroconversion rate of 7.3%, which is higher than the 0.9% and 3.9% seroconversion in Korea and Japan, respectively. The higher rate of seroconversion indicates potential risk of Leptospira exposure. Additional testing of water samples in the pools and pits around the training sites to locate the infected areas is important to eliminate or reduce future exposure to Leptospira during trainings. The rates of seroconversion for ST, MT, spotted fever Rickettsia, and QF were 4.3%, 1.9%, 3.9%, and 2.7%, respectively, indicating the potential exposure to a variety of rickettsial-re...
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Chien-Chung Chao Zhiwen Zhang Tatyana Belinskaya Hua-Wei Chen Wei-Mei Ching Source Type: research

Application of Damage Control Tactics and Transpapillary Biliary Decompression for Organ-Preserving Surgical Management of Liver Injury in Combat Patient
Mil Med. 2021 Apr 16:usab139. doi: 10.1093/milmed/usab139. Online ahead of print.ABSTRACTThe combat penetrating gunshot injury is frequently associated with damage to the liver. Bile leak and external biliary fistula (EBF) are common complications. Biliary decompression is commonly applied for the management of EBF. Also, little is known about the features of combat trauma and its management in ongoing hybrid warfare in East Ukraine. A 23-year-old male was diagnosed with thoracoabdominal penetrating gunshot wound (GSW) by a high-energy multiple metal projectile. Damage control tactics were applied at all four levels of mil...
Source: Military Medicine - April 16, 2021 Category: International Medicine & Public Health Authors: Igor Khomenko Ievgen Tsema Kostiantyn Humeniuk Heorhii Makarov Dmytro Rahushyn Yurii Yarynych Artur Sotnikov Viktor Slobodianyk Serhii Shypilov Dmytro Dubenko Olena Barabanchyk Andrii Dinets Source Type: research

The Use of Whole Blood Transfusion During Non-Traumatic Resuscitation
CONCLUSION: In this retrospective study, WB was most commonly used for OBGYN-associated bleeding. As WB becomes more widespread across the USA for use in traumatically injured patients, it is likely that WB will be more commonly used for non-trauma patients. More outcome data are required to safely expand the indications for WB use beyond trauma.PMID:33856481 | DOI:10.1093/milmed/usab128 (Source: Military Medicine)
Source: Military Medicine - April 15, 2021 Category: International Medicine & Public Health Authors: Craig D Nowadly Andrew D Fisher Matthew A Borgman Kennedy S Mdaki Ronnie L Hill Susannah E Nicholson James A Bynum Steven G Schauer Source Type: research

Possible Effects on VA Outpatient Care of Expanding Medicaid: Implications of Having Access to Overlapping Publicly Funded Health Care Services
CONCLUSIONS: This study shows usage shifts when Medicaid expansion allows veterans to gain access to non-VA care. It highlights increased potential for care-coordination challenges among VA patients as states implement ACA Medicaid expansion and policymakers consider additional public health insurance options, as well as programs like CHOICE and the MISSION Act that increase veteran choices of traditional VA and community care providers.PMID:33857298 | DOI:10.1093/milmed/usab094 (Source: Military Medicine)
Source: Military Medicine - April 15, 2021 Category: International Medicine & Public Health Authors: Patrick N O'Mahen Laura A Petersen Source Type: research

The Use of Whole Blood Transfusion During Non-Traumatic Resuscitation
CONCLUSION: In this retrospective study, WB was most commonly used for OBGYN-associated bleeding. As WB becomes more widespread across the USA for use in traumatically injured patients, it is likely that WB will be more commonly used for non-trauma patients. More outcome data are required to safely expand the indications for WB use beyond trauma.PMID:33856481 | DOI:10.1093/milmed/usab128 (Source: Military Medicine)
Source: Military Medicine - April 15, 2021 Category: International Medicine & Public Health Authors: Craig D Nowadly Andrew D Fisher Matthew A Borgman Kennedy S Mdaki Ronnie L Hill Susannah E Nicholson James A Bynum Steven G Schauer Source Type: research

Possible Effects on VA Outpatient Care of Expanding Medicaid: Implications of Having Access to Overlapping Publicly Funded Health Care Services
CONCLUSIONS: This study shows usage shifts when Medicaid expansion allows veterans to gain access to non-VA care. It highlights increased potential for care-coordination challenges among VA patients as states implement ACA Medicaid expansion and policymakers consider additional public health insurance options, as well as programs like CHOICE and the MISSION Act that increase veteran choices of traditional VA and community care providers.PMID:33857298 | DOI:10.1093/milmed/usab094 (Source: Military Medicine)
Source: Military Medicine - April 15, 2021 Category: International Medicine & Public Health Authors: Patrick N O'Mahen Laura A Petersen Source Type: research

Anaphylaxis After the Covid-19 Vaccine in a Patient With Cholinergic Urticaria
We report the events, workup, and eventual second dose vaccination of a patient at the Walter Reed National Military Medical Center, who had immediate anaphylaxis after administration of the first Pfizer-BioNTech Covid-19 (BNT162b2) vaccine dose. During the initial evaluation after anaphylaxis, the patient described a history of symptoms suspicious for cholinergic urticaria but had never had this condition confirmed with standardized testing. After the episode of anaphylaxis, we performed several studies including immediate hypersensitivity skin testing, which did not demonstrate vaccine or component sensitization. We then...
Source: Military Medicine - April 14, 2021 Category: International Medicine & Public Health Authors: Hyun J Park Jay R Montgomery Nathan A Boggs Source Type: research

Best Medical Advice: Providing Medical Leadership in Uncertain Times
Mil Med. 2021 Apr 14:usab133. doi: 10.1093/milmed/usab133. Online ahead of print.ABSTRACTMilitary physicians must often balance medical and operational priorities when providing advice to operational commanders. This case describes how a Navy Medical Corps Officer serving with a Marine Corps helicopter squadron during the initial stages of the COVID-19 pandemic helped manage risk.PMID:33852014 | DOI:10.1093/milmed/usab133 (Source: Military Medicine)
Source: Military Medicine - April 14, 2021 Category: International Medicine & Public Health Authors: Anthony J Greco Ramey L Wilson Source Type: research