"Stop the Bleed": A U.S. Military Installation's Model for Implementation of a Rapid Hemorrhage Control Program.
"Stop the Bleed": A U.S. Military Installation's Model for Implementation of a Rapid Hemorrhage Control Program. Mil Med. 2018 Jul 31;: Authors: Chambers JA, Seastedt K, Krell R, Caterson E, Levy M, Turner N PMID: 30085214 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Radiofrequency Identification of the ER-REBOA: Confirmation of Placement Without Fluoroscopy.
Conclusions: Using RFID to confirm the placement of ER-REBOA is feasible with specificity highest in zone I. Future work should focus on refining this technology for the forward-deployed setting. PMID: 30085219 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Round 3: 55-Word Stories of Medical Students' Clerkship Experiences.
Authors: Hamilton JM, Moon A, Pybus A, Wilder J, Dulin N, McManamon A, Cimino FM, Chang JG PMID: 30085222 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Disaster Response to Puerto Rico: An Internal Medicine Humanitarian Response Aboard the USNS COMFORT.
Authors: Vipler B, Nissan D, Darling N, Dean D, Pettebone AD, Hicks T, Sikorski C, Landaker E, Linz N, Kronmann K, Gutierrez R, Elliott K PMID: 30085223 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Combat Readiness, Harm Aversion, and Promotion Eligibility: A Qualitative Study of U.S. Servicemembers Views on Tobacco Use and Control in the Military.
Conclusions: This qualitative study identifies military-specific themes from the tobacco user perspective that help to guide research and policy in reducing tobacco use among military servicemembers. Possible interventions suggested by our findings may include replacing tobacco breaks with fitness breaks to relieve workplace stress and support the culture of fitness, expanding the use of pharmacologic stimulants to replace tobacco when used to maintain alertness, and gathering social support for tobacco cessation from non-healthcare unit members. Further study is needed to elucidate the effectiveness of proposed interventi...
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Deployment and Smokeless Tobacco Use Among Active Duty Service Members in the U.S. Military.
Authors: Lin J, Zhu K, Soliván-Ortiz AM, Larsen SL, Schneid TR, Shriver CD, Lee S Abstract Introduction: The prevalence of smokeless tobacco use among U.S. active duty service members has been much higher than in the U.S. general population. The association between deployment and smokeless tobacco use has not been well studied. We investigated the association between deployment and smokeless tobacco use among U.S. active duty service members. We also evaluated the modification effects from other factors related to smokeless tobacco use on the deployment-smokeless tobacco use association. Materials and Me...
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

VHA-Enrolled Homeless Veterans Are at Increased Risk for Eating Disorder Diagnoses.
Conclusions: A diagnosis of eating disorders in veterans is rare at the VHA, however, the current study found that homelessness may increase risk for eating disorders in this population. Unique strategies to provide evidenced-based care while accounting for inadequate daily resources are needed to reduce the risk of eating disorders in this population. PMID: 30085246 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Smallpox Autoinoculation Via Tattoo in a Soldier.
Authors: Carius BM, Dodge PM, Randles JD Abstract Since the National Smallpox Vaccination Program began in 2002, over 2.4 million military servicemembers have been inoculated. Use of bifurcated needles to introduce live vaccinia virus by repeated skin trauma is largely the same process that was first developed over 200 years ago, and is similar to that of tattoo administration. Both tattoos and smallpox inoculation can cause local immune dysregulation, with prior research cautioning further complications if they are placed in the same area within a close timeframe. Here we present the case of a soldier with smallpo...
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Ballistic Eye Protection: Why Are Soldiers Reluctant to Use Them?
Conclusions: Significant restriction of the visual field can pose a major challenge for soldiers on the battlefield. The use of eye protection with wider lenses or no frame should be considered. Education and instruction should focus on increasing awareness among commanders and soldiers of the benefits of eye protection and fostering trust in the technology's capabilities. In parallel, it is crucial to educate soldiers about its disadvantages, and how such disadvantages can be overcome. We stipulate the findings to the standard IDF goggle and might not apply to other designs. PMID: 30085288 [PubMed - as supplied by pub...
Source: Military Medicine - August 9, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Neuromuscular Performance and Hormonal Profile During Military Training and Subsequent Recovery Period.
This study aimed to investigate the effects of garrison and field military service on neuromuscular performance and hormonal profile and to evaluate the effects of a 3-day recovery on those factors. Methods: Twenty healthy male soldiers (20 ± 1 years) participated in the study, which consisted of 4 days of garrison training [days (D) 1-4] and 7 days of military field training (Days 5-12) followed by a 3-day recovery period (Day 15). Serum hormone concentrations [testosterone (TES), cortisol (COR), sex-hormone binding globulin (SHBG), free thyroxine (T4)] were assessed at D1, D5, D8-12, and D15. Handgrip strength...
Source: Military Medicine - July 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A New Contraception Curriculum in the Internal Medicine Residency Primary Care Clinic.
Conclusion: A change in the contraception curriculum led to improved residents' skills in etonogestrel placement, and attitudes regarding the applicability of training in contraception to internal medicine, but did not significantly improve confidence in contraceptive counseling. These results suggest that internal medicine residencies should focus on teaching contraception to improve the attitudes in future internists who will need to address contraception in the military population. Future studies could include assessing physician preparedness for addressing contraception during general medical officer tours. PMID: 3...
Source: Military Medicine - July 30, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Heart Rate Variability and Cognitive Bias Feedback Interventions to Prevent Post-deployment PTSD: Results from a Randomized Controlled Trial.
Conclusion: Pre-deployment resilience training was acceptable and feasible and resulted in lower post-deployment PTSD symptom scores in subgroups of older soldiers compared with controls. Strengths of the study included cluster randomization at the company level, use of iPod device to deliver the resilience intervention throughout the deployment cycle, and minimal disruption of pre-deployment training by using self-paced resilience training. Weaknesses included self-report app use, study personnel not able to contact soldiers during deployment, and in general a low level of PTSD symptom severity throughout the study. In fu...
Source: Military Medicine - July 20, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Eyes Do not Lie: A Case of Bilateral Subconjunctival Hemorrhages and Orbital Hematoma Postpartum.
We present a case of a postpartum patient who developed bilateral subconjunctival hemorrhages with a retro-orbital hematoma. The patient is a 29-year-old gravida-1-para-0 at 41 weeks gestation who underwent an uncomplicated induction and delivery. She developed diplopia and orbital pain postpartum. Imaging revealed an orbital hematoma with an ophthalmologic workup revealing suspected glaucoma. She was followed outpatient with symptomatic treatment and had resolution of symptoms after 4 weeks. This case demonstrates a rare postpartum scenario and the subsequent workup. Subconjunctival hemorrhages are rare in the postpartum ...
Source: Military Medicine - July 18, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Impact of Adherence to Treatment for ADHD on the Quality of Military Service - The Israeli Military Experience.
Conclusions: Our hypothesis that greater adherence would correlate positively with better occupational performance was refuted. We speculate that increased adherence levels are indicative of more severe ADHD and thus, accompanied by lower occupational performance. The correlation between increased adherence and improved driving ability could be attributed to the nature of driving professions, which require a high level of concentration. Due to the importance of driving in both military and civilian settings, interventions designed to enhance adherence to treatment for ADHD among drivers could have a broad effect on driving...
Source: Military Medicine - July 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

STAIR Group Treatment for Veterans with PTSD: Efficacy and Impact of Gender on Outcome.
Conclusion: The results from this study demonstrate the feasibility and initial effectiveness of STAIR delivered in a mixed-gender group format for Veterans with PTSD. It should be noted, however, that male Veterans benefited more from this approach than female Veterans. The findings suggest the value of investigating Veterans' attitudes and beliefs about the benefits and drawbacks of mixed-gender group therapy for trauma-related difficulties. PMID: 30007286 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Predictors of Postdeployment Prescription Opioid Receipt and Long-term Prescription Opioid Utilization Among Army Active Duty Soldiers.
Conclusions: Soldiers returning from deployment were more likely to receive an opioid prescription than the overall active duty population, and 1.1% initiated a long-term opioid episode. We report a declining rate of opioid receipt and long-term opioid utilization among Army members from fiscal years 2008-2014. This study demonstrates that the most important predictors of opioid receipt were not demographic factors, but generally clinical indicators of acute pain or physical trauma. PMID: 30007291 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Energy Beverage Use Among U.S. Service Members.
Conclusion: Military Service members fit the targeted age and gender demographic of many marketing campaigns for ED/ES products, and many perceive these beverages as safe to use. The possible problems associated with overuse/reliance on ED/ES products, particularly relating to operational force readiness, merit further investigation. PMID: 30007307 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Applying Lean Principles to Reduce Wait Times in a VA Emergency Department.
Conclusions: Using Lean principles, VAPAHCS was able to improve Veteran flow in the ED. Use of Lean methods foster interdisciplinary teams and problem-solving across departments and are one approach VA EDs can use to address systemic factors and contributors to ED crowding and improve care for Veterans. Future study should incorporate additional measures of quality to determine the effect of Lean on Veteran outcomes and should evaluate the long-term sustainability of the improvement. PMID: 30007347 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evaluation of a Novel Fibrin Sealant Patch in Hemorrhage Control After Vascular or Hepatic Injury.
Conclusion: There was no significant difference in hemostasis between a novel fibrin patch and Combat Gauze after extremity arterial or hepatic injury. This novel fibrin patch may have a clinical advantage over the Combat Gauze, as it can be left in the body, thereby limiting the potential need for reoperation. PMID: 30007358 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evaluating a Health Care Disparity Among Marine Recruits Treated for Acute Appendicitis.
Authors: Prieto JM, Thompson KA, Wessels L, Moore HN, Hannon MP, Ignacio RC Abstract Introduction: One of the most common emergent surgical diseases encountered within the active duty (AD) military population is acute appendicitis, yet the rate of perforation among military members is lower than age-matched civilians in the USA. Among all demographics, a delay in presentation to surgical care has been associated with an increase in perforation rates and postoperative complications. A subset of the U.S. military population, the Marine Corps recruits (MCRs), are subjected to a unique and vigorous training environment...
Source: Military Medicine - July 11, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Low Rate of Return to Impact Activity Following Core Decompression for Femoral Head AVN in Military Servicemembers.
Conclusion: Military servicemembers undergoing core decompression for femoral head AVN experienced mild clinical improvement with moderate survivorship from THA (74%) at mid-term follow-up. However, servicemembers have a low likelihood of returning to preoperative physical function and running activities (13.7%). Older patients and those with bilateral disease were at a higher risk of progressing to THA. PMID: 29982581 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 11, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Dietary Intake in Relation to Military Dietary Reference Values During Army Basic Combat Training; a Multi-center, Cross-sectional Study.
Conclusion: The main findings of this study were that vitamins D and E, magnesium, potassium, α-linolenic acid, and fiber were under consumed by male and female recruits while males also did not consume adequate linoleic acid and females did not consume adequate calcium and iron. Future prospective research studies are needed to determine possible health and performance impacts that may be associated with suboptimal intake of these nutrients. PMID: 29982620 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - July 11, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Patterns and Associations of Shoulder Motion, Strength, and Function in MARSOC Personnel Without History of Shoulder Injury.
Conclusions: MARSOC personnel demonstrate shoulder ROM and strength symmetry patterns similar to overhead athletes. Increased dominant shoulder strength does appear to translate to a bilateral functional performance, but overall performance may be limited by the weaker nondominant upper extremity. As ARC increases, IR and ER rotation strength decrease. Repetitive, increased loading of the dominant shoulder during functional movements and training may increase risk of chronic, overuse-type injuries, common to the military. Unilateral exercises and movement analysis should be incorporated to encourage proper development of b...
Source: Military Medicine - July 11, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Retrospective and Cross-sectional Analysis of Physical Training-Related Musculoskeletal Injuries in Slovenian Armed Forces.
Authors: Kovcan B, Vodicar J, Šimenko J, Videmšek M, Pori P, Vedran H Abstract Introduction: Injury registration is an important first step of the musculoskeletal injury (MSI) prevention process that helps establish the magnitude of the problem and focus prevention on the body parts that are most frequently injured. However, an injury definition used in that process may influence the reported prevalence of MSI, causing some injuries to be under-reported which in turn alters the prevention efforts. The primary goal of our study was to identify the 10-year prevalence of MSI in members of the Slovenian A...
Source: Military Medicine - July 11, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Strategic Priorities to Improve Effectiveness of Anti-smoking Interventions for the Korean Military: An Application of the Analytic Hierarchy Process.
Conclusion: In conclusion, motivating smoking cessation and utilizing well-trained army clinicians were found to be the most important anti-smoking strategies for the Korean military. This study might provide valuable insights for policy makers to reduce tobacco use in the Korean military. PMID: 29961837 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - July 4, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Zolpidem and Eszopiclone Pre-medication for PSG: Effects on Staging, Titration, and Adherence.
Authors: Holley AB, Londeree WA, Sheikh KL, Andrada TF, Powell TA, Khramtsov A, Hostler JM Abstract Introduction: The non-benzodiazepine sedative hypnotic (NBSH) eszopiclone improves polysomnography (PSG) quality and continuous positive airway pressure (CPAP) adherence. It is unclear whether zolpidem has the same effect and neither NBSH has been studied in populations with milder forms of obstructive sleep apnea. Materials and Methods: We performed a retrospective analysis on patients undergoing level I PSG at our institution. Patients are pre-medicated with NBSHs at the discretion of the sleep physician. We c...
Source: Military Medicine - July 4, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Reliability and Feasibility Considerations in the Assessment of a Malodor Adaptation Technique: A Pilot Study.
Authors: PMID: 29961839 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - July 4, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Case Series of Smallpox Vaccination-Associated Myopericarditis: Effects on Safety and Readiness of the Active Duty Soldier.
We describe six case reports of active duty soldiers who presented to the emergency department complaining of chest pain shortly after receiving routine pre-deployment vaccinations to include smallpox. All were hospitalized and became non-deployable after developing smallpox vaccination-associated myopericarditis.Some cases of smallpox vaccination-associated myopericarditis are diagnosed in soldiers in austere environments, which have led to the soldier being removed from the mission for months at a time. This can be avoided by having all soldiers who receive the smallpox vaccine screened for clinical evidence of myoperica...
Source: Military Medicine - June 28, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Specialty Choices, Practice Characteristics, and Long-term Outcomes of Two Cohorts of USUHS Medical School Graduates Compared with National Data.
Conclusions: USUHS can play a major role by training health care professionals needed to meet the large health care strategic goals of a transforming military health system. A high percentage of USUHS graduates had significant changes in practice characteristics over time, are staying in practice for longer time compared with U.S. graduates, and practice in all 50 states including those that are underserved. PMID: 29947800 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 28, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Effects of Military Service on Marital Stability Among World War II U.S. Veterans of Japanese Descent.
Conclusion: Similar to other groups in this era, long-term marriage with one partner was the norm for both veterans and civilians. For a small portion of American men of Japanese descent, military service seemed to impact the transition into marriage. However, we found no differences in the timing of marriage or the likelihood of divorce based on military service or level of combat exposure. While our findings are inconsistent with previous research on the impact of military service and combat exposure, much of that research was conducted with mainland veterans, usually of European descent. There appears to be little long-...
Source: Military Medicine - June 27, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Non-Conventional Utilization of the Aintree Intubating Catheter to Facilitate Exchange Between Three Supraglottic Airways and an Endotracheal Tube: A Cadaveric Trial.
Authors: Lopez NT, McCoy SK, Carroll C, Jones E, Miller JA Abstract Background: Two studies by Bledsoe et al and Anand et al reported limited efficacy of the Supraglottic Airway Laryngeal Tube (SALT), which is a supraglottic airway (SGA) specifically designed for blind endotracheal intubation. Miller et al reported a 50% success rate using an Eschmann introducer as an adjunct for blind airway exchange via the laryngeal mask airway (LMA) classic. Another study by Ueki et al found that endotracheal tube (ETT) intubation was faster and less damaging to the airway when the Aintree intubating catheter was used in conjun...
Source: Military Medicine - June 25, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Deployed Military Medical Personnel: Impact of Combat and Healthcare Trauma Exposure.
This study evaluated the association between exposure to both combat experiences and medical duty stressors and post-traumatic stress symptoms in deployed military medical personnel. Materials and Methods: U.S. military medical personnel (N = 1,138; 51% male) deployed to Iraq between 2004 and 2011 were surveyed about their exposure to combat stressors, healthcare stressors, and symptoms of post-traumatic stress disorder (PTSD). All participants were volunteers, and the surveys were completed anonymously approximately halfway into their deployment. The Combat Experiences Scale was used as a measure of exposure to and im...
Source: Military Medicine - June 25, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Update: Efficacy of Military Fluid Intake Guidance.
Discussion: When calculated using actual measured sweating rates from the laboratory and model simulations, current fluid intake guidance appears to predict with 91.4% accuracy the volume of fluid required to maintain a proper euhydrated state (±2%) during 4 h of exercise. Simulations of total fluid restriction support the necessity for fluid intake guidance so that the Warfighter's performance does not degrade. It is recommended that the current military fluid intake guidance focuses on methods for accurately tracking fluid intakes. PMID: 29912380 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 20, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Moral Injury, Religiosity, and Suicide Risk in U.S. Veterans and Active Duty Military with PTSD Symptoms.
This study examines the relationship between MI and suicide risk and the moderating effect of religiosity on this relationship in V/ADM with post-traumatic stress disorder (PTSD) symptoms. Materials and Methods: This was a cross-sectional multi-site study involving 570 V/ADM from across the USA. Inclusion criteria were having served in a combat theater and the presence of PTSD symptoms. Multidimensional measures assessed MI, religiosity, PTSD symptoms, anxiety, and depression. In this secondary data analysis, a suicide risk index was created based on 10 known risk factors. Associations between MI and the suicide risk i...
Source: Military Medicine - June 20, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Acquired Stuttering in Veterans of the Wars in Iraq and Afghanistan: The Role of Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Medications.
Conclusion: Veterans with a comorbid diagnosis of TBI and PTSD were more likely to be diagnosed with AS AOR: 9.77 (95% CI = 6.93-13.78, p
Source: Military Medicine - June 20, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Predictors of Wellness Behaviors in U.S. Army Physicians.
This study reports the results of the 2015 U.S. Army Medical Corps survey regarding physician knowledge and adherence to the tenet behaviors of P3. Methods: In 2015, an anonymous survey was sent to all active duty U.S. Army physicians to assess demographic information, work hours, and knowledge of and adherence to P3. The survey assessed the tenets of P3 with questions about the following topics: obtaining 8 h of sleep per day; performing at least 2 d of resistance training and 1 day of agility training per week; re-fueling 30-60 min after exercise; incorporating at least 150 min of moderate and 75 min of vigorous aero...
Source: Military Medicine - June 20, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Nuclear Stress Testing Referrals: Time for a Novel Radiation Sparing Approach?
This study sought to measure our compliance with appropriate use criteria,6 and then to apply our own Novel Radiation Sparing Approach (NRSA) to measure what percentage could have been evaluated without radiation. Methods: The appropriateness of each referral for nuclear stress testing was evaluated using the AUC. Our NRSA was then applied, reserving a grade of 'appropriate' for patients with LBBB, pacemaker, or known resting wall motion abnormalities. The rate of appropriate referrals was then compared using McNemar's test. Results: We analyzed 423 consecutive referrals between Aug 2010 and Feb 2012. Median age wa...
Source: Military Medicine - June 20, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Need for a Combat Casualty Care Research Program and Trauma Registry for Military Working Dogs.
Authors: Orman JA, Parker JS, Stockinger ZT, Nemelka KW, Military Working Dog Trauma Registry Strategic Planning Group PMID: 29912454 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 20, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Veterans Health Administration's Traumatic Brain Injury Screen and Evaluation: Service Delivery Insights.
Conclusions: The value of VA TBI screen service delivery is appreciated by its participants, but delivery is perceived as vulnerable to failure; the extent of such failure and short- and long-term effects on patient health and well-being outcomes is incompletely understood and merits investigation. Evaluating VA TBI screen service delivery under alternate modes of delivery, e.g., one-stop visits, expanded hours of delivery, shared appointment sessions, telehealth, and intensified case management is suggested. PMID: 29912463 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 20, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Genitourinary Surgical Workload at Deployed U.S. Facilities in Iraq and Afghanistan, 2002-2016.
Conclusions: All deploying surgeons may be required to evaluate, stage, and surgically manage genitourinary, gynecologic, and obstetrical conditions. Surgery on the male genitalia, bladder, and kidney were the most commonly required genitourinary operative procedures in deployed facilities; therefore, non-urological surgeons should receive pre-deployment training in these techniques. The workload data from our study can be used to help guide the development of pre-deployment training to ensure military surgeons have the skills to perform the specialty procedures required while deployed. PMID: 29901722 [PubMed - as supp...
Source: Military Medicine - June 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Veterans Caregiving for Others: Caregiving as a Factor in the Health of America's Military Veterans.
This study proposed to determine if there are differences in health and health behaviors between veterans who are caregiving for others (VCOs) and veterans who are not caregiving for others (VNCOs). Materials and Methods: Data were analyzed from a population-based observational cross-section involving persons who identified as veterans in the 2009 Center for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) national telephone survey. Those identifying as veterans were then grouped by those who also identified as caregivers and those who did not identify as caregivers. Data were w...
Source: Military Medicine - June 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Posterior Shoulder Dislocation During Morning PT: A Case Report.
Authors: Williams SE, Hackett AJ, Jensen C, Riddle ML Abstract Posterior shoulder dislocation should be considered in the differential diagnosis of acute shoulder pain and immobility following trauma. Although far less common then the anterior dislocation, it is associated with high rates of comorbidity. Seventy-nine percent of posterior shoulder dislocations are missed on initial presentation, which is partially responsible for the high rate of comorbidity associated with these injuries. The mechanism of injury is varied from generalized seizure to minor trauma, which adds to the complexity of the diagnosis. There...
Source: Military Medicine - June 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Serotonin Syndrome in Obstetrics: A Case Report and Review of Management.
This study presents a case of SS provoked by an atypical antipsychotic in a second trimester, singleton gestation, and reviews the management of SS in an obstetric patient. We present a case of a schizophreniform, pregnant patient with a singleton gestation admitted to a community, military hospital for serotonin syndrome. The patient was admitted to the intensive care unit (ICU) by the obstetrics team, where she was managed conservatively. The cornerstones of therapy were as follows: discontinuation of offending agent, intravenous fluids, supplemental oxygen, telemetry, and hourly neurological assessments. Fetal status wa...
Source: Military Medicine - June 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Preparedness Evaluation of French Military Orthopedic Surgeons Before Deployment.
Conclusion: In the French Army, deployed orthopedic surgeons perform general surgical activity. Their initial training must be adapted to this constraint and enhanced by continuing medical education. PMID: 29901771 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Global Health Engagement Playbooks: Aligning Tactics with Strategy Using Standardized Engagement Packages.
Authors: Levine MA, Lutz EA, Licina D PMID: 29901785 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Physical Fitness and Body Anthropometrics Profiles of the Female Recruits Entering to Voluntary Military Service.
Authors: Santtila M, Pihlainen K, Koski H, Ojanen T, Kyröläinen H Abstract Introduction: The physical fitness of male conscripts has decreased, and body mass increased during the last few decades, especially in Nordic countries. However, limited research-based reports are available concerning the physical fitness profiles of female recruits. Therefore, the purpose of this study was to investigate changes in physical fitness and body composition of female recruits entering voluntary Finnish military service between the years 2005 and 2015. Materials and methods: Data were collected from the initial fit...
Source: Military Medicine - June 15, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Anonymous Feedback: What Should a Leader Do?
Authors: Harding S, Hartzell JD Abstract Leaders are required to evaluate and provide feedback to those they lead. This often involves giving feedback on direct observations, but at times can result from feedback brought to them via other pathways. When a leader is given feedback from a subordinate about another subordinate, they must decide how to best proceed. Often they must collect more data in order to make an informed decision. Followers continuously observe how leaders handle feedback from subordinates, which will directly impact mission success and unit morale. The following case highlights one junior offic...
Source: Military Medicine - June 14, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Return to Duty Practices of Army Behavioral Health Providers in Garrison.
Conclusions: If the military is to address the concern of under-reporting behavioral health readiness levels in garrison, it is critical to develop more predictability in treatment planning and reporting, as well as access to necessary data to make these clinical decisions. The interviews and focus groups revealed that while the technical process for initiating a profile does not vary, there is great disparity about the amount and type of information that is taken into consideration when making profile decisions. Categorization of the information that supports RTD decisions can lead to a better understanding of the process...
Source: Military Medicine - June 14, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Combat Injury of the Sciatic Nerve - An Institutional Experience.
Authors: PMID: 29897489 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - June 14, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Pulmonary Infarction: Right Upper Quadrant Pain as a Presenting Symptom With Review of Typical Computed Tomography Imaging Features.
Authors: Fosmire ST, Gibson GN, Copeland JC, Maydew MS, Eggers C Abstract The purpose of this case presentation is to discuss right upper quadrant pain as an atypical presenting symptom in pulmonary infarction and review the typical computed tomography (CT) imaging features of pulmonary infarction to improve diagnostic accuracy. Pulmonary infarction results from occlusion of distal arterial vasculature within the lung parenchyma leading to ischemia, hemorrhage, and ultimately necrosis. Patients with lung infarction typically present with pleuritic chest pain and may have associated signs or symptoms of pulmonary th...
Source: Military Medicine - June 13, 2018 Category: International Medicine & Public Health Tags: Mil Med Source Type: research