Optimal Physical Space for En Route Care: Medic Posture and Injury Survey.
CONCLUSION: Results of this survey emphasize the need for injury mitigation and prevention strategies to reduce impacts on soldier health and readiness. PMID: 32968770 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 26, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Can This Be Healed, Doctor? Perspectives on Capacity, Chronic Mental Illness, and Practicing Compassionate Medicine.
Authors: Horch M, Scott J, Hesdorffer C, Logan J PMID: 32976582 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 26, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Adverse Childhood Experience, Genes, and PTSD Risk in Soldiers: A Methylation Study.
CONCLUSION: Our study suggests that methylation of key genes involved in synaptic plasticity and the hypothalamic-pituitary-adrenal axis is associated with lower levels of methylation in military PTSD subjects exposed to combat when compared to their non-PTSD counterparts. Strengths of this study include controlling for antidepressant use and excluding TBI patients. Similar studies in an active duty population of this size are scarce. What is not clear is whether methylation changes are driving PTSD symptomology or whether they are merely a marker of disease. Future areas of research include prospective studies that measur...
Source: Military Medicine - September 26, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Direct Peritoneal Resuscitation Improves Survival in a Murine Model of Combined Hemorrhage and Burn Injury.
CONCLUSIONS: After a combined burn injury and hemorrhage, DPR leads to increased survival in mice. Survival was similar with the use of normal saline or Delflex. DPR with normal saline reduced the inflammatory response seen with Delflex and delayed the progression of acute lung injury. DPR may be a valuable strategy in the treatment of patients with combined burn injury and hemorrhage. PMID: 32962326 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - September 25, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Letter From Executive Director Dr. John Cho.
Authors: PMID: 32964239 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - September 25, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Rapid Cognitive Decline Secondary to CSF Venous Fistula With Postoperative Rebound Intracranial Hypertension and a Hyperintense Paraspinal Vein Sign Seen Retrospectively.
Authors: Tatum PS, Anderson E, Kravtsova A, Alnasser O, Hedges T, Green-Laroche DM, Madan N Abstract A 56-year-old female with 2 prior Chiari decompressions presented with rapidly progressive cognitive decline. Brain magnetic resonance imaging, computed tomography myelogram, and prone digital subtraction myelography revealed signs of brain sag and left T9 perineural cysts but no cerebrospinal fluid leaks. Symptoms improved after multilevel blood patches but recurred. Lateral decubitus digital subtraction myelography revealed a spinal cerebrospinal fluid venous fistula (SCVF), which resolved after neurosurgeons liga...
Source: Military Medicine - September 15, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Association With Physical Fitness and Academic Performance at America's Military Medical School.
CONCLUSIONS: Our investigation suggests that there may be correlations between physical fitness and clinical exam performance such as USMLE Step 2 CK and average core clerkship NBME exams. Although there is no statistically significant change in individual fitness total points or BMI, the study suggests that physical fitness and BMI may decline during medical school. This may be as a result of increasing academic demands while balancing clinical duties from clerkship rotations. PMID: 32909600 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 12, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Associations Among Behavioral Risk, Sociodemographic Identifiers, and Sexually Transmitted Infections in Male and Female Army Enlisted Personnel.
CONCLUSION: Our findings support the need for development of STI prevention strategies that include education and skills-building approaches to reduce alcohol misuse among enlisted military personnel, and especially male personnel. Such programs should include factors that uniquely influence the experiences of males and females in the military context. PMID: 32909601 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 12, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

What Influences the Decision to Interview a Candidate for Medical School?
CONCLUSIONS: The use of holistic review generated a class with a composition different from that which would be predicted by Medical College Admission Test and grade point average alone. Further, holistic review produced an interview pool and class more representative of the wider Military Health Service beneficiary population. In the case of USU, holistic review allowed the school to better meet its mission to create a representative class able to "care for those in harm's way." PMID: 32909602 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 12, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Atraumatic Splenic Rupture After Weight Lifting in a Patient Presenting With Left Shoulder Pain.
Authors: Halliday M, Ingersoll J, Alex J Abstract We discuss a 23-year-old active duty male who presented to the emergency department with left shoulder pain after deadlifting heavy weights the day prior. His physical examination revealed a nontender and otherwise unremarkable left shoulder with full range of motion and mild tenderness to palpation in the left upper quadrant of the abdomen. A bedside focused assessment with sonography for trauma (FAST) examination showed free fluid in the abdomen and a computed tomography scan showed a splenic laceration and splenomegaly. He later tested positive for infectious mon...
Source: Military Medicine - September 12, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Standardizing Postoperative Rehabilitation Protocols for the Tri-Service: A Consensus Meeting Hosted by the Musculoskeletal Injury Rehabilitation Research for Operational Readiness Organization.
Authors: Isaacson B, Miranda M, Hager N, Wagner L, West S, Lucio W, Heller J, Dalgarno R, Dickens JF, Schoomaker E, Pasquina P PMID: 32897320 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 9, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Hearing Problems Among the Members of the Defence Forces in Relation to Personal and Occupational Risk Factors.
CONCLUSIONS: The members of the Defence Forces experience noise from various sources, most of it resulting from outdoor activities. Personal and work conditions-related risk factors as well as stress increase the risk of hearing problems. PMID: 32879984 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 5, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evolution of the United States Military Extracorporeal Membrane Oxygenation Transport Team.
CONCLUSIONS: Utilization of the U.S. military ECMO team has increased exponentially since January 2017. With an increased tempo of transport operations and distance of critical care transport, survival to decannulation and discharge rates exceed national benchmarks as described in ELSO published data. The ability to cannulate patients in remote locations and provide critical care transport to a military medical treatment facility has allowed the U.S. military to maintain readiness of a critical medical asset. PMID: 32885813 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 5, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Department of Defense and Eye Injury Data: Shedding New Light.
Authors: Colyer MH PMID: 32886126 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 5, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Public Health Response to Zika Virus Exposure of Air Force Members Deployed to Caribbean Islands, 2016.
Authors: Voss J, Dacey D, Ruiz S, Burkhardt A, Pujolar A, Swope C, Lehman M, Shaw T, Leon J, Erich R, Cowan J, West C, Walters C, Macias E, Lucas P Abstract INTRODUCTION: The emergence of Zika virus disease (ZVD) in areas of military operations provided a new opportunity for force health protection. ZVD infection had an estimated 4:1 asymptomatic-to-symptomatic ratio and can cause neurologic sequelae. MATERIALS AND METHODS: We provide a brief report of a field investigation utilizing laboratory-based surveillance and survey instruments to characterize ZVD risk among personnel deployed to the Dominican Republic ...
Source: Military Medicine - September 4, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Applying Anthropology: A Mission-Essential Skill for Culturally Competent Healthcare.
Authors: Autrey LK, Anderson CW PMID: 32869080 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 2, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Splinting in Carpal Tunnel Syndrome: The Optimal Duration.
CONCLUSION: Neutral wrist splint for 6 weeks resulted in better clinical improvements in patients with untreated mild and mild to moderate CTS. There was no additional benefit in extending splinting 6 additional weeks. This is the first study to compare duration of wrist splint use beyond 8 weeks. A larger sample size is needed to identify the reason for lack of functional improvement in group B. Long-term follow-up of this cohort will be helpful to determine the natural history of initial wrist splint use. PMID: 32870276 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 2, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Veterans Health Administration Whole Health Model of Care: Early Implementation and Utilization at a Large Healthcare System.
CONCLUSION: Implementation of the WH model of care has the potential to transform the way VHA delivers healthcare and improve the health and lives of veterans. However, a shift of this magnitude is likely to face challenges during implementation. This article reports on initial barriers to implementation, which can guide implementation at other sites as well as future investigations. Further research is needed to replicate these results as well as to determine underlying causal factors. However, if replicated, these results indicate that successful implementation of WH, or similar models of care, will require extensive eff...
Source: Military Medicine - September 2, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prolonged Stabilization During a Mass Casualty Incident at Sea in the Era of Distributed Maritime Operations.
Authors: Day WG, Cooper E, Phung K, Miller B, DuBose J, Lin AH Abstract In August 2017, the USS Bataan received a mass casualty incident (MCI) of 6 foreign special forces operators after a helicopter crash. All 6 patients were medically evacuated successfully to the USS Bataan, and all patients survived and were successfully returned to their allied country. Four of the patients received whole blood with 2 receiving over 10 units of blood or massive transfusions. One patient required 44 units of blood, and at 1 point in his resuscitation, he received 12 units of whole blood every 30 minutes. Due to a...
Source: Military Medicine - September 2, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Non-Pharmaceutical Interventions and Military Hygiene at the United States Military Academy between 1890 and 1910.
CONCLUSIONS: The USMA experience mirrored what was occurring in the larger U.S. Army in the early 20th century and may serve as a model for the application of NPIs in response to modern infectious diseases resulting from novel or unknown etiologies. PMID: 32870979 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 2, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Are Patients Discharged on the HEART Pathway Following Up?
CONCLUSIONS: Of the subjects discharged on the HEART Pathway, 67.6% followed up. Of those subjects that followed up, 18% did so at the HEART Clinic. PMID: 32871008 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - September 2, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evaluation of a Functional Restoration Program at Fort Bliss Interdisciplinary Pain Management Clinic.
This article reports our first-year FRP results at William Beaumont Army Medical Center IPMC. MATERIALS AND METHODS: The FRP is designed to improve the participants' functionality and quality of life, both personally and professionally. Service members with chronic pain were evaluated for psychological and physical clearance before enrollment in an intense and structured FRP for 8 hours a day over 3 weeks. The program focused on physical and occupational exercises, yoga, acupuncture, and educational classes regarding pain medications, nutrition, and coping skills. The resulting data were analyzed using paired two-taile...
Source: Military Medicine - August 30, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

An Analysis of Essential Pediatric Surgical Cases Encountered During a Decade of Large-Scale Military Humanitarian Aid Missions.
CONCLUSIONS: This study represents the largest known analysis of military humanitarian assistance. Pediatric operations represented over one-third of the surgical volume during Pacific Partnership missions from 2006 to 2018. The majority of cases were DCP3-aligned and associated with a low complication rate. Future humanitarian aid missions and host nations should allocate appropriate medical and educational resources to treat DCP3 pediatric surgical diseases in low- and middle-income countries to support long-term capacity building while maintaining optimal surgical outcomes. PMID: 32856051 [PubMed - as supplied by pu...
Source: Military Medicine - August 30, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Comparative Trends in the Distribution of Lung Cancer Stage at Diagnosis in the Department of Defense Cancer Registry and the Surveillance, Epidemiology, and End Results data, 1989-2012.
CONCLUSIONS: The majority of NSCLC patients in the MHS and general population are diagnosed with stage IV NSCLC and the percentage is increasing. Compared to the general population, NSCLC patients in the MHS have a higher percentage of stage I, a lower percentage of stage IV, and of unknown stage cancer. Universal care along with more rigorous staging across the MHS may play a role in these findings. PMID: 32857164 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 30, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Characterization and Comparison of Primary Care Appointment Utilization Patterns Among Military Health System Beneficiaries.
CONCLUSIONS: Primary care utilization trends are different among different demographic subgroups within the Military Health System (MHS). Unmet demand, patient acuity, clinician continuity, robustness of team support, and other important factors that influence appointment utilization were not incorporated in this study. Superficially, these data suggest that the MHS enrollment target of 1,100-1,300 patients per full-time primary care clinician is roughly appropriate, though this should be interpreted with caution given the limitations. PMID: 32851412 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 29, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Development and Implementation of Specimens for Accident Forensic Toxicology Investigation Kit for Special Operations Forces.
CONCLUSION: SOCAFRICA established a prepared kit with all of the materials for sample collection, accompanied by step-by-step descriptions of the procedure, and clear guidance on the proper completion of the requisite paperwork that meets medico-legal requirements. PMID: 32851413 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 29, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Incidence and Mechanisms of Musculoskeletal Injuries in Deployed Navy Active Duty Service Members Aboard Two U.S. Navy Air Craft Carriers.
CONCLUSION: Care should be used interpreting the results since participants were volunteers and a small proportion of eligible subjects chose not to participate in the study. Nevertheless, our data are generally consistent with other studies of musculoskeletal injury on board U.S. Navy ships and are useful for health care planning purposes and for planning for future studies that may take place on board U.S. Navy vessels. The novel and important finding of this study suggests that sports and exercise activity on board ship may warrant a new area of attention for safety. PMID: 32852526 [PubMed - as supplied by publisher...
Source: Military Medicine - August 29, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Novel Algorithm for Automated Optic Nerve Sheath Diameter Measurement Using a Clustering Approach.
Authors: Rajajee V, Soroushmehr R, Williamson CA, Najarian K, Gryak J, Awad A, Ward KR, Tiba MH Abstract INTRODUCTION: Using ultrasound to measure optic nerve sheath diameter (ONSD) has been shown to be a useful modality to detect elevated intracranial pressure. However, manual assessment of ONSD by a human operator is cumbersome and prone to human error. We aimed to develop and test an automated algorithm for ONSD measurement using ultrasound images and compare it to measurements performed by physicians. MATERIALS AND METHODS: Patients were recruited from the Neurological Intensive Care Unit. Ultrasound images...
Source: Military Medicine - August 26, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Automated Partial Versus Complete Resuscitative Endovascular Balloon Occlusion of the Aorta for the Management of Hemorrhagic Shock in a Pig Model of Polytrauma: a Randomized Controlled Pilot Study.
CONCLUSIONS: This study demonstrates the feasibility of intermediate-term experiments in a complex swine model of polytrauma with 90 minutes of REBOA. EVAC may be associated with improved survival at 24 hours when compared with complete REBOA. EVAC resulted in normalized physiology after 24 hours, suggesting that prolonged partial occlusion is possible. Longer studies evaluating partial REBOA strategies are needed. PMID: 32830262 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 26, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Extending Peer Support Across the Military Health System to Decrease Clinician Burnout.
CONCLUSIONS: Implementation of a PSP at our institution led to rapid utilization across multiple hospitals in the military health system, a model that could easily expand to deployed settings and remote locations. Access to peer support across the military health system could both mitigate the increased risks of military clinician burnout, and improve patient safety, healthcare worker resilience, and service member readiness. PMID: 32830273 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 26, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Expeditionary Immersion Circulating Heating Device: A Promising Technique for Treating Frostbite Injuries and Warming Intravenous Fluids in a Forward Deployed Cold Weather Environment.
CONCLUSION: A heating immersion circulator device is a lightweight, flameless, and inexpensive way to consistently heat large volumes of water for treatment of cold weather injuries, hypothermia, and whole blood rewarming in a cold austere environment. PMID: 32820339 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 22, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Ruptured Abdominal Aortic Aneurysm Presenting as Septic Shock.
Authors: Davis B, Brockshus A, Merritt C, Donaldson C Abstract A patient presented to the emergency department with undifferentiated shock 4 days after discharge from a hospitalization for a lower gastrointestinal bleed. The patient fulfilled 4/4 of the Systemic Inflammatory Response Syndrome criteria and 3/3 of the quick Sequential Organ Failure Assessment criteria on presentation to the emergency department, notably, without a localized source of infection and no localizing symptoms. After admission, the patient's hemoglobin was found to have dropped more than expected after intravenous (IV) fluid administration,...
Source: Military Medicine - August 22, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

An Endovascular Surgery Experience in Far-Forward Military Healthcare-A Case Series.
CONCLUSIONS: Interventional neuroradiology can fill an important role in military far forward care as these providers can treat both traumatic and atraumatic cerebral and extracranial vascular injuries. In addition, knowledge and skill with vascular access and general interventional radiology principles can be used to aid in other lifesaving interventions. As interventional equipment becomes more available and portable, this relatively young specialty can alter the treatment for servicemen and women who are injured downrange. PMID: 32812042 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 20, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Triaged Treatment-Based Conventional Weapon Combat Wound Classification Code Design and Injury Spectrum Statistical Analysis.
CONCLUSIONS: The combat wound classification codes that were established through the HHI index and expert consultations achieved good results in terms of having higher classification speed and accuracy than traditional methods. This means they could be used to identify injuries with a high-incidence of fatality and provide guidance to improve the efficiency of treatment among all treatment echelons in the army. PMID: 32803217 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 19, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Orthopedic Surgery and Flight Surgery: Income Differences Between the Navy Health Professions Scholarship Program and Civilian Orthopedic Surgery.
CONCLUSIONS: It was found that the shorter tours in the Navy had a higher net FV than those who made the Navy a career in orthopedic surgery. Flight surgery is a rewarding operational experience with among the highest net FV among Navy scenarios and is only slightly less than the net FV of a pure civilian career. However, it can be more difficult to apply for civilian orthopedic surgery after serving a flight surgeon tour. Lastly, the net FV was very similar between a civilian orthopedic surgeon career and the shorter tours served in the Navy. Factors such as higher civilian income with associated loan repayment/signing bo...
Source: Military Medicine - August 19, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Impact of Mammography Screening Guideline Changes Among Women Serving in the U.S. Military.
CONCLUSIONS: The USPSTF guidelines had differential impacts among some subpopulations. While older women, aged 50 to 64 years, had a greater temporary reduction immediately after the guideline change, younger women aged 40 to 49 years had a longer-term reduction in screening following the guideline changes. No racial disparities in the proportion screened or in the impact of the guideline change were noted in this population with universal health coverage. The lack of Department of Defense standard breast cancer screening guidelines was evident from the different patterns of mammography utilization observed among...
Source: Military Medicine - August 19, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Descriptive and Injunctive Norms Related to E-Cigarettes.
CONCLUSIONS: Descriptive norms were more commonly mentioned than injunctive norms, which may indicate that injunctive norms are not as influential for e-cigarette use. Additionally, all estimates related to e-cigarette prevalence were higher than actual rates of use, showing an overestimation of use, which previous literature has shown increases likelihood of e-cigarette use. Future research should specifically ask about injunctive norms as well as determine if descriptive and injunctive norms influence actual e-cigarette use behaviors among military personnel. PMID: 32803243 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 19, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Bariatric Curveball: A Rare Case of Recurrent Lactobezoars after Roux-en-Y Gastric Bypass Surgery.
Authors: Kravitz SA, Song KH, Cioffi JH, Vega Colon KM, Lu MA Abstract Bariatric surgery is a major risk factor for bezoar formation secondary to decreased gastric motility, gastric acidity, and pyloric function.1 This case is about a 49-year-old female veteran, 3 weeks status-post Roux-en-Y gastric bypass surgery, who presented with acute abdominal pain and oral intolerance. After being diagnosed with a bezoar and esophagogastroduodenoscopic removal, the patient had immediate relief of symptoms. Unfortunately, over the course of 4 months, this patient experienced three recurrent episodes of bezoar formation (with ...
Source: Military Medicine - August 19, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Letter From the Executive Director Dr. John Cho.
Authors: Cho JM PMID: 32797177 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 17, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Investigation of the Sterility of Diluent in Prefilled Syringes Used for Vaccine Reconstitution at Department of Defense Recruit Training Sites.
CONCLUSIONS: Our results demonstrate that in spite of variations in current practices used in various RTS, the diluent in the prefilled syringe tested from each site maintains its sterility and was determined to be safe for use in military health system-wide vaccine reconstitution. PMID: 32789444 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 15, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Subcutaneous Perforation of Recurrent Gastric Fistula After Abdominoplasty with Scar Revision.
Authors: DeSoucy ES, Nelson VS Abstract This case represents an unusual, and previously unreported, complication of delayed leakage of gastric contents into the subcutaneous tissues 2 years after division of a gastrostomy tube tract during abdominoplasty. Our patient required urgent exploration for contamination control and closure of the fistula and recovered fully. Persistent gastrocutaneous fistula is uncommon in adults and even less common is recannulization of a fistula track after initial closure. A thorough review of operative history and comparison to previous imaging were crucial for appropriate diagnosis ...
Source: Military Medicine - August 15, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Quantification of Global Health Impact.
Authors: Hussain F, Delgado A Abstract Global Health Engagement is used as one of the instruments of power to win hearts and minds of our partner nations and allies worldwide. Global Health Engagement is dynamic process with myriads of dimensions, applications, and deliverables. Planned and executed correctly, it can yield huge dividends as per SCP and Theater Campaign Plan. PMID: 32789457 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 15, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Rheumatology Clinicians' Perceptions of Telerheumatology Within the Veterans Health Administration: A National Survey Study.
CONCLUSIONS: While the majority of rheumatology clinicians did not report past experience with telerheumatology, they agreed that it has potential to further the VA mission of improved access and quality of care. Rheumatology clinicians felt the suitability of telerheumatology is dependent on the phase of care. As remote care technologies continue to be rapidly adopted into clinic, clinician perceptions of and experiences with telemedicine will need to be addressed in order to maintain high-quality and clinician- and patient-centric care within VA rheumatology. PMID: 32789463 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 15, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Importance of Validating Sleep Behavior Models for Fatigue Management Software in Military Aviation.
CONCLUSIONS: Current Fatigue Risk Management Systems require accurate fatigue and sleep behavior modeling, which can only be achieved by studying specific target populations to determine their culture of work/rest routines, and optimizing sleep behavior model settings accordingly. PMID: 32789473 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 15, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Why Shifting Mindset Matters.
Authors: Woo JJY Abstract The transformation to health and readiness for individuals and organizations, while structured in common strategies, metrics, and process improvement frameworks, used throughout healthcare, will not be achieved or sustained without a shift in mindset. PMID: 32754729 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 13, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Workforce Planning for Embedded Mental Health Care in the U.S. Navy.
CONCLUSION: The current project represents the first systematic workforce planning initiative designed to help staff the USN's global demand for community focused MH care. The results of this project have identified areas where additional embedded mental health resources should be made available. By systematically documenting all services and capabilities and carefully examining the operational demands of each community, the current solution was able to identify precisely what type of MH resources should be allocated to a given community. PMID: 32754734 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 13, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

An analysis of radial pulse strength to recorded blood pressure in the Department of Defense Trauma Registry.
Authors: Naylor JF, Fisher AD, April MD, Schauer SG Abstract INTRODUCTION: Hemorrhage is the leading cause of potentially preventable death on the battlefield. The tactical combat casualty care guidelines recommend the use of the radial pulse strength to guide the administration of blood products or intravenous fluids when equipment for blood pressure monitoring is not available. Data supporting this measurement tool are limited. We sought to validate this method in a deployed trauma population. MATERIALS AND METHODS: This is a secondary analysis of a previously published dataset from the Department of Defense ...
Source: Military Medicine - August 13, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Combat Facial Fractures Sustained During Operation Resolute Support and Operation Freedom's Sentinel in Afghanistan.
CONCLUSIONS: Complications Rates from facial fractures were higher than that reported in civilian trauma. This likely reflects factors such as energy deposition, bacterial load, and time to treatment. Load sharing osteosynthesis should be the default modality for fracture fixation. External fixation should be considered in particular for complex high-energy or infected mandible fractures where follow-up is possible. PMID: 32754743 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 13, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Pediatric Prehospital Airway Management by U.S. Forces in Iraq and Afghanistan.
CONCLUSIONS: In this dataset, 6.8% of children underwent prehospital intubation and 0.5% underwent prehospital cricothyrotomy. Airway interventions were frequently associated with head injuries. This highlights the importance of training and equipping prehospital medical personnel for pediatric trauma care in accordance with military clinical practice guidelines. PMID: 32754753 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 13, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Diagnostic Workup of Constrictive Bronchiolitis in the Military Veteran.
Authors: Falvo MJ, Sotolongo AM, Osinubi OY, Helmer DA, Galvin JR, Franks TJ PMID: 32761145 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - August 13, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research