Intratesticular Leiomyoma: A Case Report.
We report here a case of intratesticular leiomyoma, the associated imaging, and pathologic findings. PMID: 31825085 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 13, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The USU Global Health Distance Learning Program: An International Educational Consortium for Global Health Engagement.
Authors: Boetig B, Kumpf J, Jindal RM, Lawry LL, Baines L, Cullison TR Abstract USU's Global Health Distance Learning Program has successfully enrolled over 400 students from all four services spread across six continents. British and Australian military physicians have joined as international partners, and the program now invites additional international, as well as USG interagency and war college partnerships. The program should also be employed as a tool for global health engagement itself. PMID: 31829422 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 13, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Rare Use of Posterolateral Thoracotomy in an Austere Environment.
Authors: Devasahayam RJ, Fabich RA, Tighe CA, Becker TE Abstract A 25-year-old local national male presented to a split Forward Surgical Team after impalement of the posterior chest with a metal fragment. The patient was hemodynamically normal, but no imaging was available to determine the depth of penetration or the size of the internal portion of the fragment. This case represents a rare indication for posterolateral thoracotomy in an austere trauma setting. PMID: 31819958 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 12, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Functional Movement Screen (FMS ™) Scores and Demographics of US Army Pre-Ranger Candidates.
This study was a descriptive, cross-sectional investigation examining associations between FMS scores and the various measures of health and performance of active duty soldiers in light infantry units who were involved in the U.S. Army Pre-Ranger Course (PRC). MATERIALS AND METHODS: Before the PRC, 491 male soldiers (mean age = 24.0 ± 3.8 years; mean height = 176.6 ± 7.2 cm; mean body mass = 80.2 ± 9.8 kg) completed a questionnaire which included items on self-assessed physical fitness, last Army physical fitness test (APFT)...
Source: Military Medicine - December 12, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Case of Serum Sickness-Like Reaction in an Adult Treated with Omalizumab.
We report a case of serum sickness-like reaction in a patient treated with omalizumab for chronic idiopathic urticaria/angioedema. An adult female experienced episodic urticaria/angioedema without repeatable trigger, ultimately receiving diagnosis of chronic idiopathic urticaria/angioedema. After initial treatment, attempts with escalating cetirizine and montelukast doses were unsuccessful due to sedation; she began treatment with subcutaneous omalizumab 150 mg monthly. Urticaria frequency partially improved after two injections; therefore, the dose was increased to 300 mg after four treatments. Several days afte...
Source: Military Medicine - December 12, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Cross-Border Military-Based Medical Involvement Can Reduce the Refugee Crisis: Israel's Experience.
Authors: Braverman A PMID: 31814015 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 10, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Risk of Preterm Birth and Newborn Low Birthweight in Military Women with Increased Pregnancy-Specific Anxiety.
CONCLUSIONS: Pregnancy-specific anxiety was found to significantly increase the risk of PTB and LBW in a military population. Understanding this relationship is essential in developing effective assessments and interventions. Results emphasize the importance of prenatal maternal mental health to fetal health and birth outcomes. Further research is needed to determine the specific physiological pathways that link prenatal anxiety and depression with poor birth outcomes. PMID: 31808825 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 8, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Empty Bullet-Related Ocular Injuries During Military Shooting Training: A 20-Year Review.
CONCLUSIONS: The prognosis of EBOI is unpredictable and is dependent on the severity of ocular damage. The best treatment option is prevention of EBOI with protective eyewear. PMID: 31808913 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 8, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Understanding Barriers to HPV Vaccination: Perspectives From Air Force Family Medicine Physicians and Active Duty Air Force Males.
CONCLUSION: Deficiencies in public knowledge and insufficient provider practices are likely contributing to the suboptimal rates of HPV vaccination among eligible males. Additionally, eligible males are not interested in speaking with their healthcare providers about either HPV or the HPV vaccine. If the rates of HPV vaccination within the male population are to increase, health educators, public health proponents, and vaccine advocates need to devise a more effective approach to disseminate this information to eligible male recipients. PMID: 31808930 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 8, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Diplopia and Strabismus After Corneal Refractive Surgery.
CONCLUSION: Diplopia and strabismus are rare complications after CRS in the U.S. military population. These procedures continue to increase the operational readiness of our service members with minimal risk of these potentially debilitating complications. Overall, this study provides support for the continued use of PRK and LASIK despite study limitations related to the use of large databases for retrospective review. Future prospective studies using delineated preoperative and postoperative examinations with sensorimotor testing included may be able to resolve the limitations of this study. PMID: 31808933 [PubMed - as...
Source: Military Medicine - December 8, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Case Report of Tumor Necrosis Factor Alpha Inhibitors in an Active Duty Service Member with Dissecting Cellulitis of the Scalp Resistant to Treatment.
Authors: Maxon CE, Modlin CK, Durso CTA, Miletta MNR Abstract Dissecting cellulitis of the scalp represents a disease of follicular occlusion that may be worsened by tight-fitting clothing, such as the patrol cap or advanced combat helmet used by military service members. Treatment poses a challenge to the clinician, and the treatment of choice, oral retinoids, may not improve the condition sufficiently to maintain active duty status. Early treatment augmentation with tumor necrosis factor-alpha inhibitors may improve efficacy of oral retinoids and prevent medical separation of the active duty service member. P...
Source: Military Medicine - December 8, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Use of Ultrasound-Guided Platelet-Rich Plasma Injection of the Sacroiliac Joint as a Treatment for Chronic Low Back Pain.
Authors: Broadhead DY, Douglas HE, Bezjian Wallace LM, Wallace PJ, Tamura S, Morgan KC, Hemler DE Abstract Back pain and its associated complications are of increasing importance among military members. The sacroiliac joint (SIJ) is a common source of chronic low back pain (LBP) and functional disability. Many patients suffering from chronic LBP utilize opioids to help control their symptoms. Platelet-rich plasma (PRP) has been used extensively to treat pain emanating from many different musculoskeletal origins; however, its use in the SIJ has been studied only on a limited basis. The patient in this case report pr...
Source: Military Medicine - December 8, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Hyphema in Open-Globe Versus Closed-Globe Injuries in Operation Iraqi Freedom and Enduring Freedom: 2001-2011.
Authors: Miller NR, Justin GA, Kim WI, Brooks DI, Ryan DS, Weichel ED, Colyer MH Abstract INTRODUCTION: The goal of this study is to update the incidence of hyphema in Operation Iraqi (OIF) and Enduring Freedom (OEF). We wanted to assess associated ocular injuries and final visual acuity (VA) in open-globe versus closed-globe injuries with a hyphema. MATERIALS AND METHODS: We performed a retrospective review of the Walter Reed Ocular Trauma Database (WRTOD) to identify U.S. Service members and DoD civilians with hyphema who were evacuated to Walter Reed Army Medical Center between 2001 and 2011. Primary outcome...
Source: Military Medicine - December 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Influence of Concussion Education Exposure on Concussion-Related Educational Targets and Self-Reported Concussion Disclosure among First-Year Service Academy Cadets.
CONCLUSION: These data suggest disparities in concussion education exposure that can be addressed in first-year cadets. Additionally, findings support the importance and use of multiple sources of concussion education in improving cadet's concussion-related decision-making. PMID: 31789379 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Comminuted Femur Fracture in a Free Fall Jump: A Case Report.
This report describes a 33-year-old Marine Corps Reconnaissance operator who sustained left comminuted basicervical femoral neck fracture requiring cephalomedullary nail internal fixation with a full recovery. This femoral neck fracture highlights the high-energy injuries experienced by these invaluable operators, especially when conducting combat or night jumps. PMID: 31789382 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Toward Personalized Medicine Implementation: Survey of Military Medicine Providers in the Area of Pharmacogenomics.
Authors: DeLuca J, Selig D, Poon L, Livezey J, Oliver T, Barrett J, Turner C, Hellwig L Abstract INTRODUCTION: Personalized medicine is the right treatment, to the right patient, at the right dose. Knowledge of genetic predisposition to variable metabolism and distribution of drugs within the body is currently available as pharmacogenomic testing and is one of the pillars of personalized medicine. Pharmacogenomic testing is growing. It has become part of guidelines for dosing on FDA labels and has been used by health care organizations to improve outcomes and reduce adverse events. Additionally, it has been FDA app...
Source: Military Medicine - December 3, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Antimicrobial Stewardship Challenges in the Deployed Setting.
CONCLUSIONS: Antimicrobial stewardship programs in theater are in the early stages of development in theater. Areas identified for improvement are access to expertise, development of a focus on high-impact lines of effort, laboratory support, and the culture of antimicrobial prescribing. Risks can be mitigated through theater level formalization of efforts, expert mentoring through telehealth, and a focus on implementation and adherence and feedback to national guidelines. PMID: 31786601 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - December 3, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Subdural Empyema in an Immunocompetent Active Duty Soldier: A Case Report.
Authors: Bridwell RE, Larson NP, Yoo MJ, Oliver JJ Abstract Intracranial subdural empyema is a rare clinical entity with incidence estimates of 0.1 per 100,000 people. The condition is most often the sequela of a primary infection elsewhere and carries a high morbidity and mortality. The authors present the case of a 22-year-old active duty soldier on mission on the southern border of the United States. The patient had been complaining of headaches that became progressively worse over 2 weeks and presented to a civilian hospital where he was diagnosed with intracranial abscess versus sinus thrombosis on radiographi...
Source: Military Medicine - December 3, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Opportunities and Obstacles in the Prevention of Skin and Soft-Tissue Infections Among Military Personnel.
CONCLUSIONS: In the military, a disproportionate burden of SSTIs is borne by the recruit population. Strategies relying upon routine application of agents for S. aureus decolonization have not been effective in preventing SSTIs. A novel S. aureus vaccine candidate is being currently evaluated in a military training population and may represent a new opportunity to prevent SSTIs for the military. PMID: 31778193 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Acute Respiratory Infection Consortium: A Multi-Site, Multi-Disciplinary Clinical Research Network in the Department of Defense.
CONCLUSIONS: The ARI burden in the armed services remains significant every year and the threat is dynamic given emergent and evolving threats, such as influenzas. With strong successes to date, future initiatives of the ARI Research Area will focus on interventional studies, ARI transmission dynamics in congregate military settings, and determinants of risk of pandemic influenza and other emergent respiratory viruses. PMID: 31778194 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Infectious Disease Clinical Research Program: Building the Bench.
Authors: Coles C, Ottolini MG Abstract The role of physicians in the U.S. Armed Forces is diverse, encompassing a wide array of skills and responsibilities to provide superior healthcare to their patients and to advance military medicine. In addition to healthcare delivery and medical education, military physicians are engaged in public health, operational medicine, and cutting-edge medical research. Thus, clinical research is a crucial component of Graduate Medical Education (GME) and supports critical thinking (knowledge, skills, and abilities) and the development of leadership skills among U.S. military physicia...
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Deployment Infectious Disease Threats: IDCRP Initiatives and Vision Forward.
CONCLUSIONS: The research area has proven its ability to conduct impactful research, including the development of field-expedient diagnostics, the largest DoD multi-site travelers' diarrhea randomized control trial in peacetime and combat settings, and informed Force Health Protection guidance. The research area continues to provide surveillance data to military commands via an established collaborative network of military treatment facilities, DoD laboratories (both within and outside the continental United States), foreign militaries, and academia. The conduct of clinical and translational research in a deployment settin...
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Infectious Disease Clinical Research Program: Overview.
Authors: Burgess TH, Tribble D PMID: 31778197 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Biomedical Response to Neisseria gonorrhoeae and Other Sexually Transmitted Infections in the US Military.
CONCLUSION: Continued monitoring of circulating resistance patterns on a global scale is critical for ensuring appropriate treatments are prescribed for service members that may be infected in the U.S. or while deployed. Domestic surveillance for gonococcal AMR within the Military Health System has indicated that resistance patterns, while variable, are not dramatically different from what is seen in U.S. civilian data. Global patterns of gonococcal AMR have been described through the establishment of a central DoD gonococcal reference laboratory and repository. This repository of global isolates provides a platform for fu...
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

After the Battlefield: Infectious Complications among Wounded Warriors in the Trauma Infectious Disease Outcomes Study.
CONCLUSIONS: The TIDOS project has focused research on four initiatives: (1) blast-related wound infection epidemiology and clinical management; (2) DoD-VA outcomes research; (3) Multidrug- Resistant and other Virulent Organisms Trauma Infections Initiative; and (4) Joint Trauma System clinical practice guidelines and antibiotic stewardship. There is a continuing need for longitudinal data platforms to support battlefield wound research and clinical practice guideline recommendation refinement, particularly to improve care for future conflicts. As such, maintaining a research platform, such as TIDOS, would negate the lengt...
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Infectious Disease Clinical Research Program: Future Direction.
Authors: Burgess TH, Tribble D PMID: 31778200 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The US Military HIV Natural History Study: Informing Military HIV Care and Policy for Over 30 Years.
CONCLUSIONS: The US Military HIV NHS has been critical to understanding the impact of HIV infection among active-duty service members and military beneficiaries, as well as producing insights that are broadly relevant. In addition, the rich repository of NHS data and specimens serves as a resource to investigators in the DoD, NIH, and academic community, markedly increasing scientific yield and identifying novel associations. Looking forward, the NHS remains relevant to understanding host factor correlates of virologic and immunologic control, biologic pathways of HIV pathogenesis, causes and consequences of residual infla...
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Orthopedic Surgeon Decision-Making Processes for Postsurgical Opioid Prescribing.
CONCLUSION: The results of this quality improvement project identified several target areas for future initiatives focused on improving opioid prescribing practices. This included a provider training program, improved patient education system, increased awareness and use of opioid tracking databases, and development of a standardized (but adaptable per patient characteristics and history) recommended dose for common orthopedic surgeries. Future projects will target tailored development, implementation, and evaluation of such efforts. PMID: 31781751 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Silver Lining: Advances in the Surgical Management of Brain Trauma Attributable to War.
Authors: Janatpour ZC, Welch MC, Shanmuga S, Curry BP, Coughlin DJ, Sabersky AE, Bell RS, Gilhooly JE Abstract Within the text we elaborate on the relationship between war and medicine, particularly as it pertains to neurosurgery and the management of brain trauma, and emphasize neurosurgical advancements in the treatment of brain trauma gleaned from U.S.-involved conflicts of the 21st century. PMID: 31781754 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Managing Complex Peripheral Nerve Injuries Within the Military Health System: A Multidisciplinary Approach to Treatment, Education, and Research at Walter Reed National Military Medical Center.
CONCLUSIONS: The WRNMMC PNP facilitates comprehensive, patient-centered care for PNI patients within the MHS. Moreover, the program helps to prepare the next generation of providers for evaluating and treating PNI patients through its involvement with graduate medical education training. It also conducts critical peripheral nerve research and lays the foundation for collaborations with other institutions involved with peripheral nerve research. In the years ahead, the WRNMMC PNP aims to expand its outreach and capabilities within the MHS through more expansive use of telemedicine consultation and the establishment of satel...
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Effect of Repeated Shoulder Motion on Scapular Dyskinesis in Army ROTC Cadets.
CONCLUSIONS: Repeated shoulder motion increased the frequency of scapular dyskinesis in army ROTC cadets. The cadets that developed scapular dyskinesis also reported greater disability and lower function of the upper extremity. The results provide a link between scapular dyskinesis, upper extremity function, and the strength of the scapular stabilizing muscles. Improving the strength of the scapular stabilizing musculature might reduce the effects of repeated arm motions. PMID: 31783408 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 30, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Development of the U.S. Army's Suicide Prevention Leadership Tool: The Behavioral Health Readiness and Suicide Risk Reduction Review (R4).
CONCLUSIONS: The R4 development process entailed the simultaneous integration of leadership feedback with evidence-based predictors of suicide risk and design considerations. Thus, the development of these tools builds upon previous Army leadership tools by specifically tailoring elements of those tools to accommodate leader preferences, accounting for potential implementation barriers (eg, institutional factors), and empirically evaluating the implementation of those tools. Future studies should consider utilizing a similar process to develop empirically based resources that are more likely to be incorporated into the rou...
Source: Military Medicine - November 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Viability of tDCS in Military Environments for Performance Enhancement: A Systematic Review.
CONCLUSIONS: The conclusions to be drawn from this systematic literature review include the identification of a brain region for targeting with stimulation to enhance a broad range of cognitive constructs applicable to military tasks, as well as stimulation parameters for duration and intensity. The dorsolateral prefrontal cortex was most frequently targeted in the studies that found enhanced performance across several cognitive constructs. Stimulation intensities of 2 mA and durations of 20 minutes or longer appeared frequently as well. Although several parameters were identified, further work is required before this...
Source: Military Medicine - November 19, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Does Validity Measure Response Affect CPT Group Outcomes in Veterans with PTSD?
CONCLUSION: These results suggest that Veterans with PTSD whose validity testing scores are indicative of poor effort and symptom exaggeration may be less resilient but may still complete a CPT group treatment and benefit from treatment at a rate comparable to Veterans who evidence good assessment effort and genuine symptom reporting pre-treatment. These findings also challenge the assumption that pre-treatment assessment effort failure and symptom exaggeration accurately predict poor effort in trauma-focused psychotherapy. PMID: 31735961 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 19, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Accelerated Resolution Therapy-Based Intervention in the Treatment of Acute Stress Reactions During Deployed Military Operations.
CONCLUSION: Based on these encouraging preliminary findings, the authors recommend that behavioral health providers who are preparing to deploy become familiar with ART or related interventions in order to develop the confidence and the skills that are needed to provide timely and effective trauma-focused care for deployed soldiers. PMID: 31735965 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 19, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Weight Loss Intervention Impact on the Physical Fitness Test Scores of Air Force Service Members.
CONCLUSIONS: Behavioral weight management interventions that achieve 5% weight loss may help improve military fitness test ratings. PMID: 31735969 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 19, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Efficacy of a Temporary Hemostatic Device in a Swine Model of Closed, Lethal Liver Injury.
CONCLUSIONS: The device, which combined 20 g of CELOX particles and 20 pieces of CELOX (8 g) sponge tablets with 50-mmHg intra-abdominal compression for 10 minutes, prolonged the ST by an average of 30 minutes with less BL. It was not markedly different from the full four quadrants gauze packing of liver in hemostatic effect, with no CELOX clot formation in other organs. PMID: 31711174 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 13, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Response to Preserving the Military Medicine Workforce: One Team, One Fight.
Authors: Wiesen CAR, Marcum CRE, Soltis CMA, Peterson CKA PMID: 31711191 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 13, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Health Care Utilization Among Homeless Veterans in Chicago.
CONCLUSIONS: Veterans eligible for VA servicers who are homeless, or at risk of becoming homeless, frequently sought care in the community for a variety of chronic health conditions. Health information exchanges and partner-based registries may represent an important tool for identifying vulnerable Veteran populations while reducing duplication of care. PMID: 31714995 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 13, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Occult HBV Infection: A Case Series at a Military Treatment Facility.
Authors: Pak K, Ordway S, Torres D Abstract Occult HBV infection (OBI) is defined as the presence of detectable hepatitis B virus (HBV) DNA in HBV surface antigen (HBsAg) negative individuals. Rarely, OBI is attributed to mutant HBV that cannot be detected by commercial assays, but most cases occur in the setting of chronic hepatitis B, particularly infection with wild-type viruses associated with strong HBV suppression. OBI is a high-risk diagnosis as it is associated with multiple complications: HBV reactivation in immunocompromised states, transmission of HBV, progression of liver disease, and hepatocellular car...
Source: Military Medicine - November 6, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Status Update on Infection Prevention and Control at Deployed Medical Treatment Facilities.
CONCLUSIONS: Despite successes, ongoing challenges with optimal deployed IPC were noted. Recommendations for improvement include strengthening IPC culture, accountability, predeployment training, and stateside support for deployed IPC assets. Variability in IPC practices may occur from rotation to rotation, and regular reassessment is required to ensure that successes are sustained through times of turnover. PMID: 31681959 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 6, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Acute and Chronic Carbon Monoxide Toxicity from Tobacco Smoking.
CONCLUSIONS: Many active duty military and military veterans are tobacco smokers and these patients and their health care providers should be aware of the adverse effects of CO toxicity from tobacco smoking. Patients may have symptoms such as headaches, syncope, and ataxia in the setting of acute CO toxicity; however, the chronic effects of CO may not be completely understood. Future work could explore chronic CO toxicity and its effects on strength and exercise tolerance in military personnel and provide education to service members, veterans, and health care providers. PMID: 31670370 [PubMed - as supplied by publishe...
Source: Military Medicine - November 2, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Neuropsychiatric Implications of Chronic Lead Exposure.
This report describes the case of a 42-year-old active duty officer with a history of anxiety, cognitive impairment, and paroxysmal hypertensive episodes associated with elevated body burdens of lead as measured in bone, while having low or unremarkable blood level measurements. Challenges related to work-up, treatments, and outcomes are discussed. An elevated body burden of lead may contribute to increased irritability, fatigue, and anxiety, mimicking posttraumatic stress disorder and other primary psychiatric conditions. This presentation highlights the need for an increased index of suspicion of lead poisoning in both m...
Source: Military Medicine - November 2, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Military Surgical Team Communication: Implications for Safety.
Authors: Stucky LCH, De Jong CMJ, Kabo FW Abstract INTRODUCTION: Medical error is the third leading cause of death in the United States, contributing to suboptimal care, serious patient injury, and mortality among beneficiaries in the Military Health System. Recent media reports have scrutinized the safety and quality of military healthcare, including surgical complications, infection rates, clinician competence, and a reluctance of leaders to investigate operational processes. Military leaders have aggressively committed to a continuous cycle of process improvement and a culture of safety with the goal to transfor...
Source: Military Medicine - November 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Strategy That May Be Tried in Military Regime-Leprosy.
Authors: Thangaraju P, Venkatesan AS PMID: 31665397 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Aortic Mycetoma From Disseminated Cunninghamella Species Infection.
We present a case of disseminated Cunninghamella sp. infection after stem cell transplant for refractory multiple myeloma with formation of bilateral pleural effusions and an aortic mycetoma. PCR analysis of the patient's aortic mycetoma demonstrated a 90% match to Cunninghamella spp. This case illustrates the potential for severe opportunistic fungal infections in immunocompromised patients that can mimic other disease processes and result in an accelerated demise. PMID: 31665398 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Anemia Screening in Naval Aviation: Is Hemoglobin a Better Indicator Than Hematocrit as the Primary Index?
Authors: Nguyen WB, Wyse JM, Drollinger SM, Cheng K Abstract INTRODUCTION: Because of the rigorous mental and physical health requirements for Naval Aviation, all applicants and designated personnel must meet physical standards, including initial and periodic screening for anemia. Most standards, including for accession to the U.S. Navy, use hemoglobin as the standard marker to screen for anemia. Moreover, previous literature generally supports the assertion that hemoglobin is more reliable and accurate than hematocrit. However, the U.S. Navy Aeromedical Reference and Waiver Guide uses a hematocrit standard for ane...
Source: Military Medicine - November 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evaluation of Systematic Blood Testing at the Time of Recruitment to the Armed Forces: Retrospective Monocentric Study Among 726 French Army Soldiers.
CONCLUSION: CBCs gave useful information but iron deficiency was common and insufficiently detected by this single analysis. Assessing aminotransferase levels without screening for viral hepatitis and systematic measurement of fasting plasma glucose levels did not appear to be efficient. In addition, the only interest in systematic measurement of creatinine serum levels was to obtain a reference level for long-term follow-up. In addition to the urinary dipstick, the systematic biological checkup at recruitment could be limited to a CBC with measurement of plasma ferritin levels and Hepatitis B virus serology, providing tha...
Source: Military Medicine - November 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Corrigendum to: Population Smoking Characteristics and Cessation Behaviors in a Nationally Representative Cohort of Hispanic Veterans and Hispanic Non-Veterans.
Authors: Hammett PJ, Nelson D, Burgess DJ, Fu SS, Pinsker EA PMID: 31665405 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Management of Melanoma Patients by Non-Dermatologists in the Military Health System: A Retrospective Observational Study.
CONCLUSION: Our study demonstrated that a number of different specialties outside of dermatology are involved in performing biopsies on patients in which melanoma is a concern. Although the results show that the majority of patients biopsied by non-dermatologists received appropriate follow-up care, there is still room to improve to ensure that all melanoma patients receive referrals to and are seen by dermatologists after a diagnosis of melanoma. PMID: 31665406 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - November 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research