A Prospective Cohort Study of Vitamin D Supplementation in AD Soldiers: Preliminary Findings.
Authors: McCarthy MS, Elshaw EB, Szekely BM, Raju D Abstract PURPOSE: To explore response to vitamin D supplementation in active duty (AD) warfighters and translate findings into evidence-based health policy. BACKGROUND: Soldiers are at risk for musculoskeletal injuries and metabolic dysfunction that impact physical performance and military readiness; the link with low vitamin D status is unclear. METHODS: This prospective trial enrolled 152 soldiers; baseline 25 hydroxyvitamin (OH) D level determined assignment to a no-treatment control (CG) or treatment group (TG) receiving a vitamin D3 supplement for 90 ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Combat-Related Extremity Wounds: Injury Factors Predicting Early Onset Infections.
We examined risk factors for combat-related extremity wound infections (CEWI) among U.S. military patients injured in Iraq and Afghanistan (2009-2012). Patients with ≥1 combat-related, open extremity wound admitted to a participating U.S. hospital (≤7 days postinjury) were retrospectively assessed. The population was classified based upon most severe injury (amputation, open fracture without amputation, or open soft-tissue injury defined as non-fracture/non-amputation wounds). Among 1271 eligible patients, 395 (31%) patients had ≥1 amputation, 457 (36%) had open fractures, and 419 (33%) had open soft-tissue wounds...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

I'm Wearing My Hearing Protection - Am I Still At Risk for Hearing Loss? Lurking Ototoxins in the Military Environment.
CONCLUSIONS: While evidence in humans is limited, potentially ototoxic substances are worthy of improved surveillance and further research to understand their ototoxic mechanisms, effects, and possible mitigation strategies. A triad approach of monitoring, protecting, and educating is recommended for effective prevention of hearing loss: the Department of Defense Hearing Center of Excellence's Comprehensive Hearing Health Program model employs such an approach. PMID: 30901442 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Relationships and Evidence-Based Theoretical Perspectives on Persisting Symptoms and Functional Impairment Among Mild Traumatic Brain Injury and Behavioral Health Conditions.
Authors: Herrold AA, Smith B, Aaronson AL, Coleman J, Pape TL Abstract The purpose of this study is to characterize and describe the relationships between symptoms and functional impairment following mild traumatic brain injury (mTBI) and behavioral health conditions (BHCs) in order to inform evidence-based theories on why symptoms and functional impairments persist in some individuals but not others. This is a retrospective, multi-site, cross-sectional study utilizing data collected from a total of 289 Operation Iraqi Freedom/Operation Enduring Freedom Veterans who were classified into diagnostic groups using the ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Issue Overview.
Authors: Reilly PA, Hendrickson Mat TL PMID: 30901444 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Perceptions of High-Risk Situations for Sexual Assault: Gender Differences in the U.S. Air Force.
This study explored U.S. Air Force service members' perceptions of high-risk situations for sexual assault victimization. Qualitative data were collected from 52 active duty Airmen, including sexual assault survivors and general population officers and enlisted personnel. Participants were recruited through posted flyers, base-wide e-mail messages, and referrals from the Sexual Assault Response Coordinator's office. Content analysis was used to summarize participants' opinions and experiences. High-risk situations for all Airmen included excessive alcohol use, specific physical settings, and situations associated with work...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Mechanical and Finite Element Analysis of an Innovative Orthopedic Implant Designed to Increase the Weight Carrying Ability of the Femur and Reduce Frictional Forces on an Amputee's Stump.
This study was designed to test the hypothesis that: "A properly designed implant that harnesses the principle of the incompressibility of fluids can improve the weight carrying ability of an amputee's residual femur and reduce the frictional forces at the stump external socket interface." The hypothesis was tested both mechanically on an Amputee Simulation Device (ASD) and through Finite Element Analysis (FEA) modeling software. With the implant attached to the femur, the FEA and ASD demonstrated that the femur carried 90% and 93% respectively of the force of walking. Without the implant, the FEA model and ASD f...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evaluation of Three Postal Invitational Strategies to Increase Survey Response Rates in a Combat-Injured U.S. Military Population: Findings From the Wounded Warrior Recovery Project.
Authors: Sack DI, Woodruff SI, McCabe CT, Galarneau MR, Han PP Abstract The survival rate of those injured in combat in overseas contingency operations is higher than in previous conflicts. There is a need to assess the long-term psychosocial and quality of life outcomes of those injured in combat, yet surveying this population presents inherent challenges. As part of a large-scale, longitudinal examination of patient-reported outcomes of service members injured on deployment, the present manuscript evaluated the effectiveness of three postal strategies on response rates: (1) mailing a study prenotification postcar...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

An Exploratory Pilot Study to Describe Shared Decision-Making for PTSD Treatment Planning: The Provider Perspective.
CONCLUSION: These results offer a preliminary understanding of VA MH providers' facilitation of SDM for PTSD care. Findings may provide insights for MH providers who wish to engage patients with PTSD in SDM. PMID: 30901448 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Pilot Study of a Novel Swine Model for Controlling Junctional Hemorrhage Using the iTClamp in Conjunction With Hemostatic Agents.
Authors: Stuart SM, Zarow G, Walchak A, McLean J, Roszko P Abstract Exsanguinating hemorrhage is a primary cause of battlefield death. The iTClamp is a relatively new device (FDA approval in 2013) that takes a different approach to hemorrhage control by applying mechanism wound closure. However, no previous studies have explored the feasibility of utilizing the iTClamp in conjunction with hemostatic packing. To fill this important gap in the literature, a novel swine model was developed, and a total of 12 trials were performed using QuikClot Combat Gauze or XSTAT sponges in conjunction with the iTClamp to treat art...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Development of a Methodology for Simulating Complex Head Impacts With the Advanced Combat Helmet.
Authors: Begonia M, Rooks T, Pintar FA, Yoganandan N Abstract Blunt impact assessment of the Advanced Combat Helmet (ACH) is currently based on the linear head response. The current study presents a methodology for testing the ACH under complex loading that generates linear and rotational head motion. Experiments were performed on a guided, free-fall drop tower using an instrumented National Operating Committee for Standards on Athletic Equipment (NOCSAE) head attached to a Hybrid III (HIII) or EuroSID-2 (ES-2) dummy neck and carriage. Rear and lateral impacts occurred at 3.0 m/s with peak linear accelerations (PLA...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Novel Gradient Echo Plural Contrast Imaging Method Detects Brain Tissue Abnormalities in Patients With TBI Without Evident Anatomical Changes on Clinical MRI: A Pilot Study.
CONCLUSIONS: Our data suggest that GEPCI quantitative R2t* metric has potential to detect abnormalities in GM cellular integrity in individual TBI patients, including abnormalities that are not detectable by a standard clinical MRI. PMID: 30901451 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

More Than Just Counting Deaths: The Evolution of Suicide Surveillance in the Canadian Armed Forces.
Authors: Rolland-Harris E Abstract Suicide prevention and surveillance are of primary concern to the Canadian Armed Forces (CAF) and to the CAF Health Services (CFHS). Suicide surveillance has been conducted on behalf of the CFHS by the Directorate of Force Health Protection for nearly 30 years. Over time, multiple changes have occurred within CAF: changes in its military role (from a primarily peacekeeping role to one also involving active combat), changes in operational tempo, temporal changes in at-risk subpopulations, as well as increased awareness and concern with suicide and suicide prevention. This has resul...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Accelerating Psychological Health Research Findings into Clinical Practice Through the Practice-Based Implementation Network Model.
Authors: Creason AH, Ruscio AC, Tate KE, McGraw KL Abstract The benefits of new clinical research developments often take years to reach patients. As such, the Departments of Defense (DoD) and Veterans Affairs built the Practice-Based Implementation (PBI) Network as an infrastructure to facilitate more rapid translation of psychological health (PH) research into clinical practice changes to improve the quality of care for military and Veteran patients. To regularly identify research findings appropriate for enterprise implementation, the DoD PBI Network developed a model aligned with the Consolidated Framework for ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Human Papillomavirus Vaccination Rates of Military and Civilian Male Respondents to the Behavioral Risk Factors Surveillance System Between 2013 and 2015.
Authors: Collins MK, Tarney C, Craig ER, Beltran T, Han J Abstract OBJECTIVE: To evaluate human papillomavirus (HPV) vaccination rates among men in the USA and to compare vaccination rates among men who had served in the military to those reporting no previous military service. METHODS: We performed a cross-sectional analysis using Behavioral Risk Factor Surveillance System (BRFSS) data from the 2013 to 2015 to analyze HPV vaccination rates for vaccine eligible adult men. The BRFSS is a multistage, cross-sectional telephone survey conducted nationally by state health departments. Univariable and logistic regres...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Low-Level Primary Blast Induces Neuroinflammation and Neurodegeneration in Rats.
CONCLUSIONS: This study reveals a role of neuroinflammation in neurodegeneration after mild blast traumatic brain injury. Therapies that target this process might in warfighters might function either by attenuating the development of post-traumatic stress disorder, chronic traumatic encephalopathy and Alzheimer's disease, or by slowing their progression. PMID: 30901455 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Reusable Perfused Human Cadaver Model for Surgical Training: An Initial Proof of Concept Study.
CONCLUSIONS: Explanted vessels of soft-embalmed cadavers show adequate durability over time with realistic vascular surgery handling characteristics. This shows promise as initial proof of concept for a reusable perfused cadaver model. Further study with serial regional and whole-body perfusion is warranted. PMID: 30901456 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Sweating the Little Things: Tourniquet Application Efficacy in Two Models of Pediatric Limb Circumference.
DISCUSSION: The current study suggests that commercial windlass TQs can be applied to upper and lower extremities of children aged 5 years and older at the 50%th percentile for limb circumference. In younger children, windlass TQ efficacy is variable. Further study is required to better understand the limitations of TQs in the youngest children, and to determine actual hemorrhage control efficacy. PMID: 30901457 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Joint Pathology Center/Vision Center of Excellence Approach to Analyzing Intra-Ocular "Foreign Bodies".
CONCLUSION: The JPC/VCE approach to analyzing IOFBs promotes uniform handling and shipping of specimens to minimize contamination. The analytical approach allows for the characterization of IOFBs with a wide variety of compositions. The results support clinical management decisions aimed at optimal treatment for the preservation of patients' visual acuity. PMID: 30901458 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Implementing the Knowledge Assessment of CPT Critical Skills (KACCS) Scale.
Authors: Atuel HR, Ursich L, Schuyler A, Berg D, Kintzle S, Castro C Abstract Cognitive processing therapy (CPT) has been endorsed as an evidence-based therapy for PTSD. It is currently being implemented within the Veterans Health Administration (VA) as a manualized, trauma-focused psychotherapy in line with recommendations from the most recent VA/DOD Clinical Practice Guideline for the management of PTSD. While research on CPT implementation has focused on individual factors that facilitate or hinder adoption, little is known on whether trainees retain core concepts of CPT. The present research addresses this gap ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Comparative in vivo Study of Semi-constrained and Unconstrained Cervical Artificial Disc Prostheses.
CONCLUSIONS: Unconstrained multi-piece artificial cervical discs may be prone to anterior migration and extrusion out of the disc space. This outcome deserves attention in individuals with a hypermobile neck and/or an occupation involving the use of a head-supported mass, such as helmets. PMID: 30901460 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Enhanced Survival in Mice Exposed to Ionizing Radiation by Combination of Gamma-Tocotrienol and Simvastatin.
Authors: Pathak R, Kumar VP, Hauer-Jensen M, Ghosh SP Abstract Ionizing radiation exposure is a major concern for active military service members, as well as civilian population. Considering that the exposure is not predictable, it is imperative that strategies to counteract radiation damage must be discovered. Recent in vitro studies performed in our laboratory demonstrated that the vitamin E analog gamma-tocotrienol (GT3) in combination with cholesterol-lowering drugs (Statins), synergistically induced endothelial thrombomodulin, an anticoagulant with radio-protective efficacy. It was hypothesized that the combin...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Forward.
Authors: Rauch TM PMID: 30901462 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Applications of Future Technologies to Detect Skill Decay and Improve Procedural Performance.
Authors: Linde AS, Miller GT Abstract Medical simulation training has progressed in its use of incorporating various technologies to provide quality training interfaces from novices to experts. The purpose of this paper is to explore modeling, simulation and visualization training technology interfaces to improve precision learning, rigorous, objective assessment, and performance improvement feedback for clinical procedural skill training and sustainment. Technologies to include augmented reality (AR), haptic technology and computer vision will be defined and clarified. It is believed that by exploring the combinat...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Identifying Predictors of Pressurized Submarine Escape Training (PSET) Attrition.
Authors: Hughes LM, Clarke J Abstract Pressurized Submarine Escape Training (PSET) physically prepares submariners to safely escape a submarine at depth. Failure to complete PSET is not a submarine service disqualification. Serious medical incidents are rare, but the safety record tradeoff has been low throughput. From 2009 to 2015, only 34% of students screened completed PSET. Students may be medically screened out of the training altogether (disqualified), or dropout during the physical training (attrite). Training records from 12,122 U.S. Navy students were used to identify factors contributing to training disqu...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Is Vitamin D Level at Melanoma Diagnosis Associated With Stage Of Tumor? An Observational Study of Melanoma Patients Living in a High Ultraviolet Radiation Environment.
CONCLUSIONS: When complete, this study will give insights into the association between vitamin D at diagnosis and melanoma tumor characteristics whilst adjusting for recent sun exposure and sun protection use. This study may impact military sun exposure and nutrition policies as vitamin D may play a role in melanomagenesis. PMID: 30901465 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Military Case Review Method to Determine and Record the Mechanism of Injury (BioTab) from In-Theater Attacks.
Authors: Danelson KA, Frounfelker P, Pizzolato-Heine K, Valentine R, Watkins LC, Tegtmeyer M, Bolte JH, Hardy WN, Loftis KL Abstract A recent study of all mounted vehicle underbody blast attacks found that 21% of Abbreviated Injury Scale Severity 2+ injuries in the Joint Trauma Analysis and Prevention of Injury in Combat network were injuries to the leg and ankle. To develop effective countermeasure systems for these attacks, the epidemiology and mechanisms of injury from this loading environment need to be quantified. The goal of this study was to develop a military correlate of an existing civilian case review fr...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Quantification of Mild Traumatic Brain Injury via Cortical Metrics: Analytical Methods.
In this study, such cortical metrics were obtained from 52 college students before and after they experienced sports-related concussions by delivering vibrotactile stimuli to the index and middle fingertips. Performance on four of the sensory test protocols is described: reaction time, amplitude discrimination, temporal order judgment, and duration discrimination. The collected test performance data were analyzed using methods of uni- and multivariate statistics, receiver operated characteristic (ROC) curves, and discriminant analysis. While individual cortical metrics vary extensively in their ability to discriminate betw...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Autoimmunity-Associated Gut Commensals Modulate Gut Permeability and Immunity in Humanized Mice.
CONCLUSIONS: Our studies suggest that gut commensals influence immune response in and away from the gut by changing the gut permeability and immunity. Dysbiosis helps the growth of RA-associated bacteria and reduces the beneficial bacteria. PMID: 30901468 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Mass Properties Comparison of Dismounted and Ground-Mounted Head-Supported Mass Configurations to Existing Performance and Acute Injury Risk Guidelines.
Authors: Estep PN, Bonts EG, Shivers BL, Wurzbach JM, Novotny BL, Rybarczyk K, Chancey VC Abstract In order to limit the aviator's exposure to potentially unsafe helmet configurations, the U.S. Army Aeromedical Research Laboratory (USAARL) developed the USAARL Head-supported mass (HSM) Performance Curve and Acute Injury Risk Curve as guidelines for Army aviation HSM. These Curves remain the only established guidelines for Army HSM, but have limited applicability outside of the aviation environment. Helmet developers and program managers have requested guidelines be developed for the dismounted, ground-mounted, and ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Characterization of Protection Mechanisms to Blast Overpressure for Personal Hearing Protection Devices - Biomechanical Measurement and Computational Modeling.
Authors: Gan RZ, Leckness K, Smith K, Ji XD Abstract Hearing damage induced by blast exposure is a common injury in military personnel involved in most operation activities. Personal hearing protection devices such as earplugs come as a standard issue for Service members; however, it is not clear how to accurately evaluate the protection mechanisms of different hearing protection devices for blast overpressures (BOP). This paper reports a recent study on characterization of earplugs' protective function to BOP using human cadaver ears and 3D finite element (FE) model of the human ear. The cadaver ear mounted with p...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Impact of Multi-Disciplinary Care and Clinical Coach Coordinators on Participant Satisfaction and Retention in TBI Clinical Trials: A TEAM-TBI Study.
CONCLUSIONS: The multi-disciplinary care approach and individualized treatment plans of the TEAM-TBI study yielded high participant retention and satisfaction scores. The Clinical Coach component of the trial was one of the highest rated aspects of the program and was associated with participant motivation and high retention rates. PMID: 30901471 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Predictive Power of Head Impact Intensity Measures for Recognition Memory Performance.
Authors: Leeds DD, D'Lauro C, Johnson BR Abstract Subconcussive head injuries are connected to both short-term cognitive changes and long-term neurodegeneration. Further study is required to understand what types of subconcussive impacts might prove detrimental to cognition. We studied cadets at the US Air Force Academy engaged in boxing and physical development, measuring head impact motions during exercise with accelerometers. These head impact measures were compared with post-exercise memory performance. Investigators explored multiple techniques for characterizing the magnitude of head impacts. Boxers received ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Percutaneous Peripheral Nerve Stimulation for Pain Reduction and Improvements in Functional Outcomes in Chronic Low Back Pain.
Authors: Cohen S, Gilmore C, Kapural L, Hanling S, Plunkett A, McGee M, Boggs J Abstract Chronic low back pain represents one of the most common sources of disability and a significant healthcare burden for the U.S. military. Present treatments for chronic back pain are often ineffective, poorly tolerated, invasive, destructive, and/or associated with complications and lead to the progression to invasive surgical procedures. There have been multiple calls for the development of a minimally invasive system that is effective without the risks or complications of existing surgical therapies, which could prevent the ne...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Early Complement and Fibrinolytic Activation in a Rat Model of Blast-Induced Multi-Organ Damage.
CONCLUSION: Our data reveal that blast injury triggers the complement and fibrinolytic systems, which likely contribute to blast-induced MOF. Conceivably, therapies that target these systems early may improve clinical outcomes in blast patients. PMID: 30901474 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Serum Biomarkers for Racial Disparities in Breast Cancer Progression.
In this study, we attempted to identify the race-specific non-invasive protein biomarkers that may particularly benefit interventions aimed at reducing the risk of recurrence and metastasis in breast cancers (BrCa). Our technical strategy has been to discover candidate protein biomarkers in patient sera using a high throughput antibody microarray platform. A total of 240 subjects were selected, composed of controls and all immunohistochemistry-based subtypes of breast cancer cases, subdivided by pre- and post-menopausal status and by race. A global Wilcoxon analysis comparing no-cancer controls and cancer patients identifi...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

On the Development of Interspecies Traumatic Brain Injury Correspondence Rules.
Authors: Saunders R, Tan XG, Bagchi A Abstract Traumatic brain injury analysis in human is exceedingly difficult due to the methods in which data can be collected, thus many researchers commonly implement animal surrogates. However, use of these surrogates is costly and restricted by ethical concerns and test logistics. Computational models and simulations do not have these constraints and can produce significant amounts of data in relatively short periods. This paper shows the development of a human head and neck model and a full body porcine model. Both models are developed from high-resolution CT and MRI scans a...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prehospital Use of Ketamine: Effectiveness in Critically Ill and Injured Patients.
CONCLUSION: Prehospital ketamine use is effective alone or in conjunction with other medications for analgesia, sedation, and procedural use in trauma and critically ill patients with minimal hemodynamic and respiratory consequences. PMID: 30901477 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Retrospective, Epidemiological Review of Hemiplegic Migraines in a Military Population.
Authors: Moore BA, Hale WJ, Nabity PS, Koehn TR, McGeary D, Peterson AL Abstract INTRODUCTION: Headaches are one of the world's most common disabling conditions. They are also both highly prevalent and debilitating among military personnel and can have a significant impact on fitness for duty. Hemiplegic migraines are an uncommon, yet severely incapacitating, subtype of migraine with aura for which there has been a significant increase amongst US military personnel over the past decade. To date, there has not been a scientific report on hemiplegic migraine in United States military personnel. MATERIALS AND METH...
Source: Military Medicine - March 17, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Successful Surgical Treatment of Severe Perforating Diametric Craniocerebral Gunshot Wound Sustained during Combat: A Case Report.
This report details our unusual case of successful treatment of a perforating diametric craniocerebral gunshot wound. PMID: 30877796 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 17, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Cost of Military Eye Injury and Vision Impairment Related to Traumatic Brain Injury: 2001-2017: Corrigendum.
Authors: PMID: 30877798 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 17, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Perceived Knowledge, Skills, and Preparedness for Disaster Management Among Military Health Care Personnel.
CONCLUSIONS: Disaster preparedness among military healthcare personnel could be improved to function optimally for future global health engagement missions. This study expands current understandings of disaster preparedness among US military health care providers and identifies ways to improve and enhance training. PMID: 30877799 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 17, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Comparison of National and Local Approaches to Detecting Suicides in Healthcare Settings.
CONCLUSIONS: Combining national and local approaches to detect suicide may help to improve the classification of suicide deaths in the healthcare setting. PMID: 30877803 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 17, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Extended Ketogenic Diet and Physical Training Intervention in Military Personnel.
CONCLUSIONS: US military personnel demonstrated high adherence to a KD and showed remarkable weight loss and improvements in body composition, including loss of visceral fat, without compromising physical performance adaptations to exercise training. Implementation of a KD represents a credible strategy to enhance overall health and readiness of military service members who could benefit from weight loss and improved body composition. PMID: 30877806 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 17, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Cost-Efficiency of Breast Cancer Care in the US Military Health System: An Economic Evaluation in Direct and Purchased Care.
CONCLUSIONS: In the MHS, higher breast cancer costs in the first 6 months after diagnosis were associated with lower risk for clinical outcomes in direct care, but not in purchased care. Organizational, institutional, and provider-level factors may contribute to the observed differences by care source. Replication of our findings in breast and other tumor sites may have implications for informing cancer care financing and value-based reimbursement policy. PMID: 30839064 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

What Do Veterans Want? Understanding Veterans' Preferences for PTSD Treatment Delivery.
CONCLUSIONS: Fewer than 50% of the sample preferred one method, and each modality was preferred by at least a quarter of all participants, suggesting that one treatment modality does not fit all. Both home-based care options were desirable, highlighting the value of offering a range of options. The use of home-based care can expand access to care, particularly for rural veterans. The current study includes a diverse group of veterans and increases our understanding of how they would like to receive PTSD treatment. The study used a forced choice preference measure and did not examine the strength of preference, which limits...
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Equine Assisted Therapy for Patients with Post Traumatic Stress Disorder: A Case Series Study.
Authors: Shelef A, Brafman D, Rosing T, Weizman A, Stryjer R, Barak Y Abstract INTRODUCTION: Equine assisted therapy (EAT) which includes therapeutic horseback riding (THR), grooming, horsemanship and ground level work with horses, has been studied as treatment for children with special needs and/or autistic spectrum disorder. Preliminary evidence indicates that EAT is also effective for improving self-efficacy and self-esteem in adults with psychiatric disorders. Empowerment, bonding and building trust with the horses, may promote functioning of patients struggling with post traumatic stress disorder (PTSD).The au...
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Effects of Load Carriage and Step Length Manipulation on Achilles Tendon and Knee Loads.
Authors: Willy RW, DeVita P, Meardon SA, Baggaley M, Womble CC, Willson JD Abstract INTRODUCTION: Longer steps with load carriage is common in shorter Soldiers when matching pace with taller Soldiers whereas shorter steps are hypothesized to reduce risk of injury with load carriage. The effects of load carriage with and without step length manipulation on loading patterns of three commonly injured structures were determined: Achilles tendon, patellofemoral joint (PFJ) and medial tibiofemoral joint (mTFJ). MATERIALS AND METHODS: ROTC Cadets (n = 16; 20.1 years ± 2.5) walked with and without load carriage ...
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Latent Lyme Disease Resulting in Chronic Arthritis and Early Career Termination in a United States Army Officer.
Authors: Weiss T, Zhu P, White H, Posner M, Wickiser JK, Washington MA, Barnhill J Abstract Lyme disease is a continuing threat to military personnel operating in arboriferous and mountainous environments. Here we present the case of a 24-year-old Second Lieutenant, a recent graduate from the United States Military Academy, with a history of Lyme disease who developed recurrent knee effusions following surgery to correct a hip impingement. Although gonococcal arthritis was initially suspected from preliminary laboratory results, a comprehensive evaluation contradicted this diagnosis. Despite antibiotic therapy, asp...
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Review of Environmental Barriers to Obtaining Adequate Sleep in the Military Operational Context.
CONCLUSIONS: Environmental disruptors, such as light, noise, temperature, and air pollution, can negatively impact sleep in the military operational context. Simple, feasible steps can be taken to reduce sleep disruptions that are caused by light and noise. Yet there is a need for research and development on tools to mitigate air pollution, extreme temperatures, and inhospitable sleeping surfaces. Leadership at the discussed military bases and training facilities should focus on improving the sleep environment for individuals under their command. Such interventions could ultimately improve warfighter health, wellness, and ...
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research