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

The Role of CT Angiography in Evaluating Lower Extremity Trauma: 157 Patient Case Series at a Military Treatment Facility.
Authors: Kelly SP, Rambau G, Tennent DJ, Osborn PM Abstract INTRODUCTION: Physical exam and angiography have important roles in the diagnosis of traumatic lower extremity vascular injury with similar reported high rates of sensitivity and specificity. It has been previously shown that CTA is not universally indicated in the setting of acute lower extremity trauma when a reliable physical examination is obtained. As such, the purpose of this study was to determine if obtaining a CTA following physical examination altered the clinical care of patients following high-energy lower extremity trauma and the generalizabil...
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Genetic, Physiologic, and Behavioral Predictors of Cardiorespiratory Fitness in Specialized Military Men.
CONCLUSION: This study signifies a shift toward inclusive explanatory models of CRF and aerobic performance, accounting for combined roles of genetic, physiologic, and behavioral influences. Although we were able to quantify combined effects, we were unable to evaluate interaction effects (e.g., gene-gene, gene-behavior) due to limited statistical power. Other limitations are that this specialized military population may not readily generalize to broader populations, and the current sample was all male. Considering these limitations, we aim to replicate this study in various populations, both male and female. Despite its l...
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Effects of Early Altitude Exposure on the Open Abdomen After Laparotomy in Trauma.
CONCLUSION: These results demonstrate the complex interaction of AE and temporary or definitive abdominal closure after post-injury laparotomy. Contrary to our hypothesis, we found that AE in those animals with open abdomens is relatively safe with no difference in mortality compared to those with closed abdomens. However, given the physiologic and inflammatory changes observed in animals with open abdomens, further evaluation is necessary prior to definitive recommendations regarding the safety or downstream effects of exposure to AE prior to definitive abdominal closure. PMID: 30839078 [PubMed - as supplied by publis...
Source: Military Medicine - March 7, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

N-Acetylcysteine (NAC) for the Prevention of Liver Failure in Heat Injury-Mediated Ischemic Hepatitis.
Authors: Will JS, Snyder CJ, Westerfield KL Abstract Exertional Heat Illness with associated ischemic hepatitis (IH) is a common occurrence among military trainees; however, few specific therapies exist if unresponsive to appropriate supportive measures. A 27-year-old basic combat trainee presented with altered mental status, renal insufficiency, rhabdomyolysis, and a core temp of 107.9 °F after collapsing during a run, leading to the diagnosis of heat stroke. While the patient's azotemia and creatinine kinase levels rapidly improved with aggressive intravenous hydration, transaminases continued to increase to ...
Source: Military Medicine - March 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Body Mass Index Effect on Health Service Utilization Among Active Duty Male United States Army Soldiers.
CONCLUSIONS: More than 70% of soldiers had overweight or obesity in FY 2015, showing the highest prevalence yet measured for these conditions. Previous reports of lower prevalence may be due to the inclusion of circumference-based body fat assessments, which have been criticized for inaccuracy. In our study, disproportionately high health service use by soldiers with obesity suggests decreased readiness, as these soldiers may experience both poorer health and lose necessary training time due to increased provider visits. Proportional usage by soldiers with overweight suggests the protective effect of regular physical activ...
Source: Military Medicine - March 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Descriptive Analysis of Cardiac Patients Transported by Critical Care Air Transport Teams.
CONCLUSIONS: Critically ill cardiac patients make up a significant portion of patients transported out of the combat theater. These patients are older, overweight and have identified risk factors for cardiac morbidity. More strenuous pre-deployment screening for risk factors and prevention strategies could minimize the use of military resources to evacuate these patients from the combat theater. PMID: 30811531 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Low Revision Rates at 10 years for Metal on Metal Hip Implants in a Military Population.
CONCLUSIONS: Revision rates of MoM THA and HR in this young, predominantly male population were 2.9% and 5.3%, respectively, and patients maintained generally good hip-specific outcomes. PMID: 30811533 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Polycystic Ovary Syndrome in Active Duty Service Women: A Retrospective Analysis.
CONCLUSIONS: PCOS is present in ADSW. Obtaining an accurate prevalence rate of this condition helps reveal the extent of its presence, helps increase awareness, and identify that there is a population in need of targeted support and interventions to maintain a fit and ready force. PMID: 30811534 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Medical Scribe Impact on Patient and Provider Experience.
CONCLUSION: In multiple settings, documentation requirements burden providers. The consideration of scribes could foster work life balance, retention, and wellness. The patient and provider experience was strengthened through the utilization of medical scribes, so future research centered on the provider and patient experience could be beneficial to organizations. Further study of the scribe's experience, especially considering the positive comments from the hospital corpsmen that participated as scribes during the project, could provide beneficial outcomes. Navy Medicine is advancing every opportunity to strengthen clinic...
Source: Military Medicine - March 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Retrospective Assessment of the Efficacy of Modified Progressive Tinnitus Management Skills Education in a Military Medical Treatment Facility.
Authors: Sherlock LP, Ortiz CE, Blasco GP, Brooks DI Abstract INTRODUCTION: The number-one service-connected disability is tinnitus. Tinnitus currently has no cure, but the functional impact of tinnitus has been shown to be mitigated by Progressive Tinnitus Management (PTM), a multi-level management approach. The duration of PTM Level 3 skills education (PTM-SE) and the inclusion of mental health providers have been identified as barriers to implementation of PTM-SE in Department of Defense (DOD) medical treatment facilities. The goal of this study was to determine if a version of PTM-SE modified for use in DOD med...
Source: Military Medicine - March 1, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Letter from the Executive Director.
Authors: PMID: 30805616 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - February 27, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research