Implementation of Low-Cost Obstetric Hemorrhage Simulation Training Models for Resident Education.
Authors: Ramseyer AM, Lutgendorf MA Abstract INTRODUCTION: Simulation is beneficial training for low frequency high acuity events such as management of obstetric hemorrhage. Our objective was to evaluate perceived competency in management of obstetric and pelvic hemorrhage following training with low fidelity task trainers using inexpensive and common medical supplies. MATERIALS AND METHODS: This was a prospective observational study of training residents for management of obstetric and pelvic hemorrhage using a brief didactic instruction and low-cost task trainers with inexpensive common medical supplies. Part...
Source: Military Medicine - May 2, 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: Corrigendum.
Authors: PMID: 31038163 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - May 2, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Global Health Outreach by United States Ophthalmology Residency Programs: Understanding of Host Country Systems-Based Practice.
CONCLUSION: From the small sample of program directors, Ophthalmology residency program global health outreach varies in faculty and resident participation, and in goals and services offered. In addition, there was a wide variation in ophthalmology program director understanding of host country systems of care. PMID: 31038165 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - May 2, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Elevated Environmental Carbon Dioxide Exposure Confounding Physiologic Events in Aviators?
CONCLUSION: PEs are a growing safety concern for the aviation community in the military. As such, increasing measures are taken to ensure safety of flight and completion of the mission. To date, there is no correlation of CO2 exposure and altitude DCS. While elevated CO2 levels cannot be conclusively implicated as causative, this case series suggests a potential role of CO2 in altitude DCS through CO2 direct involvement with emboli gas composition, as well as pro-inflammatory cascade. Aviators exposed to elevated CO2 in poorly ventilated rooms developed PE symptoms consistent with DCS, while at the same command, aviators t...
Source: Military Medicine - May 2, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

On the Contrary, Dr Tuesca-Molina's Points Are Addressed in the Article.
Authors: Lennon RP, Orduña KC, Moreno JA, García FE, Chandler JW, Sweet NN, Hawley LA, Smith DK, Sanchack KE PMID: 31038181 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - May 2, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Development of an Emergency Medicine Resident Research Program in the United States Military.
CONCLUSION: Resident scholarly activity increased following the institution of a new research curriculum and graduation requirement. PMID: 31004142 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Discontinuation Rates of Antidepressant Use by Dutch Soldiers.
CONCLUSION: More than half of the soldiers discontinued their prescribed antidepressant within 3 months and after 6 months, only 30% were still on antidepressants. PMID: 31004149 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Outcomes of Pectoralis Major Tears in Active Duty US Military Personnel: A Comparison of Surgical Repairs Performed in the Forward Deployed Setting to Those Performed in the Continental United States.
CONCLUSIONS: When comparing deployed to CONUS results, we demonstrated that surgical repairs at one permanent US military in-theater tertiary referral medical center were as successful as repairs performed at one CONUS US Army academic tertiary referral medical center. Although in-theater surgical repair was technically feasible and clinically successful, we believe the lengthy convalescence, stringent post-operative restrictions, demanding environment and impact on operational readiness should preclude deployed surgical repairs from becoming standard practice. PMID: 31004160 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Brazilian Jiu Jitsu Training for US Service Members and Veterans with Symptoms of PTSD.
CONCLUSIONS: The results from this first-of-kind pilot study suggest that including BJJ as a complementary treatment to standard therapy for PTSD may be of value. It will be necessary to validate these promising results with a larger subject cohort and a more rigorous experimental design before routinely recommending this complementary therapy. PMID: 31004163 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prospective Memory in Service Members with Mild Traumatic Brain Injury.
CONCLUSIONS: The results suggest that implementation intentions may be a useful PM remediation strategy for those who have sustained mTBI. Future research should validate these findings in a larger sample. PMID: 31004164 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Preserving the Military Medicine Workforce: One Team, One Fight.
Authors: Kellermann AL, Reamy BV PMID: 31004168 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

An Editorial Review of Mobile Health: Implications for the US Military Health System.
CONCLUSIONS: Mobile health is a powerful platform which can help deliver standardized care in missions around the world and improve access to care for patients at military treatment facilities in the United States. The United States Military Health System would benefit greatly from creating universal mobile health applications to assist providers in patient access to care, military mission readiness, and disease specific modules. Future resources should be dedicated to the development of a mobile health application pool that is universally implemented across services to improve quality of care delivered at home and in thea...
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Cross-Sectional Study of Sexual Behavior, Alcohol Use, and Mental Health Conditions Associated With Sexually Transmitted Infections Among Deploying Shipboard US Military Personnel.
CONCLUSIONS: Previously unreported factors significantly associated with STIs at the PDT among MSW in the adjusted analysis were meeting sexual partners at work and IDC. IDC during the PDT warrants further exploration. These results can inform tailored STI reduction interventions among shipboard personnel and similarly aged civilians undergoing similar transition/travel experiences. PMID: 31004170 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Timing of Intradermal Rabies Pre-exposure Prophylaxis Injections: Immunological Effect on Vaccination Response.
CONCLUSIONS: Timing of vaccine dose administration, timing of serology testing, sex and age do significantly influence the humoral B-cell response to ID administered rabies vaccine. PMID: 31004174 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Scopolamine Toxicity in an Elderly Patient.
We present a case of a 66-year-old female who was to undergo a scheduled operation and placed on our institution's ERAS (Enhanced Recovery After Surgery) protocol. The intraoperative course was unremarkable. The patient developed delayed emergence in the Post-Anesthesia Care Unit. On physical exam, the patient was noted to have a transdermal scopolamine patch adjacent to an area of skin breakdown. She also displayed signs of central anti-cholinergic toxicity including mydriasis and tachycardia. Following removal of the scopolamine patch and administration of physostigmine, her mental status returned to baseline. This inter...
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Impact of Trust, Satisfaction, and Perceived Quality on Preference for Setting of Future Care Among Veterans With PTSD.
CONCLUSIONS: These findings suggest that it is important to retain foundational mental health services within VA, as well as to continue to invest in building provider and network capacity in community settings, to ensure alignment with veteran preferences for care setting. PMID: 31004426 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Validity of Digital and Manual Refractometers for Measuring Urine Specific Gravity During Field Operations: A Brief Report.
Authors: Heileson JL, Jayne JM Abstract INTRODUCTION: Dehydration can have an immediate negative impact on the performance of Soldiers in training or combat environments. Field expedient methods for assessing hydration status may be valuable for service members. Measurement of urine-specific gravity (USG) via refractometer is inexpensive, simple, fast, and a validated indicator of hydration status. Manual (MAN) and digital (DIG) refractometers are commonly used in laboratory settings however, digital (DIG) devices have not been validated in the field against MAN devices. The purpose of this study was to determine t...
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Emerging Infectious Diseases and Antimicrobial Resistance (EIDAR).
CONCLUSIONS: The EIDAR Research Area is responsive to military-relevant infectious disease threats that are also frequently global public health concerns. Several new EIDAR efforts are underway that will provide Combatant Command Surgeons, Infectious Diseases Service Chiefs, and other Force Health Protection stakeholders with epidemiological information to mitigate the impact of EIDs and antimicrobial resistance on the health of U.S. military service members and their dependents. PMID: 31004432 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Factors Affecting Performance on an Army Urban Operation Casualty Evacuation for Male and Female Soldiers.
This study was conducted to determine what physical and physiological characteristics contribute to the performance of an urban operation casualty evacuation (UO) and its predictive test, FORCE combat (FC) and describe the metabolic demand of the UO in female soldiers. METHODS: Seventeen military members (9 M and 8 F) completed a loaded walking maximal aerobic test, the UO and FC. Heart rate reserve (HRR) and completion time were used as efficiency/performance measures. Oxygen consumption (VO2) was directly measured for UO on five female participants with a portable indirect calorimetry system, and analyzed using descr...
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Missile Injury of the Sciatic Nerve: Observational Study Supporting Early Exploration and Direct Suture With Flexed Knee.
Authors: Mathieu L, Pfister G, Murison JC, Oberlin C, Belkheyar Z Abstract Missile injuries of the sciatic nerve are frequently encountered in modern violent conflicts. Gunshot and fragment wounds may cause large nerve defects, for which management is challenging. The great size of the sciatic nerve, in both diameter and length, explains the poor results of nerve repair using autografts or allografts. To address this issue, we used a simple technique consisting of a direct suture of the sciatic nerve combined with knee flexion for 6 weeks. Despite a published series showing that this procedure gives better results ...
Source: Military Medicine - April 22, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Letter From AMSUS Executive Director Dr. John Cho.
Authors: PMID: 30986305 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 16, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Defining Normal Balance for Army Aviators.
Authors: Karch SJ, Lawson BD, Milam LS Abstract INTRODUCTION: One challenge clinicians face is determining when a military Service Member (SM) can return to duty after an injury that affects the postural control. The gold standard to measure postural control is the Sensory Organization Test (SOT). This test measures the amount of sway present in an individual's static stance that may be used to examine range of function and monitor recovery from injury. Normative values currently available were developed using a sample of clinically normal adults from the general population (i.e., civilian non-aviator). Previous re...
Source: Military Medicine - April 6, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Restricting Retail Hours of Alcohol Sales within an Army Community.
CONCLUSIONS: This was the first known evaluation within a military community to report improvements in crime statistics following an eight hour reduction in daily retail sale hours of alcohol. The reduction in alcohol-related harms presented in this evaluation are typical for small communities implementing alcohol-related policies; however, the effect sizes reported here are larger than those reported in the current literature, suggesting that the policy positively impacted the installation community in decreasing alcohol-related harms. Evaluation data did not show statistically significant reductions in DUI/DWI citations ...
Source: Military Medicine - April 6, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Superficial Ballistic Trauma and Subjective Pain Experienced during Force-on-Force Training and the Observed Recovery Pattern.
CONCLUSIONS: Participants were able to safely conduct force-on-force training with simulated ammunition by following the manufacturer recommended safety standards. Participants did rate a statistically significant level of subjective pain, although this mild pain serves as a necessary factor to create the stressful environment of simulating combat conditions. It is possible that the subjective pain was rated higher for the chest due to the increased number of total rounds striking the chest, or the more direct impact of the rounds upon this tissue. The differences in subjective pain and recovery between impact regions of t...
Source: Military Medicine - April 6, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Epworth Sleepiness Scale in Service Members with Sleep Disorders.
This study assessed the clinical utility of the ESS in differentiating sleep disorders amongst a sample (N = 488) of U.S. military personnel with insomnia (n = 92), OSA (n = 142), COMISA (n = 221), and a NISA group (n = 33) which served as the control population. RESULTS: In the present sample, 68.4% of service members reported excessive daytime sleepiness (EDS) with an ESS> 10. ESS scores differed between military personnel with COMISA (13.5 ± 4.83) and those with OSA only (11.5 ± 4.08; p
Source: Military Medicine - April 6, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Arthroscopy for Management of Femoroacetabular Impingement Syndrome in the Military Health System: A 10-Year Epidemiological Overview of Cases with 2-year Follow-up.
CONCLUSION: Rates of arthroscopy have grown in the MHS over the last decade. Complication rates are similar to those reported in other populations and settings. Utilization of physical therapy was much more likely after surgery than prior to it. Opioid use was high prior to surgery and many individuals continued to receive opioid prescriptions beyond the initial perioperative period. PMID: 30941406 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Injury and Illness Surveillance During the 2016 Department of Defense Warrior Games: Review of Methods and Results.
CONCLUSIONS: From the surveillance data, staff levels and treatment supplies can be adjusted. In addition an improved surveillance tool can be created. Continuous surveillance is required to provide information on trends in injury and illness to support prevention strategies. PMID: 30941408 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Multidimensional Approach to Assessing Anthropometric and Aerobic Fitness Profiles of Elite Brazilian Endurance Athletes and Military Personnel.
CONCLUSION: In conclusion, military endurance athletes have similar anthropometric and physiological profiles to non-military athletes and superior levels to non-athlete military. These findings indicate that the Brazilian Armed Forces scouting system has been successful in identifying endurance athletic talent in line with their historic role of developing sport in Brazil. PMID: 30941410 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Burden of Dental Emergencies, Oral-Maxillofacial, and Cranio-Maxillofacial Injuries in US Military Personnel.
CONCLUSIONS: The percentage of DE and OMF casualties that can be expected in hostile environments is approximately 12%. Using the most recent data since 2000, the mean DE rate was 118.2 per 1,000 PPY and the OMF rate was 3.0 per 1,000 PPY. Future research should yield information which is representative of the evolving military environment. This information should be used to enhance military-specific dental therapies and to guide protection of the craniofacial region. More importantly, quality data are necessary (1) to enable the accurate prediction of DE, CMF, and OMF casualties to insure that troop levels are sufficient ...
Source: Military Medicine - April 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Prevalence of Faculty Physician Burnout in Military Graduate Medical Education Training Programs: A Cross-Sectional Study of Academic Physicians in the United States Department of Defense.
CONCLUSIONS: We estimate that 26% of physician faculty in military GME programs are experiencing burnout. No specialty, branch of service, or specific demographic was immune to burnout in our sample. Institutional leaders in the MHS should take action to address physician burnout and consider using our prevalence estimate to assess effectiveness of future interventions. PMID: 30941415 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Medical Encounters During the United States Army Special Forces Assessment and Selection Course.
CONCLUSION: The major limitations of this investigation were: 1) the low specificity with regard to many of the diagnoses/complaints; and 2) the fact that the medical problems reported here are only those seen by medical care providers and are likely an underestimate of the total morbidity in the SFAS course. Soldiers often self-treat and some may be reluctant to see medical personnel because of how it might affect their rating in the course. Nonetheless, this investigation alerts medical personnel to the injuries and illnesses to expect, and public health workers and leadership with activities to target for injury prevent...
Source: Military Medicine - April 5, 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.
Authors: PMID: 30941427 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Military Factors Associated with Smoking in Veterans: Erratum.
Authors: PMID: 30941428 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Costs for Colon Cancer Treatment Comparing Benefit Types and Care Sources in the US Military Health System.
CONCLUSIONS: In the MHS, median cost for colon cancer treatment was lower in direct care compared to purchased care or patients using a combination of direct and purchased care. The variation in cancer treatment costs between care sources may be due to differences in treatment incentives or capabilities. Additional studies on cost differences between direct and purchased services are needed to understand how provision of care affects cancer treatment costs and to identify possible targets for cost reduction. PMID: 30941433 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 5, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Behaviors Associated with Internet Use in Military Medical Students and Residents.
CONCLUSIONS: The study results indicated that our population showed problematic Internet use in the lower range of global estimates of IA. Rates of IA further decreased between medical students and residents. Multiple lifestyle variables were significantly associated with IA score and may serve as indicators of a higher score. Interestingly, the use of social media during sleeping hours was most significantly associated with increased IAS. This paper discusses IA among military medical and nursing trainees and how problematic Internet use may affect work performance and force readiness. PMID: 30938768 [PubMed - as supp...
Source: Military Medicine - April 4, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Acute Calcific Periarthritis of the Hand: A Case Report in an Active Duty Soldier.
Authors: Reifsnyder JW Abstract Acute calcific periarthritis of the hand is a condition that can easily be misdiagnosed resulting in unnecessary diagnostic studies and treatment. The condition is thought to be benign with a self-resolving course. The author presents a case of an active duty 29-year-old male who presented to a military emergency department with severe atraumatic hand pain developing overnight with initial concern for flexor tenosynovitis. Following orthopedic consultation, he was determined to have acute calcific periarthritis of the small finger (metacarpophalangeal) MCP joint with resolution over ...
Source: Military Medicine - April 4, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Association Between Dietary Supplement Use and ICD-9-CM Code Classification in Active Duty US Navy and Marine Corps Service Members.
CONCLUSIONS: The percentages of service members with diseases in specific ICD-9-CM diagnostic categories were similar to those reported in other studies using military medical data. There is a greater prevalence of dietary supplement use by the service members who participated in this survey compared with the general population, with 73% of US Navy and Marine Corps personnel reporting use of dietary supplements one or more times per week compared to the estimated 50% of all Americans currently using some form of dietary supplement. The DoD ensures the optimal readiness, performance, and health of its military service membe...
Source: Military Medicine - April 4, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Metachronous Contralateral Male Breast Cancer: Case Report and Literature Review.
Authors: O'Leary TR, Shriver CD, Wind G Abstract Male breast cancer (MBC) is rare and consequently understudied. Here we present the case of contralateral breast cancer in a male patient nearly a quarter century following his initial breast cancer diagnosis and treatment. The epidemiology, risk factors, diagnosis, characterization, treatment, and prognosis of male breast cancer are reviewed. MBC accounts for 1 in 15 lifetime risk of breast cancer and is present in>11% of MBC patients, while BRCA1 is present in an estimated
Source: Military Medicine - April 4, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Changes in Post-traumatic Stress Disorder Service Connection Among Veterans Under Age 55: An 18-Year Ecological Cohort Study.
CONCLUSIONS: Particularly for men, discontinuing or reducing PTSD service connection in this cohort was rare and often reversed. Regardless of gender, most Veterans with discontinued PTSD service connection did not experience reductions in their overall, total disability rating. Cost-benefit analyses could help determine if mandated, age-based re-evaluations of PTSD service connection are cost-effective. PMID: 30938816 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 4, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Simulated Casualty Evacuation Performance Is Augmented by Deadlift Peak Force.
Authors: Poser WM, Trautman KA, Dicks ND, Christensen BK, Lyman KJ, Hackney KJ Abstract INTRODUCTION: The purpose of the current study was to examine if isometric peak force and rate of force development (RFD) were related to the ability to successfully perform a simulated casualty evacuation task in both unweighted and weighted conditions. METHODS: Eighteen male participants from Army Reserve Officers' Training Corps (ROTC) completed a maximum isometric deadlift on a force plate (IRB#HE16227). Isometric peak force and RFD were calculated from ground reaction force. Two simulated casualty evacuation performance...
Source: Military Medicine - April 4, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Improvements in Gulf War Illness Symptoms After Near-Infrared Transcranial and Intranasal Photobiomodulation: Two Case Reports.
This report describes the first documentation of improved GWI symptoms in two GW veterans following 12 weeks of PBM treatments. PMID: 30916762 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 29, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Development and Implementation of U.S. Army Guidelines for Managing Soldiers at Risk of Suicide.
CONCLUSIONS: Combined efforts in crafting policy for risk identification and communication resulted in a policy that was acceptable and feasible from the perspective of commanders and clinicians. Synchronization efforts between commanders, clinicians, and support services are crucial to ensure effective intervention to prevent suicide behavior. PMID: 30901390 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prehospital Interventions Performed in Afghanistan Between November 2009 and March 2014.
CONCLUSIONS: In our study, the most commonly performed prehospital LSI in a combat setting were for vascular access and hemorrhage control. The most common incorrectly performed and missed interventions were airway interventions and chest procedures respectively. PMID: 30901391 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

IV DripAssist: An Innovative Way to Monitor Intravenous Infusions Away From an Outlet?
Authors: Couperus K, Kmiecik K, Kang C Abstract Intravenous (IV) administration of fluids and medications are a significant part of patient treatment. In austere environments, typical methods of counting drops from gravity drips or infusion pumps both have limitations such as accuracy, weight, and need for power. The DripAssist device calculates drip rates by counting drops in IV tubing drip chambers and may provide a useful patient safety monitor adjunct. The protocol was IRB approved, prospective, and designed as a pilot study involving 28 Madigan Army Medical Center Emergency Department personnel. After a brief ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

An Association Between Herpes Zoster Vaccination and Stroke Reduction Among Elderly Individuals.
Authors: Klaric JS, Beltran TA, McClenathan BM Abstract Herpes zoster (HZ, shingles) affects individuals (60+ years) by reactivation of varicella virus from primary infection. Approximately one-third of the general population will develop HZ and are at increased risk of stroke. Our objective was describing possible associations between self-reported HZ vaccination and stroke with the Centers for Disease Control and Prevention's Behavioral Risk Factors Surveillance System, a cross-sectional nationwide telephone survey. Non-institutionalized U.S. adults answered items concerning health risk behaviors. 2014 survey dat...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Augmented Reality as a Medium for Improved Telementoring.
Authors: Rojas-Muñoz E, Andersen D, Cabrera ME, Popescu V, Marley S, Zarzaur B, Mullis B, Wachs JP Abstract Combat trauma injuries require urgent and specialized care. When patient evacuation is infeasible, critical life-saving care must be given at the point of injury in real-time and under austere conditions associated to forward operating bases. Surgical telementoring allows local generalists to receive remote instruction from specialists thousands of miles away. However, current telementoring systems have limited annotation capabilities and lack of direct visualization of the future result of the surgica...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Percutaneous Peripheral Nerve Stimulation to Control Postoperative Pain, Decrease Opioid Use, and Accelerate Functional Recovery Following Orthopedic Trauma.
The objective of this report is to summarize the findings of case series of a non-opioid therapy-percutaneous peripheral nerve stimulation (PNS) - and describe its potential for postoperative analgesia, early opioid cessation, and improved function following orthopedic trauma. Percutaneous PNS has been evaluated for the treatment of multiple types of pain, including two case series on postoperative pain following total knee replacement (n = 10 and 8, respectively) and a case series on postamputation pain (n = 9). The orthopedic trauma induced during TKR is highly representative of multiple types of orthopedic trauma sustai...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Preliminary Investigation of Civilian Clinician Perspectives & Just-in-Time Guidance for Tourniquet Use to "Stop the Bleed".
This study aimed to determine surgical trainee knowledge and attitudes regarding tourniquet application and compare the effectiveness of instructions. METHODS: Thirty surgical trainees performed a tourniquet application simulation using a Combat Application Tourniquet and one of the three instructions sets developed by ACS, Department of Homeland Security, and the tourniquet manufacturer. Participants reported tourniquet knowledge, attitudes, and confidence and discussed the instructions. One instruction set was updated and compared to the original set with 20 new trainees. RESULTS: Participants with ACS instructio...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prevalence of Musculoskeletal Injuries Sustained During Marine Corps Recruit Training.
Authors: Jensen AE, Laird M, Jameson JT, Kelly KR Abstract Musculoskeletal injuries cost the U.S. Marine Corps approximately $111 million and 356,000 lost duty days annually. Information identifying the most common types of injuries and events leading to their cause would help target mitigation efforts. The purpose of this effort was to conduct an archival data review of injuries and events leading to injury during recruit training. An archival dataset of Marine recruits from 2011 to 2016 was reviewed and included 43,004 observations from 28,829 unique individuals. Injuries were classified as mild, moderate, and se...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Assessing the Burden of Chlamydia and Gonorrhea for Deployed and Active Duty Personnel Assigned Outside the USA.
This study assessed chlamydia and gonorrhea rates by unit of country assignment and evaluated the demographic profile of affected personnel during deployment. Chlamydia and gonorrhea cases among active duty personnel were identified from laboratory results and ambulatory encounter records in the Military Health System from fiscal years October 2006 through September 2015; these were linked to personnel and deployment records to ascertain demographic characteristics, unit of country assignment, and if the case was captured during a period of deployment. Case rates were higher for chlamydia (1,321.7 per 100,000) than gonorrh...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research