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Reappraising the Use of Systemic Immunomodulators for Psoriasis and Eczema in the Military Mil. Med. (IF 1.2) Pub Date : 2024-04-12 Alexius Russell, Samantha Williamson, Alexandra Rosenberg, Sunghun Cho
Introduction Psoriasis and atopic dermatitis are chronic, immune-mediated skin disorders that are disqualifying for entrance into the military. Both conditions can cause difficulty wearing body armor and other protective equipment when poorly controlled, limiting a service member’s ability to train and deploy worldwide. In addition, these conditions may be exacerbated by military service because of
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What Does the Military Health System Need to Support Future Combat Operations? Lessons from Aeromedical Evacuations from 2008 to 2020 Mil. Med. (IF 1.2) Pub Date : 2024-04-04 Matthew M McDonough, Isaiah R Gray, Robert G Pickering, Kyle N Remick
Introduction Aeromedical evacuations from the past few decades have yielded massive amounts of data that may inform the Military Health System (MHS) on patient needs, specifically for understanding the inpatient and outpatient needs of evacuees. In this study, we evaluate inpatient and outpatient trends based on aeromedical evacuation data from recent conflicts. We anticipate that evacuations requiring
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Lessons Learned: Large-Scale Perfused Cadaver Training in Three Different Curricular Environments Mil. Med. (IF 1.2) Pub Date : 2024-03-30 Alex Y Koo, David K Rodgers, Marc H Hohman, Jason R Muise, Kyle S Couperus, Jillian F Phelps
Background Perfused cadavers are viable training models for operating room surgical skills, increasing fidelity of vascular anatomy, dissection, and tissue handling. In addition, perfused cadavers may have benefits in military medical training environments with a focus on hemorrhage control and vascular access. Objectives We created a large-scale training exercise with perfused cadavers in three different
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Addressing Differences in Knowledge and Experience in Trauma Care Capabilities Among an International Team of Military Medical Care Providers in a Deployed Setting Mil. Med. (IF 1.2) Pub Date : 2024-03-30 Sarah Holvelinsky, Taylor Travers, Joshua B Stierwalt, Paul Schunk, Brian Patrick Murray
Military medical personnel are crucial in providing life-saving care at the point of injury (POI) in challenging environments such as combat zones and disaster areas. This article examines the specialized training US Military medical personnel undergo before deployment and the increasing trend of deploying as part of multinational forces in operations like those in Afghanistan with NATO and non-NATO
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Cumulative Blast Impulse Is Predictive for Changes in Chronic Neurobehavioral Symptoms Following Low Level Blast Exposure during Military Training Mil. Med. (IF 1.2) Pub Date : 2024-03-30 Cory McEvoy, Adam Crabtree, John Case, Gary E Means, Peter Muench, Ronald G Thomas, Rebecca A Ivory, Jason Mihalik, James S Meabon
Introduction Cumulative low-level blast exposure during military training may be a significant occupational hazard, increasing the risk of poor long-term outcomes in brain function. US Public Law 116-92 section 717 mandates that US Department of Defense agencies document the blast exposure of each Service member to help inform later disability and health care decisions. However, which empirical measures
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Clinical Readiness: Can Providers Learn to Perform Lower Leg Fasciotomy Through a Tablet-based Augmented Reality Surgical Training Environment? Mil. Med. (IF 1.2) Pub Date : 2024-03-30 Kieran Wolf, Mark Bowyer, Matthew Bradley, Brenton Franklin, Elizabeth Weissbrod, Ryan Dinnen, Pamela Andreatta
Introduction The uses of on-demand, interactive tablet-based surgical training environments are of interest as potential resources for both the acquisition and maintenance of rarely performed, critical procedures for expeditionary surgical care. This study examined the effectiveness of a tablet-based augmented reality (AR) procedural training environment for lower leg fasciotomy with a cohort of novice
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The Link Between Somatization and Dissociation and PTSD Severity in Veterans Who Sought Help From the IDF Combat Stress Reaction Unit Mil. Med. (IF 1.2) Pub Date : 2024-03-30 Nizan Shabat, Uzi Bechor, Nirit Yavnai, Lucian Tatsa-Laur, Leah Shelef
Introduction This study aimed to examine the relationships between dissociative and somatic symptoms and how they might contribute to PTSD severity among ex-soldiers who sought help from the IDF Combat Stress Reaction Unit (CSRU). Materials and Methods This cross-sectional study included 1,305 former compulsory, career, and reserve soldiers, who filled out self-report questionnaires on admission for
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A Case of Multidrug-Resistant Tuberculosis in an Active Duty Military Health Care Worker Mil. Med. (IF 1.2) Pub Date : 2024-03-30 Amanda E Saunders, Kevin M Shanahan, John W Downs
Cases of active tuberculosis (TB) in the U.S. Military have fallen over the last century in large part due to improved screening and treatment options. The subset of multidrug-resistant TB (MDR-TB) is almost nonexistent within the U.S. Military. We present a case of MDR-TB in an active duty U.S. Military health care worker and discuss several considerations for treatment that may present challenges
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Exploring Knowledge, Skills, and Abilities Needed for Army Pharmacist Readiness Using the Nominal Group Technique Mil. Med. (IF 1.2) Pub Date : 2024-03-30 Ryan C Costantino, Eulho Jung, Michael Soh, Anita Samuel
Introduction The purpose of this study was to conduct a general educational needs assessment to identify deficiencies in current Army pharmacy education while projecting future educational requirements based on changes in pharmacy practice and evolving demands of military medicine. Materials and Methods Twelve pharmacists participated in a facilitated discussion using the nominal group technique. Data
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Amplified PTSD Symptoms From Self-Attributed Moral Transgressions are Linked to Internalized Moral Identity During Military Deployment Mil. Med. (IF 1.2) Pub Date : 2024-03-30 Walter J Sowden, Rachell L Jones
Introduction Military personnel frequently experience stressful, morally challenging situations that can lead to posttraumatic stress disorder (PTSD). The relationships between moral identity, transgressive acts, and symptoms related to posttraumatic stress disorder (i.e., posttraumatic stress symptoms; PTSS) among U.S. Army Soldiers were assessed. Materials and Methods A convenience cohort of 1,547
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Telemedicine for Potential Application in Austere Military Environments: Neurosurgical Support for a Decompressive Craniectomy Mil. Med. (IF 1.2) Pub Date : 2024-03-28 Pieter W Stark, O J F van Waes, John S Soria van Hoeve, Boudewijn L S Borger van der Burg, Rigo Hoencamp
Introduction The main goal of this study was to assess the feasibility of a head-mounted display (HMD) providing telemedicine neurosurgical support during a decompressive craniectomy by a military surgeon who is isolated from readily available neurosurgical care. The secondary aim was to assess the usability perceived by the military surgeon and to evaluate technical aspects of the head-mounted display
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Prediction of Occult Hemorrhage in the Lower Body Negative Pressure Model: Initial Validation of Machine Learning Approaches Mil. Med. (IF 1.2) Pub Date : 2024-03-27 Navid Rashedi, Yifei Sun, Vikrant Vaze, Parikshit Shah, Ryan Halter, Jonathan T Elliott, Norman A Paradis
Introduction Detection of occult hemorrhage (OH) before progression to clinically apparent changes in vital signs remains an important clinical problem in managing trauma patients. The resource-intensiveness associated with continuous clinical patient monitoring and rescue from frank shock makes accurate early detection and prediction with noninvasive measurement technology a desirable innovation.
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Female-Specific Health Care of Military Female-Designated Service Members and Veterans: A Systematic Overview of Reviews Mil. Med. (IF 1.2) Pub Date : 2024-03-27 Megan C McDermott, Megan G Musilli, Jill E Brown, John L Melton, Michael J Miller, Rhonda J Allard, Monica A Lutgendorf
Introduction Since the War in Afghanistan began in 2001, service members have faced significant health effects related to service during war, with female-designated service members facing unique challenges. Numerous high-quality review articles have been published on the health and care of female-designated service members and veterans. Given the increasing volume of literature, we completed an overview
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The Impact of a Pandemic on a Military Oral and Maxillofacial Pathology Biopsy Service Mil. Med. (IF 1.2) Pub Date : 2024-03-27 Trevor E Miller, Noel E Dickens, Matthew R Rehmel, Bradley E Jones, Nicholas J Hamlin, Quinn C Robbins
Introduction Coronavirus disease 2019 (COVID-19) and the resulting societal reaction presented new challenges to the medical community by limiting patient access to care in 2020 and 2021. The Navy Postgraduate Dental School (NPDS) oral and maxillofacial pathology biopsy service is dependent on in-office physician or dentist appointments and patient biopsies. The purpose of this study was to understand
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Don’t Overlook Syphilis: An Atypical Rash in a Woman With Neurologic, Ocular, and Otic Involvement Mil. Med. (IF 1.2) Pub Date : 2024-03-27 Elena M Crouch, Michael T O Stein, Matthew R Geringer, Aeja Weiss, Molly Stalons, Jamie L Geringer
The manifestations of syphilis, a sexually transmitted infection caused by Treponema pallidum, can be divided into primary, secondary, or tertiary stages. In addition, syphilis can cause a latent infection with no clinical manifestations and be diagnosed solely by serologic testing. Secondary syphilis is especially known for causing a rash and diverse clinical manifestation which can make its diagnosis
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Deployment-related Cigarette Smoking Behaviors and Pulmonary Function Among U.S. Veterans Mil. Med. (IF 1.2) Pub Date : 2024-03-27 Jennifer R Maccarone, Olivia R Sterns, Andrew Timmons, Anna M Korpak, Nicholas L Smith, Karen S Nakayama, Coleen P Baird, Paul Ciminera, Farrah Kheradmand, Vincent S Fan, Jaime E Hart, Petros Koutrakis, Michael Jerrett, Ware G Kuschner, Octavian C Ioachimescu, Philippe R Montgrain, Susan P Proctor, Carrie A Redlich, Christine H Wendt, Paul D Blanc, Eric Garshick, Emily S Wan
Introduction The effects of smoking on lung function among post-9/11 Veterans deployed to environments with high levels of ambient particulate matter are incompletely understood. Materials and Methods We analyzed interim data (04/2018-03/2020) from the Veterans Affairs (VA) Cooperative Studies Program #595, “Service and Health Among Deployed Veterans”. Veterans with ≥1 land-based deployments enrolled
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Identifying Risk Factors for Dental Emergency Visits in the US Army Mil. Med. (IF 1.2) Pub Date : 2024-03-27 Patrick J Arbuckle, Thomas Beltran, Erik Reifenstahl
Introduction The purpose of this study is to examine the relationship between subjects’ oral health characteristics and the incidence of a dental emergency over 1 year. Materials and Methods The Corporate Dental System (CDS) generated a limited data set for service members assigned for dental care at Fort Liberty, North Carolina. Data extracted included demographics and oral health characteristics
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Prevalence of Pain With Movement in Active Duty US Army Soldiers Mil. Med. (IF 1.2) Pub Date : 2024-03-26 Jennifer S Emberton, Benjamin G Adams, Brittany R Hotaling, Kristen L Zosel, Stephen M Grist, Nancy Henderson, Joseph Kardouni, Richard B Westrick
Introduction Soldiers must be able to perform a multitude of physically demanding tasks as part of their regular duty, but their physical readiness is often degraded due to pain and musculoskeletal injury (MSKI). The presence of pain with movement has been associated with increased MSKI risk in Soldiers. Improved awareness of the prevalence of painful movements in uninjured Soldiers could help inform
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Comparison of Vestibular/Ocular Motor Screening (VOMS) and Computerized Eye-tracking to Identify Exposure to Repetitive Head Impacts Mil. Med. (IF 1.2) Pub Date : 2024-03-26 Anthony P Kontos, Aaron J Zynda, Amir Minerbi
Introduction Military service members (SMs) are exposed to repetitive head impacts (RHIs) in combat and training that are purported to adversely affect brain health, including cognition, behavior, and function. Researchers have reported that RHI from blast-related exposure may affect both vestibular and ocular function, which in turn may be related to symptomology. As such, an examination of the effects
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Optimization and Validation of an FTIR-based, All-in-one System for Viable MDR Bacteria Detection in Combat-related Wound Infection Mil. Med. (IF 1.2) Pub Date : 2024-03-22 Ying Chen, Andrew Leung, Yulia Wang, Nathan K Archer
Introduction The U.S. Military members experiencing combat-related injuries have a higher chance of developing infections by multidrug-resistant (MDR) bacteria at admission to military hospitals. MDR wound infections result in higher amputation rates and greater risks for subsequent or chronic infections that require readmission or extended stay in the hospital. Currently, there is no FDA-clear, deployable
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Self-Perception of Risk for HIV Acquisition and Calculated Risk for HIV Acquisition Among Active Duty Air Force Members With Newly Diagnosed HIV Infection Mil. Med. (IF 1.2) Pub Date : 2024-03-22 Audie B Schmid, Jason F Okulicz, Walter Mika, Shilpa Hakre, Joseph M Yabes
Introduction There have been nearly 1,600 new diagnoses of Human Immunodeficiency Virus (HIV) across the US Armed Forces between 2017 and 2022. While treatment has improved overall survival, self-perception of acquiring HIV may not align with actual risk of acquiring HIV, thus slowing diagnosis and treatment. We aim to evaluate self-perceived risk (SPR) versus calculated risk (CR) of HIV infection
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The Impact of COVID-19 on Health Behavior Engagement and Psychological and Physical Health Among Active Duty Military Enrolled in a Weight Management Intervention: An Exploratory Study Mil. Med. (IF 1.2) Pub Date : 2024-03-22 Jessica L Morse, Jennalee S Wooldridge, Matthew S Herbert, Niloofar Afari
Introduction The COVID-19 pandemic profoundly affected the health and well-being of people globally. Some studies suggest individuals with overweight or obesity may have been more adversely impacted by pandemic restrictions. Additionally, military personnel may have been more vulnerable to stress during the pandemic because of job demands (e.g., work in close quarters). Our research group was conducting
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Interfacility Transfer Teams: A Pilot Study to Assess Viability as a Skill Sustainment Platform Mil. Med. (IF 1.2) Pub Date : 2024-03-22 Andrew J Medenbach, Alexandre Nguyen, Emily Raetz, Theodore Morrison, Benjamin Walrath
Introduction A US Naval hospital in the remote Pacific region has developed interfacility transfer (IFT) teams staffed by active duty personnel out of necessity due to a large percentage of critically ill patients requiring IFT and a lack of local resources. The IFT program underwent significant improvements in training and quality assurance in 2017. We sought to assess patient safety when transport
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Public versus Private Care in the Military Health System: Evidence From Low Back Pain Patients Mil. Med. (IF 1.2) Pub Date : 2024-03-16 Christopher G Leggett, Rachel O Schmidt, Jonathan Skinner, Jon D Lurie, William Patrick Luan
Introduction There is a longstanding debate about whether health care is more efficiently provided by the public or private sector. The debate is particularly relevant to the Military Health System (MHS), which delivers care through a combination of publicly funded federal facilities and privately contracted providers. This study compares outcomes, treatments, and costs for MHS patients obtaining care
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Preliminary Investigation Into the Effectiveness of Group webSTAIR for Trauma-exposed Veterans in Primary Care Mil. Med. (IF 1.2) Pub Date : 2024-03-05 Jamie S Kim, Annabel Prins, Elizabeth W Hirschhorn, Alison C Legrand, Kathryn S Macia, Sherry S Yam, Marylene Cloitre
Introduction A substantial number of trauma-exposed veterans seen in primary care report significant symptoms of PTSD and depression. While primary care mental health integration (PCMHI) providers have been successful in delivering brief mental health treatments in primary care, few studies have evaluated interventions that combine mobile health resources with PCMHI groups. This pilot study assessed
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Associations Among Environmental Exposures and Physical and Psychiatric Symptoms in a Care-Seeking Sample of U.S. Military Veterans Mil. Med. (IF 1.2) Pub Date : 2024-03-05 Jessica L Morse, Dean T Acheson, Erin Almklov, James O E Pittman, Ariel J Lang, Laurie Lindamer
Introduction Recent research and policy (e.g., the Sergeant First Class (SFC) Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act) have highlighted the potential health consequences of toxic environmental exposures. The purpose of the current study was to assess the self-reported prevalence of such exposures among a sample of U.S. military veterans seeking care at a Veterans
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Bronchoalveolar Lavage Fluid Cytology of Deployed Military Personnel With Chronic Respiratory Symptoms From the STAMPEDE III Study Mil. Med. (IF 1.2) Pub Date : 2024-03-02 Joshua M Boster, William J Moore III, Steven T Stoffel, Jess T Anderson, Michael A Gonzales, Mateo C Houle, Robert J Walter, Michael J Morris
Introduction Deployed military personnel may be at risk for developing acute and chronic lung disease. Prior studies of this patient population have revealed that unexplained exertional dyspnea is the most common diagnosis despite an extensive evaluation. There is a concern that an occult disorder may be affecting this population. This study evaluated the role for bronchoalveolar lavage (BAL) fluid
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Hyperventilation During Manual Ventilation Can Be Reduced Using a Novel Ventilator but Not With Education Interventions Mil. Med. (IF 1.2) Pub Date : 2024-03-02 Andrea R Trent, Raymond Fang, Hegang Chen, Curtis C Copeland, Napoleon P Roux, Thomas E Grissom
Introduction Traumatic brain injury (TBI) is the leading cause of combat casualties in modern war with an estimated 20% of casualties experiencing head injury. Since the release of the Brain Trauma Foundation’s Guidelines for the Management of Severe Traumatic Brain Injury in 1995, recommendations for management of TBI have included the avoidance of routine hyperventilation. However, both published
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Cryotherapy-Induced Iatrogenic Frostbite on Distal Digit: Case Report and Review of Management Strategies Mil. Med. (IF 1.2) Pub Date : 2024-03-02 Gehan Pendlebury, Catherine Brahe, Rudy Schmiedecke
Cryotherapy is a widely utilized topical treatment for various dermatological conditions. While generally safe and effective, it carries potential risks, such as frostbite injury. Frostbite, a vascular condition causing skin and tissue freezing, is usually associated with prolonged exposure to freezing environments. Certain populations, like military personnel navigating frigid terrains, face an increased
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Mental and Physical Health-Related Quality of Life Following Military Polytrauma Mil. Med. (IF 1.2) Pub Date : 2024-02-29 Jay R McDonald, Matthew Wagoner, Faraz Shaikh, Erica Sercy, Laveta Stewart, Emma R Knapp, John L Kiley, Wesley R Campbell, David R Tribble
Introduction The long-term impact of deployment-related trauma on mental and physical health-related quality of life (HRQoL) among military personnel is not well understood. We describe the mental and physical HRQoL among military personnel following deployment-related polytrauma after their discharge from the hospital and examine factors associated with HRQoL and longitudinal trends. Materials and
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A Comprehensive Summary of the Meta-Analyses and Systematic Reviews on Platelet-Rich Plasma Therapies for Knee Osteoarthritis Mil. Med. (IF 1.2) Pub Date : 2024-02-29 Emily Mende, Ryan J Love, Jody-Lynn Young
Introduction Osteoarthritis (OA), including that of the knee joint, represents a significant proportion of musculoskeletal injuries in the Canadian Armed Forces (CAF) due to the frequent, high-stress physical activity for which member participation is necessary. Platelet-rich plasma (PRP) is a conservative, autologous treatment that has the potential to relieve symptoms and improve functionality of
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An Augmented Reality Rifle Qualification Test for Return-to-Duty Assessment in Service Members Mil. Med. (IF 1.2) Pub Date : 2024-02-29 Ryan D Kaya, Karissa Hastilow, Kelsey M Owen, Eric M Zimmerman, Anson B Rosenfeldt, Jay L Alberts
Introduction Variability in return-to-duty (RTD) decision-making following mild traumatic brain injury (mTBI) is a threat to troop readiness. Current RTD assessments lack military-specific tasks and quantitative outcomes to inform stakeholders of a service member’s (SM) capacity to successfully perform military duties. Augmented reality (AR), which places digital assets in a user’s physical environment
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A Novel Peritoneal Packing Method for Management of Hyperkalemia During Acute Kidney Injury in Trauma Mil. Med. (IF 1.2) Pub Date : 2024-02-29 Eric M Zimmerman, Ian J Stewart, Todd L Graham, Timothy J Kovacs, Tamaz Guliashvili, Thomas D Golobish, James D Ross
Introduction United States Military operations in resource limited areas are increasing. Furthermore, future peer or near-peer conflicts will require caring for larger numbers of casualties with limited resources. In this setting, traditional renal replacement therapy is not feasible and novel methods are required to address severe acute kidney injury in austere environments lacking definitive therapies
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A Pilot Study Using a Standardized Trauma Assessment Tool After Tactical Combat Casualty Care Course: A Comparison of the United States and Ghana Mil. Med. (IF 1.2) Pub Date : 2024-02-23 Catherine C Polley, Rossi Adu-Gyamfi, Tawfik Mahama-Toure, Fattal Okpoti Konney, Emmanuel Oti-Boateng, Lawrence Nsohlebna Nsoh, Timothy Ballard
Introduction Assessment, monitoring, and evaluation have been a required part of Global Health Engagement but difficult to accomplish. The current assessment, monitoring, and evaluation frameworks require implementation at the start of the project and are not designed to use for already existing programs. Tactical Combat Casualty Care (TCCC) is a standardized course now offered in 89 countries, but
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Medication Trends in the Military: A Comparative Analysis of Prescribing Patterns Among Service Members Seen by a Pharmacist and Implications for Medical Readiness Mil. Med. (IF 1.2) Pub Date : 2024-02-23 Ryan C Costantino, Laura E Gressler, Lee Ann Zarzabal, Cynthia M Vasquez, Richard Juneau
Introduction Medications play a critical role supporting the health of military service members. Little is known about the broad use of medications prescribed to this population. Active duty service members (ADSMs), while often younger and having fewer diagnosed comorbid conditions, face unique health challenges that benefit from pharmacotherapy. Understanding prescribing patterns is instrumental to
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The Association of High-Quality Hospital Use on Health Care Outcomes for Pediatric Congenital Heart Defects in a Universal Health Care System Mil. Med. (IF 1.2) Pub Date : 2024-02-16 Amber El-Amin, Tracey Koehlmoos, Dahai Yue, Jie Chen, Nam Yong Cho, Peyman Benharash, Luisa Franzini
Introduction Congenital heart disease (CHD) has an incidence of 0.8% to 1.2% worldwide, making it the most common birth defect. Researchers have compared high-volume to low-volume hospitals and found significant hospital-level variation in major complications, health resource utilization, and mortality after CHD surgery. In addition, researchers found critical CHD patients at low-volume/non-teaching
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Platelet-Rich Plasma Injections for the Treatment of Degenerative Orthopedic Conditions Mil. Med. (IF 1.2) Pub Date : 2024-02-13 Gary E Means, Peter Muench
Platelet-rich plasma injections for the treatment of degenerative orthopedic conditions have good evidence for safety, pain relief, and functional improvement. The U.S. Military is providing platelet-rich plasma services for military services members and TRICARE beneficiaries. The use of this safe and effective treatment should be continued and expanded.
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Nonpharmacological Therapies for Musculoskeletal Injury in Military Personnel: A Systematic Review/Meta-Analysis Mil. Med. (IF 1.2) Pub Date : 2024-02-12 Laura A Talbot, Lin Wu, Christopher H Morrell, David F Bradley, Vanessa J Ramirez, Ross M Scallan, Pilar D Zuber, Kayla Enochs, Jesse Hillner, Mathias Fagan, E Jeffrey Metter
Introduction Musculoskeletal (MSK) injury is an inherent risk for military personnel that can potentially impact job performance, productivity, and military readiness. Evidence is needed to show the efficacy of nonpharmacological, self-managed therapies to reduce MSK symptoms at common injury sites that are feasible for use during expeditionary operations and home stations. This systematic review and
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Chlamydial Proctitis Mimicking Inflammatory Bowel Disease in a Young Active Duty Sailor With Undiagnosed Human Immunodeficiency Virus Infection: A Case Report Mil. Med. (IF 1.2) Pub Date : 2024-02-12 Logan Oliver, Kevin Pak, Adam Maier, Brett Sadowski
Proctitis is an inflammation of the lining of the rectum that can be either acute or chronic in presentation. Symptoms include rectal bleeding, constipation, rectal discharge, rectal pain, and tenesmus. It is commonly associated with inflammatory bowel diseases (IBDs) such as ulcerative colitis and Crohn’s disease. However, it is important to consider the infectious causes of proctitis such as the
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Disparities in Demographics in Hip Arthroplasty Between U.S. Active Duty Military and the ACS-NSQIP Clinical Registry Mil. Med. (IF 1.2) Pub Date : 2024-02-12 Vivek M Abraham, Joshua M Junge, Greg Booth, Aaron A Olsen, George C Balazs, Ashton H Goldman
Introduction Patient demographics, such as sex and age, are known risk factors for undergoing revision following primary total hip arthroplasty (THA). The military population is unique because of the increased rates of primary and secondary osteoarthritis of the hip. Treatment options are limited for returning patients to their line of duty; however, THA has been shown to be an effective option. The
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Cervical Disc Displacement in Military Pilots Mil. Med. (IF 1.2) Pub Date : 2024-02-09 Patrick J Tansey, Cory F Janney, Daniel C Jupiter, Matthew Henriques, Pouya Alijanipour, Patrick B Morrissey
Introduction Cervical disc displacement (CDD) may disqualify pilots from flying and have a profound impact on military unit capability. The objective of this retrospective database review is to characterize the incidence and demographic predictors of symptomatic cervical spine disc displacement in pilots of fixed- and rotary-wing aircraft and ground-based controls. Materials and Methods The Defense
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When a Critically Ill Child is Oceans Away From a PICU: A Military Pediatric CCAT Mission Mil. Med. (IF 1.2) Pub Date : 2024-02-08 Kevin M Brinkman, Luke Zabrocki, Noelle Cadotte, Renée I Matos
A 4-year-old former 26-week premature male presented to the U.S. Naval Hospital Guam emergency department in respiratory failure secondary to human metapneumovirus requiring urgent intubation. His condition was complicated by a bradycardic arrest requiring 15 minutes of resuscitation before the return of circulation. He was admitted to the adult intensive care unit and was managed via pediatric telecritical
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The Impact of Military Tobacco Control Policy: A Systematic Review Mil. Med. (IF 1.2) Pub Date : 2024-02-08 Muhamad Arham Bin Hashim, Khairul Fikri Bin Sebri, Muhammad Faiz Bin Mohd Hanim, Diyana Shereen Binti Anwar, Nawwal Alwani Binti Mohd Radzi, Ahmad Farhan Bin Ahmad Fuad, Budi Aslinie Binti Md Sabri
Introduction Tobacco use is synonymous with the military. Despite that military personnel are trained to follow commands, opportunities exist to implement various tobacco control strategies. We conducted a systematic review to evaluate the impact of tobacco control policy employed in military settings. Materials and Methods We searched for published English articles in Medline, Web of Science, Scopus
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Quantitative Analysis of Condition-based Limited Duty Duration of Musculoskeletal Conditions Mil. Med. (IF 1.2) Pub Date : 2024-02-08 Christopher S Smith, Laura Yoon, Julia N Zuppke, Mike Zundel
Introduction Musculoskeletal injuries affect nearly a million service members annually within the DoD, ultimately costing the U.S. Military half a billion dollars in direct patient costs and a significant loss to fleet readiness as many members are assigned days on limited duty (LIMDU) until they are deemed medically fit to return to duty (RTD). The new approach implemented by Navy Medicine in 2022
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Impact of Overseas Deployment on Fatty Liver and Metabolic Diseases Among Korean Soldiers Mil. Med. (IF 1.2) Pub Date : 2024-02-08 Chang In Han, Jaejun Lee
Background The prevalence of metabolic diseases is increasing worldwide and is influenced by multiple environmental, psychological, and dietary factors. As overseas deployment (OD) of Korean soldiers brings about changes in these factors, this study aimed to explore the impact of OD on metabolic diseases. Materials and Methods We collected paired health checkup data of Korean soldiers between January
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The Value of Strength as a Predictor of Musculoskeletal Injury in Canadian Armed Forces Basic Infantry Candidates Mil. Med. (IF 1.2) Pub Date : 2024-02-08 Eric Robitaille, Tara Reilly, Scott Heipel, Hollie Buttici, Etienne Chasse, Hans Christian Tingelstad
Introduction Musculoskeletal injuries (MSKI) impact military organizations by threatening their operational readiness, warranting investigation into relevant factors to inform risk reduction strategies. While several self-reported and physical performance measures have been associated with MSKI among military personnel, few have been validated and none have been reported in Canadian basic infantry
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Suspected Mal de Debarquement Syndrome: A Case Report Highlighting the Difficulty in Diagnosis and Management Mil. Med. (IF 1.2) Pub Date : 2024-02-08 Nathan M Tommas, Meagan Ferguson
MdDS is syndrome of oscillating vertigo following cessation of passive motion. The pathogenesis of this disorder is not well understood, but functional imaging studies suggest cortical connectivity dysfunction in feedback loops of the vestibulo-ocular system and visuo-spatial system. Patients go through multiple appointments and often specialist referrals before being diagnosed. After diagnosis, optimal
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Incidence and Risk Factors for Bone Stress Injuries in United States Air Force Special Warfare Trainees Mil. Med. (IF 1.2) Pub Date : 2024-02-07 Andrew S Johnson, Jean-Michel Brismée, Troy L Hooper, Courtney N Hintz, Benjamin R Hando
Objectives To determine (1) the incidence rate of lower extremity (LE) bone stress injuries (BSIs) in United States Air Force Special Warfare (AFSPECWAR) trainees during the first 120 days of training, and (2) factors associated with sustaining a LE BSI. Design Retrospective cohort study. Methods AFSPECWAR Airmen (n = 2,290, mean age = 23.7 ± 3.6 years) entering an intensive 8-week preparatory course
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The Fascial Distortion Model in Military Aircrew with Chronic Neck Pain: A Case Study Mil. Med. (IF 1.2) Pub Date : 2024-02-01 Allison J Fullenkamp
Musculoskeletal pain can be a significant safety risk to aircrew. Flight surgeons are the primary care providers for aircrew and are responsible for safely treating musculoskeletal pain. Certain medical interventions can be used to treat pain while maintaining the ability to fly safely. A previous F-18 Naval Flight Officer presented to the flight surgeon with chronic neck pain seeking noninvasive and
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Examining the Intersection of Strategic Thinking and Continuous Process Improvement Through the Lens of Military Medical Education to Build a Novel Model Mil. Med. (IF 1.2) Pub Date : 2024-02-01 Melanie M Lazarus, Ruth L Bush, Sara McNeil
In 2020, the U.S. Air Force School of Aerospace Medicine hired its first civilian dean since its founding in 1918, tasked with building the school’s first strategic plan to modernize and improve the institution. Using a combination of military continuous process improvement and academic strategic thinking, the dean produced a highly successful strategic plan. However, its resource-heavy and time-consuming
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Stability of One-Step Spray-on Splint for Lower Extremity Fractures During Splinting, MEDEVAC, and Impact Mil. Med. (IF 1.2) Pub Date : 2024-01-31 C Grace P Hobayan, Nathaniel A Bates, John Heyniger, Kenan Alzouhayli, Franco Piscitani, Clifton R Haider, Christopher Felton, Adam T Groth, Kevin D Martin
Introduction Military transport can induce whole-body vibrations, and combat almost always involves high impact between lower extremities and the ground. Therefore, robust splinting technology is necessary for lower extremity fractures in these settings. Our team compared a novel one-step spray-on foam splint (FastCast) to the current military standard structured aluminum malleable (SAM) splint. Materials
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Disguised Among the Sea: The Implications of Artificial Islands on Casualty Care in the Indo-Pacific Mil. Med. (IF 1.2) Pub Date : 2024-01-31 Ryan M Leone, Mason H Remondelli, Jason B Brill, Jay B Baker
As reported in the 2022 Biden-Harris National Security Strategy, China is perceived as the primary U.S. competitor with the intent and means to become the world’s greatest superpower. China’s efforts, which are at odds with America’s ambition to maintain its global influence, are complemented by ostensibly harmless “gray zone tactics,” defined as coercive geopolitical, economic, military, and cyber
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Return to Sport and Duty in French Military Personnel after Medial Opening Wedge High Tibial Osteotomy Mil. Med. (IF 1.2) Pub Date : 2024-01-31 Bernard de Geofroy, Lucas Chateau, Olivier Barbier, Thomas Demoures, Sébastien Coste, Laurent Mathieu, Nicolas de L’Escalopier, Camille Choufani
Introduction Medial opening wedge high tibial osteotomy (MOWHTO) is a surgical option for medial femorotibial osteoarthritis, which preserves articular cartilage by correcting the extra-articular deformities of the lower limbs that cause osteoarthritis. This is an increasingly popular treatment in a population with high functional demand, such as the French military population. The aim of this study
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Heart Rate Variability Biofeedback as a Treatment for Military PTSD: A Meta-Analysis Mil. Med. (IF 1.2) Pub Date : 2024-01-30 Jordan Kenemore, Grant Benham, Ruby Charak, Juventino Hernandez Rodriguez
Introduction Emerging research has provided tentative support for the use of heart rate variability biofeedback (HRVB) as a treatment for several psychological disorders, with meta-analyses providing compelling evidence for HRVB as a promising treatment for anxiety, depression, and PTSD. Given the prevalence of PTSD in military veterans and the comparatively lower benefit and higher attrition rate
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Aerosolized Particulate Matter and Blunting of Ciliary Dynamic Responses: Implications for Veterans and Active Duty Military in Southwest Asia Mil. Med. (IF 1.2) Pub Date : 2024-01-30 Alan D Workman, Robert J Lee, Noam A Cohen
Introduction Respiratory diseases such as chronic rhinosinusitis and asthma are observed at increased rates in active duty and veteran military members, and they are especially prevalent in individuals who have been deployed in Southwest Asia during Operation Iraqi Freedom and Operation Enduring Freedom. Particulate matter, specifically the fine-grain desert sand found in the Middle East, may be a
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An Assessment of Clinical Accuracy of Vital Sign–based Triage Tools Among U.S. and Coalition Forces Mil. Med. (IF 1.2) Pub Date : 2024-01-29 Tate E Vernon, Michael D April, Andrew D Fisher, Julie A Rizzo, Brit J Long, Steven G Schauer
Introduction Early appropriate allocation of resources for critically injured combat casualties is essential. This is especially important when inundated with an overwhelming number of casualties where limited resources must be efficiently allocated, such as during mass casualty events. There are multiple scoring systems utilized in the prehospital combat setting, including the shock index (SI), modified
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Evaluation of Gender Disparity in Tactical Combat Casualty Care Mil. Med. (IF 1.2) Pub Date : 2024-01-22 Shanna R Vaughan, Timothy Ballard, Pamela Ward-Demo, Leslie Vojta, Anwar E Ahmed, Amy Costello
Introduction Women comprise nearly 19% of the U.S. military and now serve in almost all operational roles, increasing their risk of combat trauma and injuries.3 Data from the Joint Trauma Registry during Operation Enduring Freedom shows that battle-injured females had a higher case fatality rate at 36% compared to their male counterparts at 17%.1 The Tactical Combat Casualty Care curriculum is used
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What We Know About Homeless Veterans With Other-than-honorable and Punitive Discharges: Data From the Grant and Per Diem (GPD) Program Mil. Med. (IF 1.2) Pub Date : 2024-01-22 Eric Jutkowitz, Ellen McCreedy, Christopher Halladay, Jack Tsai
Introduction The U.S. DVA Grant and Per Diem (GPD) program funds community agencies to provide housing and case management services to Veterans experiencing homelessness. GPD is one of the few VA programs that can enroll Veterans with Other-than-Honorable (OTH) military discharges. The characteristics of OTH Veterans and their outcomes in GPD are unknown. Materials and Methods We linked the Homeless
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Expedited Provisionalization of a Missing Crown: A Case Report Mil. Med. (IF 1.2) Pub Date : 2024-01-21 Andrew S Ryser, Steven E Handel, Jennifer V Sabol, Katie M Senkiw
Provisional restorations are required in fixed prosthodontics to protect a prepared tooth until a definitive restoration can be delivered. A patient sought treatment at a prosthodontics practice to replace a missing provisional crown until definitive treatment could be performed once the patient returned from a field exercise. This case report describes a novel way to provide a provisional restoration
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Dynamics of the Oral Microbiome During Initial Military Training at Fort Benning, Georgia Mil. Med. (IF 1.2) Pub Date : 2024-01-20 Kristina K Zudock, Robert Player, Amanda Ernlund, Collin M Timm, Caroline E English, Michael W Ellis, David R Tribble, D. Scott Merrell, Jason W Bennett, Eugene V Millar
Introduction Military trainees are at increased risk for infectious disease outbreaks because of the unique circumstances of the training environment (e.g., close proximity areas and physiologic/psychologic stress). Standard medical countermeasures in military training settings include routine immunization (e.g., influenza and adenovirus) as well as chemoprophylaxis [e.g., benzathine penicillin G (Bicillin)