Body Armor and Lumbar Disc Herniation in Young Military Veterans: A Case Series
CONCLUSIONS: For military veterans, onset of lower back pain from a disc herniation at a young age may be linked to carrying heavy body armor and loads. However, the small sample size of this case series limits causal relationship inferences.PMID:38554267 | DOI:10.1093/milmed/usae131 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Akongnwi Jungong Cheo Dominic Nkafu Nkemngong Michael Mortenson Source Type: research

Occult Lung Cancer-Associated Autoimmune Encephalitis Presenting as Acute Psychosis
Mil Med. 2024 Mar 30:usae116. doi: 10.1093/milmed/usae116. Online ahead of print.ABSTRACTDuring deployment, a 52-year-old male developed acute behavioral changes. Though initially considered to have PTSD and related agitation and confusional state, his evaluation was consistent with acute encephalopathy. Magnetic resonance imaging of the brain showed T2 hyperintensities, and CSF analysis was positive for anti-N-methyl-D-aspartate receptor antibody. A nuclear protein in testis carcinoma midline carcinoma was discovered in the lung. Immunotherapy and surgical resection led to steady improvement prior to adjuvant chemotherapy...
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Shelly K McCarter K Robert Shen Mark E Wylam Source Type: research

The Military-Civilian Partnership Quality Improvement Program Concept: A Process to Improve Data Collection and Outcomes Assessment
CONCLUSIONS: The Military-Civilian Partnership Quality Improvement Program concept is an effective, locally driven process for enhancing the capture of external clinical workload data for military providers engaged in MCPs. Further examination of the Military-Civilian Partnership Quality Improvement Program process is needed at other institutions to validate its effectiveness and build a community of MCP champions.PMID:38554269 | DOI:10.1093/milmed/usae117 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Justin P Fox Ryan E Earnest Valerie Sams Source Type: research

Amplified PTSD Symptoms From Self-Attributed Moral Transgressions are Linked to Internalized Moral Identity During Military Deployment
CONCLUSIONS: The study highlights the significant role of self-attributed moral transgressions during deployment in the development of PTSS among military service members-especially in those with a strong internalized moral identity. This finding suggests a "target of opportunity" for the development of intervention strategies that mitigate PTSS by addressing the moral dimensions of military service.PMID:38554270 | DOI:10.1093/milmed/usae064 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Walter J Sowden Rachell L Jones Source Type: research

Clinical Readiness: Can Providers Learn to Perform Lower Leg Fasciotomy Through a Tablet-based Augmented Reality Surgical Training Environment?
CONCLUSIONS: Tablet-based AR procedural training improved procedural knowledge and tablet-based skills; however, those gains did not transfer to the ability to perform the procedure on a cadaver. The tablet's limited AR interface did not support the acquisition of requisite surgical technique, tissue handling, and decision-making in novice surgical trainees. Experienced surgeons may have different outcomes because their mature understanding of surgical constructs would allow extrapolation of abilities to other procedural contexts. Further investigation of the tablet-based training environments for surgical care is necessar...
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Kieran Wolf Mark Bowyer Matthew Bradley Brenton Franklin Elizabeth Weissbrod Ryan Dinnen Pamela Andreatta Source Type: research

Lessons Learned: Large-Scale Perfused Cadaver Training in Three Different Curricular Environments
CONCLUSION: Perfused cadavers can be implemented effectively for hemorrhage control training, surgical and procedure skills, and even exercises in austere environments, but require significant logistical and planning considerations. The training value is maximized with a progressive curriculum from hemorrhage control iterations to more invasive surgical procedures, such as thoracotomy and exploratory laparotomy.PMID:38554274 | DOI:10.1093/milmed/usae110 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Alex Y Koo David K Rodgers Marc H Hohman Jason R Muise Kyle S Couperus Jillian F Phelps Source Type: research

Addressing Differences in Knowledge and Experience in Trauma Care Capabilities Among an International Team of Military Medical Care Providers in a Deployed Setting
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 countries. Integrating medical teams from diverse backgrounds poses significant challenges in maintaining a cohesive and efficient team due to varying trauma management training standards and medical practices among the allied forces. Tactical Combat Casualty Care (TCCC) training and the development of clinical practice guidelines (CPG) by the US Joint Trauma Service have been key strategies...
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Sarah Holvelinsky Taylor Travers Joshua B Stierwalt Paul Schunk Brian Patrick Murray Source Type: research

Exploring Knowledge, Skills, and Abilities Needed for Army Pharmacist Readiness Using the Nominal Group Technique
CONCLUSIONS: With modernized, relevant KSAs, the Army can measure and train a ready pharmacy force. Individual Critical Tasks augmented with KSAs are one potential approach we recommend as a strategy to improve Army pharmacist health profession education.PMID:38554276 | DOI:10.1093/milmed/usae111 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Ryan C Costantino Eulho Jung Michael Soh Anita Samuel Source Type: research

The Link Between Somatization and Dissociation and PTSD Severity in Veterans Who Sought Help From the IDF Combat Stress Reaction Unit
CONCLUSIONS: While there is direct reference to dissociation in the clinical assessment by PCL or CAPS, there is no such reference to somatization. Highly functioning combatants sometimes express their distress somatically. Our findings suggest regarding severe somatic symptoms as diagnostic criteria for PTSD.PMID:38554277 | DOI:10.1093/milmed/usae118 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Nizan Shabat Uzi Bechor Nirit Yavnai Lucian Tatsa-Laur Leah Shelef Source Type: research

Cumulative Blast Impulse Is Predictive for Changes in Chronic Neurobehavioral Symptoms Following Low Level Blast Exposure during Military Training
CONCLUSIONS: These results indicate that measures of cumulative blast impulse may have utility in predicting changes in NSI scores. Such paired dosimetry-symptom measures are expected to be an important tool in safely guiding Service members' occupational exposure and optimizing force readiness and lethality.PMID:38553989 | DOI:10.1093/milmed/usae082 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Cory McEvoy Adam Crabtree John Case Gary E Means Peter Muench Ronald G Thomas Rebecca A Ivory Jason Mihalik James S Meabon Source Type: research

A Case of Multidrug-Resistant Tuberculosis in an Active Duty Military Health Care Worker
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 for U.S. Military medical practitioners. A 30-year-old active duty Soldier was referred to Army public health services after a bronchoscopy sample was positive for Mycobacterium tuberculosis complex. Sputum smears were negative for acid-fast bacilli, suggesting lower risk for community spread. One month after initiation of the standard 4-drug regimen for active TB, genetic susceptibility testing found the patient's M. tuberculosis isolate to be resistant to rifampin, is...
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Amanda E Saunders Kevin M Shanahan John W Downs Source Type: research

Pneumococcal Perplexity: Improving Awareness of Updated Pneumococcal Vaccination Recommendations in Two Large Military Treatment Facilities
CONCLUSIONS: There is a significant knowledge gap regarding ACIP pneumococcal vaccination recommendations among military providers and a low pneumococcal vaccination rate for adults aged 19 to 64 years with asthma at Joint Base-San Antonio MTFs. Focused education sessions were effective in increasing providers' knowledge of updated pneumococcal vaccination recommendations, confidence in recommending vaccines, total number of pneumococcal vaccinations given, and estimated pneumococcal vaccination rate for adults with asthma. The validity of conclusions drawn from our data were limited because of discordant numbers of survey...
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Curtis S Pacheco Joseph A Baxter Daniel Steigelman Source Type: research

Normative Values for the Head Shake Sensory Organization Test in an Active Duty Military Cohort
CONCLUSIONS: This study established normative values for the HS-SOT in a military population. Equilibrium scores did not differ between men and women or among age groups, suggesting that these values can be used as reference points for most service members. Postural stability was found to be significantly challenged during head motion, indicating the HS-SOT is a valuable tool for identifying subtle impairments in postural stability. These findings have important implications for early detection and intervention in individuals with medical conditions affecting balance, particularly concussions or vestibular disorders.PMID:3...
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Holly J Roberts Carrie W Hoppes Yadira M Del Toro Karen H Lambert Barbara A Springer Source Type: research

Efficacy of 1% Clotrimazole Powder Monotherapy for Treating Tinea Cruris: A Comparative Randomized Study
CONCLUSION: Monotherapy with 1% clotrimazole powder showed comparable efficacy to 1% clotrimazole cream. Furthermore, the powder treatment reduced sweat more effectively compared to the cream.PMID:38554260 | DOI:10.1093/milmed/usae105 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Punyawee Ongsri Nanchaya Na Bangchang Phuwakorn Saengthong-Aram Charussri Leeyaphan Penvadee Pattanaprichakul Sumanas Bunyaratavej Source Type: research

Modeling Risk for Lower Extremity Musculoskeletal Injury in U.S. Military Academy Cadet Basic Training
CONCLUSIONS: In addition to variables typically collected in this tactical setting (Injury History, BMI, and aerobic fitness), the inclusion of kinematic testing appears to enhance the precision of the risk identification model and will likely continue to be included in screening cadets at greater risk.PMID:38554261 | DOI:10.1093/milmed/usae083 (Source: Military Medicine)
Source: Military Medicine - March 30, 2024 Category: International Medicine & Public Health Authors: Darren W Hearn Zachary Yukio Kerr Erik A Wikstrom Donald L Goss Kenneth L Cameron Stephen W Marshall Darin A Padua Source Type: research