Military medicine
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Over the past three decades, a growing research base has emerged around the role of adverse childhood experiences (ACEs) in the biological, psychological, social, and relational health and development of children and adults. More recently, the role of ACEs has been researched with military service members. The purpose of this article was to provide a brief description of ACEs and an overview of the key tenets of the theory of toxic stress as well as a snapshot of ACEs and protective and compensatory experiences (PACEs) research with active duty personnel. ⋯ The contrast by rank and sex in relation to ACEs punctuates the need for attention to ACEs and protective factors among early career service members in order to promote sustainable careers in the military.
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Military personnel and civilian athletes are both at risk for mild traumatic brain injury. However, these groups are unique in their training and typical daily activities. A fundamental gap in the evaluation of military personnel following mild traumatic brain injury is the lack of military-specific normative reference data. This project aimed to determine if a separate normative sample should be used for military personnel on their performance of the Cleveland Clinic Concussion application and a recently developed dual-task module. ⋯ Differences in cognitive performance and postural stability measures may be influenced by demographic differences between military and civilian cohorts. Thus, military-specific normative datasets must be established to optimize clinical interpretation of Cleveland Clinic Concussion assessments.
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Breast cancer is the most frequent cancer detected for women, and while our ability to treat breast cancer has improved substantially over the years, recurrence remains a major obstacle. Standard screening for new and recurrent breast cancer involves clinical breast imaging. However, there is no clinically approved noninvasive body fluid test for the early detection of recurrent breast cancer. Materials and Method: In this study, we analyzed serum samples from both recurrent and nonrecurrent breast cancer patients by different proteomics methods to identify biomarkers in patients with recurrence of disease. ⋯ Our data indicated that the epigenetic regulation of inflammatory processes plays a critical role in breast cancer recurrence. The identified proteins could lay the groundwork for the development of a serum-based breast cancer recurrence assay.
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There is a tremendous opportunity to modernize the pharmaceutical manufacturing industry-relinquishing outdated machines that have been used for decades, and replacing them with state-of-the-art equipment that reflect more contemporary advanced technologies. This article describes how the implementation of continuous manufacturing, replacing outdated batch systems, can positively impact our health care sector. Important benefits will include the creation of advanced pharmaceutical manufacturing jobs in the United States, the establishment of capabilities and capacity to quickly produce drugs critical to U. ⋯ S. Government, in partnership with pharmaceutical companies, to address current issues such as drug shortages, national emergencies (eg, natural disasters or chemical, biological, radiological, or nuclear threats), the Strategic National Stockpile (ie, improving response time and reducing maintenance costs), and the delivery of critical drugs to distant geographies (eg, forward military bases). The article also provides a detailed example of a critical aspect of continuous manufacturing: the ability to overcome technical challenges encountered by batch technologies.
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Infection as sequelae to explosion-related injury is an enduring threat to our troops. There are limited data on the effects of blast on antibiotic pharmacokinetics (PK), pharmacodynamics (PD), and efficacy. The observational study presented here is our Institute's first attempt to address this issue by combining our existing interdepartmental blast, infection modeling, and in vivo PK/PD capabilities and was designed to determine the PK effects of blast on the first-line antibiotic, cefazolin, in an in vivo mouse model. ⋯ Our results indicate that blast-induced physiologic changes significantly influence cefazolin PK and suggest that efficacy could be affected in the context of the blast; assessment of efficacy and PD effects require further investigation. Metabolic changes resulting from blast may influence other classes of antibiotics and other therapeutics used with these injuries. Therefore, this may have important treatment considerations in other areas of military medicine.