Military medicine
-
A 25 year-old male presented with penetrating chest trauma to a split forward surgical team located in an austere setting. Due to limited resources and a minimal monitoring in-transit a regional anesthetic was placed for pain control. This is the first description of an Erector Spinae Block utilized in a far forward combat setting.
-
Posttraumatic stress disorder (PTSD) negatively impacts service members at high rates, causing considerable physical and psychological consequences. Additionally, many service members experience subthreshold PTSD (i.e., experiencing PTSD symptoms that do not meet full diagnostic criteria), which has also been shown to cause significant functional impairment and can be a precursor to the development of full PTSD. Typically, treatment for PTSD at Walter Reed National Military Center facility includes weekly outpatient individual therapy over a three-month period or referral to an intensive outpatient program (IOP), which emphasizes group treatment. Inclusion in these programs is dependent on the severity of symptoms. Service members with subthreshold symptoms do not typically qualify for an IOP, and weekly outpatient therapy does not meet the needs of some service members or their commands. ⋯ The opinions expressed in this abstract are those of the authors and do not necessarily represent the opinions of the Uniformed Services University of the Health Sciences, the Department of Defense, or the United States Government. Additionally, the authors have no conflicts of interests to report.
-
Within the text we elaborate on the relationship between war and medicine, particularly as it pertains to neurosurgery and the management of brain trauma, and emphasize neurosurgical advancements in the treatment of brain trauma gleaned from U. S.-involved conflicts of the 21st century.
-
Often referred to as aseptic or osteonecrosis, avascular necrosis (AVN) typically affects people between 30 and 50 years of age. Given the substantial morbidity associated with AVN as well as overlapping age groups of both the military and average age at diagnosis for AVN, the military represents an ideal cohort for a large database study to elicit the incidence and epidemiology of AVN. The purpose of this study was to identify demographic risk factors in the United States military. ⋯ The overall incidence of AVN was 0.19 per 1,000 person-years. Whilte increasing age had the greatest influence on the development of symptomatic AVN, other statistically significant risk factors were found to be increasing age, black race, senior enlisted rank, and Army branch of service.