Military medicine
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The majority of intratesticular masses are malignant. Although uncommon, benign lesions can be found as an intratesticular mass. An extremely rare lesion in the testicle is a leiomyoma, which has only been reported a handful of times in the literature. We report here a case of intratesticular leiomyoma, the associated imaging, and pathologic findings.
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Injuries are the most significant health problem of military services. Military medical surveillance data are useful for determining the magnitude and causes of the injury problem, identifying possible prevention targets and monitoring trends among military personnel. Soldiers serving in the Polish Armed Forces took part in the research. The aim of the study was to identify the most common injuries of the musculoskeletal system and to analyze causes of injuries. An additional goal was to examine whether there is a relationship between selected values of body composition indexes, the result of the functional movement screen (FMS) test and occurrence of an injury. ⋯ Parameters from the body composition analyzer such as body mass index, muscle mass distribution on lower limbs as well as evaluation in the FMS test may be helpful for the initial assessment of predisposition to injury.
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Combat-related injuries have declined substantially in recent years as we have transitioned to a low-volume combat casualty flow era. Surgeons must remain actively committed to training for the next engagement to maintain life and limb-saving skills. Soft tissue coverage procedures were imperative to the management of complex lower extremity trauma that occurred during recent conflicts. The purpose of this study was to evaluate advanced soft tissue coverage procedures performed on the lower extremity over the previous decade on military and civilian trauma patients at a Department of Defense Level 1 trauma center to provide data that can be used to guide future training efforts. ⋯ This data supports prior identified trends in military cases correlating increased number of procedures with increased combat activity related to the conflicts in Iraq and Afghanistan in 2007 and 2011, respectively. The data showed relative stability in the numbers of civilian procedures with a slight uptrend beginning in mid-2012. A comparison after mid-2012 shows military procedures declining and civilian procedures increasing to eventually become equivalent at the end of the data collection. These trends follow previously reported data on tibia fracture fixation procedures and lower extremity amputations for the same time periods. These data demonstrate the importance of the civilian trauma mission for maintaining surgical skills relevant to limb salvage, such as rotational and free flaps, during a low-volume combat casualty flow era.
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Virtual Health (VH) is posited to be a force multiplier for Military Medicine, delivering digital healthcare to the point of need for the warfighter. To date, there are no studies on the impact of both synchronous and asynchronous VH modalities during a deployment. VH usage by the 1st Squadron, 2nd Cavalry Regiment (1/2 CR) during a 6 month deployment to rural Poland was evaluated prospectively to identify mission days saved for Commanders. ⋯ Operational VH is a force multiplier that brings the resources of the Medical Center to the Warfighter at the point of need. The full spectrum of VH modalities offers the greatest benefit for deployed units. Expansion of these technologies throughout the Department of Defense will reduce medical evacuations, increase Active Duty Service Member time on mission, and reduce risks for Commanders.
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Intracranial subdural empyema is a rare clinical entity with incidence estimates of 0.1 per 100,000 people. The condition is most often the sequela of a primary infection elsewhere and carries a high morbidity and mortality. The authors present the case of a 22-year-old active duty soldier on mission on the southern border of the United States. ⋯ The patient was promptly transferred to a military tertiary care center where further workup including pivotal imaging confirmed subdural empyema and right transverse sinus thrombosis. Given the rapid patient deterioration associated with subdural empyema, the emergent intravenous antibiotics, neurosurgical consultation, and subsequent collection evacuation performed are likely to credit for saving this soldier's life. This case highlighted an atypical and time-sensitive etiology for a common complaint in the active duty population, which underscores the requirement for evacuation to higher roles of care in those soldiers with a similar diagnosis.