Military medicine
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After the 1990 to 1991 conflict in the Persian Gulf, many Gulf War Veterans began reporting numerous unexplained symptoms including, but not limited to, systemic pain, fatigue, flu-like symptoms, and difficulty with memory/concentration. These symptom clusters are now referred to as Gulf War Illness (GWI). Although the etiology of GWI is still debated, as many as 250,000 former service members have been continually suffering from GWI since 1991, making the need for treatment urgent. A broad variety of treatments have been considered for GWI, but there has not been a broad and comprehensive assessment of what is known and not known about GWI treatment. We conducted a systematic review to catalogue the types of treatments that have been examined for GWI, to evaluate the effectiveness and harms of these interventions, and to identify promising and ongoing areas of future GWI treatment research. ⋯ Cognitive behavioral therapy (moderate SOE), exercise (moderate SOE), and mindfulness-based interventions (low SOE) may be effective in improving several symptom domains in patients with GWI. Doxycycline was ineffective and associated with harms (moderate SOE). Larger, more rigorous studies are needed to confirm the benefits found in completed trials. A wide array of treatments are being assessed in ongoing trials. A sufficient evidence base will need to be developed to guide clinicians about which treatments are most likely to be effective in clinical practice and which treatments should be avoided.
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The purpose of this study was to explore the rate of unmet healthcare needs among Korean enlisted soldiers and to examine the factors associated with unmet healthcare needs, based on Andersen's Health Service Behavior Model. ⋯ The strengthening of aspect of organizational culture, such as injury-prevention efforts at the military level, or support from superior officers, will contribute to a reduction of the unmet healthcare needs of Korean enlisted soldiers.
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The incidence of compartment syndrome of the lumbar paraspinal muscles is exceedingly rare. Approximately 24 hours following a high-intensity kettlebell swing workout, a 33-year-old Sailor presented to the medical department on board a forward deployed Wasp-class amphibious assault ship with increasing discomfort in his middle and lower back, and evidence of rhabdomyolysis. Discomfort quickly turned to unrelenting pain coupled with dorsal paresthesias and rigidity in the paraspinal muscles. ⋯ As a result of limited resources aboard the deployed ship, a negative pressure wound dressing was fashioned using the supplies available aboard the ship. Following 3 days of the negative pressure wound therapy, muscle bulging decreased substantially, and the skin was closed. After 4 weeks of physical therapy, he returned to full duty.
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Rates of sexually transmitted infections (STIs) are higher among U.S. military personnel than their civilian counterparts. Yet there is a paucity of military-specific research that has utilized theoretical frameworks to describe the relative influence of the multiple and interrelated risk factors associated with STIs in this population of young, healthy men and women. The aim of this study was to examine the relative influence of Information, Motivation, and Behavioral Skills Model (IMB) factors known to be associated with condom use and STI diagnosis, as well as examine gender differences among a cohort of young, active duty enlistees who are in the very early stages of their military careers. ⋯ Our findings support the need for development of STI prevention strategies that include education and skills-building approaches to reduce alcohol misuse among enlisted military personnel, and especially male personnel. Such programs should include factors that uniquely influence the experiences of males and females in the military context.
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The purpose of this study is to introduce a virtual radiology rotation curriculum that is being used to safely maintain medical student and intern education and engagement with the Department of Radiology at Walter Reed National Military Medical Center during coronavirus disease 2019 (COVID-19) mitigation. ⋯ A virtual rotation curriculum is a viable method of maintaining medical student and intern education and engagement with the department of radiology during COVID-19 mitigation.