Military medicine
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The scope of military plastic surgery and location where care is provided has evolved with each major conflict. To help inform plastic surgeon utilization in future conflicts, we conducted a review of military plastic surgery-related studies to characterize plastic surgeon contributions during recent military operations. ⋯ Plastic surgeons continue to play a critical role in the management of wounded service members, particularly for complex extremity reconstruction, craniofacial trauma, and general expertise on wound management. Future efforts should evaluate mechanisms to maintain these skill sets among military plastic surgeons.
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We assessed the utility of a battery of neuropsychological, neurocognitive, physiological (balance, ataxia, postural tremor), and neuroimaging measures for studying the effects of blast waves in breachers-a population repeatedly exposed to low-level blast during military training and operations. ⋯ Our exploratory results suggest that self-report neuropsychological measures and structural MRI hold promise as sensitive measures for quantifying the long-term, cumulative effects of blast exposure in breachers. We discuss the limitations of our study and the need for prospective longitudinal data for drawing causal inferences regarding the impact of blast exposure on breachers' health and performance.
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The coronavirus disease 2019 (COVID-19) pandemic has had major clinical impact across the globe. Delayed presentation for medical emergencies has been noted by the medical community. There has been limited reporting on the impact for the care for emergent surgical conditions. We sought to describe the effect of the global pandemic on the presentation and outcomes for the most common urgent general surgery disease process, acute appendicitis. ⋯ The COVID-19 pandemic and the global systematic response has impacted unrelated medical and surgical conditions. At our overseas military hospital with minimal disease burden, we observed a delay in presentation for acute appendicitis with a higher incidence of perforation. Patients should be empowered to continue to seek care for urgent and emergent medical and surgical conditions so that they are not harmed by fear of COVID-19 rather than by COVID-19 itself.
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Dental Readiness Classifications (DRCs) enable the Military Health System to prioritize dental care in garrison, minimizing dental emergencies and mission degradation during deployments. Over half (52.4%) of 2008 military recruits presented with high-priority urgent needs classified as DRC3 upon initial dental examination and 18.1% required extensive treatment, needing 7 or more restorations, in order to achieve operational dental readiness. The purpose of this study is to identify risk indicators for urgent and extensive dental treatment needs in current U.S. Air Force (USAF) recruits so that Dental Corps leadership can target interventions to maximize oral health, prioritize resources, and reduce health expenditures in this patient population. ⋯ Among USAF recruits, oral health disparities are observed in certain groups. The study findings can inform targeted utilization of resources and interventions to efficiently optimize oral health and operational dental readiness and decrease dental expenditures. Additionally, a two-question screening tool is proposed to facilitate priority assignment for dental examination during boot camp. This tool has the potential to correctly identify nearly 90% of those with urgent and extensive dental treatment needs at half the typical workload.