Military medicine
-
Ex vivo normothermic limb perfusion (EVNLP) provides several advantages for the preservation of limbs following amputation: the ability to maintain oxygenation and temperature of the limb close to physiological values, a perfusion solution providing all necessary nutrients at optimal concentrations, and the ability to maintain physiological pH and electrolytes. However, EVNLP cannot preserve the organ viability infinitely. We identified evidence of mitochondrial injury (swelling, elongation, and membrane disruption) after 24 hours of EVNLP of human upper extremities. The goal of this study was to identify metabolic derangements in the skeletal muscle during EVNLP. ⋯ This study showed presence of active metabolism during EVNLP and metabolic derangement toward the end of perfusion, which correlated with detection of altered mitochondrial structure, swelling, and elongation.
-
Civilian and military research has linked parental illness and injury with increased overall mental health care and psychiatric medication use in children. Care for specific mental health conditions and medications by child age have not been reported. ⋯ Parental illness/injury is associated with increased mental health care and days of psychiatric medication use in dependent children. Practitioners who care for families impacted by parental illness/injury should be cognizant of children's mental health risk. Early identification and treatment of child-related mental health issues can improve family functioning and increase military family readiness.
-
There is increasing interest in assessing gender and race-based disparities in academic medicine and healthcare leadership in civilian medicine and the U.S. Military Health System. Approximately 15% of U.S. active duty service members are women, and racial minorities are 30% of the total active duty force. This study evaluates the following factors among uniformed services family physicians: gender and race representation in attaining early career leadership positions during training and 2 years postresidency; perceptions regarding leadership opportunities and career advancement. ⋯ This study provides important information about perceived gender and race equality among uniformed services family physicians. Key findings included that non-Caucasian military family physicians were less likely to attain junior leadership positions or be assigned to academic settings; and female respondents were more likely to agree that gender has a role in assignment of leadership positions. Evaluating composite personnel records of services' family physicians would provide invaluable information to complement this study.
-
Negative Pressure Wound Therapy (NPWT) is a procedure used for nonhealing wounds. In NPWT, a special sealed dressing of large cell foam (>400 µm) or gauze is connected to a pump. Most commonly, negative pressures between -10 and -125 millimeters of mercury (mm Hg) are used. The mechanism of healing is unknown but maybe attributable to removal of the exudate and bacteria, and the stimulation of tissue repair through microdeformation. Reticulated foams with micron-size open cells, Capillary Suction Devices (CSD; 100 to 5 µm) exert capillary suction between 10 and 70 mm of Hg with a multilayered foam dressing. ⋯ This data indicate comparable wound closure efficacies for CSD-70 and NPWT. It is felt that CSD is an effective, safe, and lower cost alternative to vacuum-assisted NPWT.
-
Military personnel during training and military operations are exposed to a large number of repeated exposures to low-level blast overpressure from a variety of sources. These exposures rarely produce a concussion, but anecdotal evidence from soldiers indicates that it can still cause transient neurological effects. Impulsive acoustic sources, such as the ones encountered during military training, are characterized by a broadband energy distribution with resulting pressure measurements that exhibit frequency components well within the infrasound range. This infrasound can couple directly with the human body and in this way alter or influence physiological processes up to inducing concussion-like symptoms. ⋯ The results presented in this article suggest that reported symptoms from military personnel exposed to repeated low-level blast may also be because of acoustic loading. Therefore, to take into account these findings, future studies aimed at characterizing the effects of repeated low-level blast exposure should consider including acoustic measurements in their investigations.