Military medicine
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A 37-year-old male presented to the emergency department with the complaint of periumbilical abdominal pain, radiating to just above pubic symphysis. The patient reported that the pain was worse with urination and associated with chills and nausea. This case reports discusses the Emergency Department (ED) course and subsequent treatment of a patient found to have an infected urachal cyst, a previously asymptomatic embryological anomaly in an otherwise healthy middle-aged adult male. This is a crucial diagnosis to make in order to avoid the potential for significant morbidity and/or mortality, given the unlikely symptomatic source.
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Disease epidemics have threatened American military preparedness and operational capabilities since 1775. The ongoing Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) pandemic, which began in 2019, again demonstrates the significant potential for infectious diseases to impact military units and threaten military readiness. We reviewed the historical and continuing threats to the U. ⋯ S. Military capabilities for conducting meaningful surveillance and response. We concluded that a structured review of military public health and preventive medicine capabilities should be conducted to assess the response to the COVID-19 pandemic and determine the capabilities necessary for infectious disease surveillance and response to future threats.
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Computed tomography (CT) Hounsfield units (HU) recently emerged as a promising screening tool for low bone mineral density (BMD). We hypothesized that CT HU measurements of the thoracic spine would significantly and positively correlate with dual X-ray absorptiometry (DXA) BMD scans of the femoral neck. ⋯ Thoracic vertebrae HU measurements correlate with a low BMD of the femoral neck as determined by DXA T-scores. A high sensitivity and negative predictive value was achieved with a screening value of 231 HU. Utilization of chest or thoracic spine CT imaging as a screening method provides a quick and available screening tool for assessing low BMD in patients with these scans.Level of Evidence: III (Diagnostic).
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Military general surgeons commonly perform urologic procedures, yet, there are no required urologic procedural minimums during general surgery residency training. Additionally, urologists are not included in the composition of forward operating surgical units. Urologic Care Army/Air Force/Navy Provider Education was created to provide military general surgeons with training to diagnose and treat frequently encountered urologic emergencies when practicing in environments without a urologist present. ⋯ We created the first-ever urologic emergencies simulation curriculum for military general surgeons that has demonstrated efficacy in improving the diagnostic confidence, procedural confidence, and topic knowledge for the urologic emergencies commonly encountered by military general surgeons.
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Vaccine technology has improved substantially since the first smallpox vaccine, developed more than 200 years ago. As technology improves, vaccines can be produced more safely and reliably for many different pathogens. A recent breakthrough saw the first full deployment of mRNA vaccines to fight a pandemic. Despite the technological and logistical feat of developing a viable vaccine in an abbreviated time frame, there have been many questions about this new approach to vaccine development. The current review will provide descriptions about different types of vaccines as well as answers to some common questions about mRNA vaccines. The purpose is to provide military medical professionals with the information needed to better convey the importance and function of these new vaccines to service members. ⋯ These mRNA vaccines are the newest and most sophisticated defensive tool military medicine has against emerging biological threats. Evolving dangers, such as synthetic biology and engineered pathogens, further enhance the importance of having defensive countermeasures that can be rapidly deployed in response. Current evidence suggests high safety and effectiveness for a biological countermeasure, decades in the making, and military medical personnel should feel confident using and recommending this technology to ensure force health protection.