Military medicine
-
Body armor and torso-borne equipment are critical to the survivability and operational effectiveness of a soldier. Historically, in-service designs have been predominantly designed for males or unisex, which may be disadvantageous for females who are shaped differently and, on average, smaller in stature and mass than their male counterparts. This study assesses the biomechanical and performance impact of two Canadian in-service armors and fighting load conditions on females. ⋯ Improved outcomes for the RC can be attributed to design differences. The lower placement of bulk in FTC may act as a physical barrier during range of motion tasks and the wall obstacle. The presence of shoulder caps on FTC provides another physical barrier that likely impedes full movement through the arms and shoulders. While the narrower shoulder straps of the RC remove the barrier, it causes more concentrated skin pressures on the shoulder that can lead to injury. The results suggest that the RC offers a potential for increased operational effectiveness in females (and potentially for males) compared to the FTC system. Shoulder pressure, an important predictor of discomfort and injury, is the only measure for which FTC outperformed the RC. Future torso-borne equipment designs targeting this outcome measure could help increase the effectiveness of the RC and other similar systems that reduce torso coverage, though survivability implications must also be considered.
-
Many service members (SMs) have been diagnosed with traumatic brain injury. Currently, military treatment facilities do not have access to established normative tables which can assist clinicians in gauging and comparing patient-reported symptoms. The aim of this study is to provide average scores for both the Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) for active duty SMs based upon varying demographic groups. ⋯ Clinicians and healthcare administrators can use the scores reported in this study to determine where SM NSI or PCL-5 scores fall within the average for their demographic group.
-
The incidence of ischemic stroke in the young is on the rise. With young stroke victims, providers must consider both typical risk factors and other rare causes. We present a case of a healthy, 38-year-old female military dependent who presented with an ischemic right posterior central gyrus stroke in the setting of a patent foramen ovale and supplement diindolylmethane use. This case serves as a reminder of the hazards associated with supplement use and the importance of a thorough investigation of etiology in medical cases of ischemic stroke in the young.
-
Hyperkalemia is a common electrolyte abnormality with characteristic electrocardiogram changes. Both angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) increase the risk of developing hyperkalemia. This case highlights a rare life-threatening episode of hyperkalemia in an individual whose only risk factor was an ARB. ⋯ While both ARBs and ACEIs are commonly associated with mild hyperkalemia, life-threatening hyperkalemia is rare, particularly in patients without concomitant renal failure, diabetes mellitus, adrenal disease, or potassium-sparing diuretic use. However, this case illustrates that life-threatening hyperkalemia is possible in patients solely taking an ARB without prior significant risk factors. Despite normal renal function in an individual without heart failure or diabetes, this patient developed life-threatening hyperkalemia.
-
Military operations provide a unified action and strategic approach to achieve national goals and objectives. Mortality reviews from military operations can guide injury prevention and casualty care efforts. ⋯ Comprehensive mortality reviews should routinely be conducted for all military operation deaths. Understanding death from both injury and disease can guide preemptive and responsive efforts to reduce death among military forces.