Military medicine
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Several adverse cutaneous reactions have been reported in the literature after SARS-CoV-2 vaccination with emerging reports on chronic spontaneous urticaria (CSU). However, there is little literature of chronic urticaria after COVID-19 boosters in a military population and the impact on operational readiness. We present a retrospective case series of CSU following Moderna COVID-19 booster vaccinations at the US Naval Academy (USNA). ⋯ Symptoms were controlled with antihistamines, and none required immunomodulator or immunosuppressive therapies. All students were able to complete their commissioning, and none were referred for a medical board. In this series, USNA students who developed CSU after the mRNA COVID-19 Moderna booster vaccine did not have limitations from commissioning, duty status, or issues with subsequent COVID-19 vaccinations.
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Longitudinal research regarding the pre- and post-separation experience has been relatively limited, despite its potential as a major life transition. Separating from the military and re-integration to civilian life is noted to be a period of increased risk of significant adjustment challenges, which impacts a service member in a multitude of areas. Active duty service members with combat-related physical or mental health or pre-existing adjustment conditions may be more likely to separate from service and more at risk for post-military service adjustment problems. ⋯ These results appear to support previous research depicting that, for some service members, transitioning out of the military and re-integrating into civilian life can be a challenging adjustment. Many factors, including personal and social circumstances, prior mental or emotional difficulties, availability of social or community support or resources, can influence the adjustment outcomes of veterans. Service members with prior adjustment difficulties and/or those with blast TBI history (and ongoing neurobehavioral symptoms) may find the transition from military to civilian life even more challenging, given the potential substantial changes in lifestyle, structure, identity, and support.
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The US Army Burn Center, the only burn center in the Department of Defense provides comprehensive burn care. The Burn Flight Team (BFT) provides specialized burn care during transcontinental evacuation. During Operations Iraqi and Enduring Freedom, burn injuries accounted for approximately 5% of all injuries in military personnel. To augment BFT capacity, US Air Force Critical Care Air Transport Teams (CCATTs) mobilized to transport burn patients. The purpose of this study was to describe critically ill, burn injured patients transported to the US Army Burn Center by BFT or CCATT, to compare and contrast characteristics, evacuation procedures, in-flight treatments, patient injuries/illnesses, and outcomes between the two groups. ⋯ Evacuation by the BFT was associated with increased ICU and ventilator days, increased mortality, and a greater risk for developing renal failure. The severity of injury/TBSA likely accounted for most of these differences.
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To determine if universal access to care for military beneficiaries improves timing of presentation to prenatal care (PNC) in adolescent and young adult (AYA) pregnancies, improving maternal and neonatal outcomes. ⋯ Our findings suggest that expanded universal access to health care may improve AYA pregnancy and delivery outcomes. Infants born to AYA military beneficiaries have improved neonatal outcomes compared to nationally published data. These results may correlate to improved maternal access within a free or low-cost healthcare system.
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Fitness is a vital component in military success. The Army is in the process of implementing a new assessment for soldier fitness, the Army Combat Fitness Test (ACFT). Success on the assessment is a major factor in job assignments and promotional opportunities. This generates questions related to modifiable (i.e., fitness and body composition) and non-modifiable (i.e., limb length and testing equipment) factors impacting performance. Currently, anthropometrics differences in ACFT performance have not been investigated. Thus, this study aimed to assess the impact of anthropometrics on ACFT performance in Reserve Officer Training Corps Cadets. ⋯ Hand and lower leg length significantly impact ACFT performance. These results present practical information to individuals responsible for developing protocols and scoring for the ACFT. Reassessment of events and the equipment utilized are warranted to assure that event performance is not hindered by a non-modifiable factor that is not representative of fitness or occupational demands. Future work should investigate how different trap-bar and kettlebell handle sizes, as well as medicine ball sizes, impact performance on the ACFT.