Military medicine
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Susac syndrome can resemble various disorders resulting in a delayed or missed diagnosis and subsequent delays in treatment. Here, we present how successful consideration of patient history, symptoms, and ancillary testing led to prompt diagnosis and treatment of Susac syndrome by ophthalmologists. A 27-year-old active duty infantryman presented with sudden vision loss in the right eye during strenuous exercise after experiencing similar symptoms in the left eye 5 months earlier. ⋯ Identification of branch retinal artery occlusions on fluorescein angiography and low-to-mid frequency hearing loss confirmed the diagnosis of Susac syndrome. The patient was immediately treated with high-dose oral prednisone and subsequently transitioned to rituximab infusions to preserve vision. Susac syndrome should be considered when a patient presents with vision loss, hearing deficits, and or cognitive changes, even if symptoms are separated by time and seemingly attributed to more common causes.
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The dearth of research investigating the efficacy of virtual Army Combat Fitness Test (ACFT) training programs among female populations necessitates further exploration. This study aims to evaluate the effectiveness of a 12-week ACFT virtual exercise program among female participants. ⋯ Following the intervention, female participants experienced a significant increase of approximately 7% in their overall ACFT scores, with upward trends observed across all 6 individual ACFT events. These findings suggest that 12-week virtual suspension training can be a valuable tool for enhancing physical fitness and performance among female participants, particularly within the context of military readiness.
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High occupational stress is generally associated with poorer mental health and reduced performance in military personnel, whereas access to support resources is associated with positive outcomes. However, little research has examined the unique stressors and supports experienced by sailors on ships while underway at sea. The objectives of this study were to (1) identify sailors' underway stressors and supports and (2) examine how these differ as a function of demographic and operational factors. ⋯ Sailors experience many stressors while underway. Increasing the resources available to underway sailors may be warranted, especially for female and enlisted personnel. Additional research is necessary to develop targeted interventions and resources. Possible recommendations include noise mitigation, berthing area improvements, sleep and/or scheduling interventions, improved access to mental and physical health care, and interventions to reduce the stigma associated with seeking mental health care.
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Annular atrophic lichen planus (AALP) is a chronic subtype of lichen planus that classically does not respond to treatment with topical steroids. An inflammatory reaction in the dermal infiltrate may play a role in the development of AALP, but the exact pathogenesis remains unclear. ⋯ Although vaccine-induced lichen planus is not common, it has been reported in various cases. We present a rare case of AALP following vaccination and then provide an in-depth discussion of factors associated with the condition and current treatment response.
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The storage of reusable medical devices (RMDs) is the final reprocessing phase and the step that directly precedes point-of-care delivery. Reusable medical devices, including surgical tools necessitating sterilization and semicritical devices such as endoscopes, undergo high-level disinfection. The rigorous reprocessing protocols and subsequent storage of RMDs are crucial in preserving their sterility and asepsis. This ensures they are available, clean, and safe for patient use, thereby significantly reducing the risk of surgical site infection. The stringent requirements for RMD storage are a testament to the critical role it plays in patient safety, making it a demanding task for health care organizations (HCOs) to comply with. These challenges are further amplified in austere environments. This integrative review aims to identify optimal storage practices, emphasize the critical importance of RMD storage in the Military Health System, and derive implications for policies and future considerations. ⋯ Although surgical teams' capabilities are crucial in delivering effective care in a dynamic environment, the management and storage of RMDs are equally essential. Numerous organizations have outlined rigorous guidelines for HCOs to comply with, which can be intensified in austere conditions. Ultimately, a commitment to integrating the literature and developing the groundwork for clinical practice guidelines can improve the safe storage of RMDs in both standard and austere environments.