Military medicine
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Randomized Controlled Trial
A Pilot Study to Examine Psychological and Neuropsychological Outcomes and a Novel Detoxification Program for Gulf War Illness.
Exposures to environmental toxins have been associated with severe health problems for approximately one-quarter of the nearly 700,000 U.S. soldiers who served in the Gulf War between the years 1990 and 1991. Gulf War illness still affects about 30% of Gulf War veterans (GWV), causing reduced psychological wellness and neuropsychological function. ⋯ We conclude that the detoxification procedure provided improvement in psychological and cognitive function for GWV and that future study is warranted.
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Randomized Controlled Trial
A Novel Stress Fracture Rehabilitation Program: A Pilot Study.
Stress fractures (SFx) of the tibia are common and limit military readiness, but there is presently no scientifically validated program that objectively fosters tibia SFx rehabilitation. Therefore, this pilot study evaluated the feasibility of a Graduated Exercise Program (GEP) based on the theory that programmed rest between exercise bouts improves the osteogenic response, which may enhance rehabilitation and military readiness. ⋯ This pilot study demonstrated the feasibility of a GEP with autonomy support, along with challenges and their solutions, providing the foundation for a formal large-sample study.
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Randomized Controlled Trial
Novel Phototherapy Kiosk Shows Promise as a Treatment Option for Low Vitamin D.
The purpose of this study was to demonstrate the feasibility of a phototherapy kiosk (PK) to engage community adults in health promotion and to stimulate production of circulating 25-hydroxyvitamin (OH)D as effectively as a vitamin D3 oral supplement (OS). Although optimal production of vitamin D comes from sun exposure, ultraviolet B radiation with a wavelength of 290 to 320 nm penetrates exposed skin and may produce vitamin D3 using a PK. ⋯ Programmed ultraviolet B phototherapy appears to be an efficacious alternative to oral vitamin D supplementation with consistent use.
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Randomized Controlled Trial
Splinting in Carpal Tunnel Syndrome: The Optimal Duration.
The purpose of this study was to evaluate optimal neutral wrist splint duration in treatment-naive mild and mild to moderate carpal tunnel syndrome (CTS). Neutral wrist splinting is a conservative treatment for CTS; however, no clear guidelines exist for how long splinting should be prescribed for optimal outcomes. ⋯ Neutral wrist splint for 6 weeks resulted in better clinical improvements in patients with untreated mild and mild to moderate CTS. There was no additional benefit in extending splinting 6 additional weeks. This is the first study to compare duration of wrist splint use beyond 8 weeks. A larger sample size is needed to identify the reason for lack of functional improvement in group B. Long-term follow-up of this cohort will be helpful to determine the natural history of initial wrist splint use.
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Randomized Controlled Trial
Effects of MOPP Gear on SAM Medical Junctional Tourniquet Application: A Prospective, Randomized Control Trial.
Hemorrhage is the leading cause of preventable death on the battlefield, and hemostasis is particularly challenging to achieve at junctional sites such as the axillary or inguinal regions. Mission-oriented protective posture (MOPP) gear, as worn most recently in Syria to guard against chemical weapons, can make the performance of technical skills more challenging still. The objective of this study was to evaluate how wearing MOPP gear affects the application time of the SAM Medical Junctional Tourniquet (SJT) by U.S. Army combat medics. ⋯ Wearing military MOPP gear significantly prolongs the amount of time required for combat medics to apply an SJT on a simulated casualty with a penetrating inguinal injury. This study highlights the importance of incorporating MOPP gear into medical training scenarios to improve skills competency while wearing these protective garments.