Articles: function.
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Combat penetrating brain injury (PBI) differs significantly from PBI in civilian environments. Differences include technical factors such as the weapons involved, strained resource environments, and limited medical materials and human resources available. Ethical issues regarding the management of PBI in military settings may occur. ⋯ Nowadays, we possess the medical and surgical resources as well as the aeromedical evacuation capability to save the life of a soldier with a penetrating craniocerebral wound. Nonetheless, the functional outcome of this type of wound places military doctors in an ethical dilemma. The line of conduct and clinical protocol established by the French Medical Health Service is to manage all PBIs when the patient's life can be saved and to provide all available financial and social support for the rehabilitation of patients and their family.
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Compartment syndrome is usually due to trauma but can also have atraumatic causes. It is defined as a compromise of neurovascular and muscle function that presents symptomatically with the six P's: pain, pallor, paresthesia, paralysis, poikilothermia, and pulselessness. Diagnosis is confirmed by a delta pressure of <30 mmHg (diastolic blood pressure minus the compartment pressure). ⋯ The patient consequently underwent fasciotomy, eventually returning to baseline function without deficits. Awareness of this atypical presentation of compartment syndrome will assist providers in making a critical diagnosis and preventing severe complications and disability. This case also demonstrates the potential of disposable pressure transducers for cost-effective and accurate diagnostic confirmation of compartment syndrome in the emergency department.
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The subject of this study was the creation of a new type of laboratory walking stress test for the Special Forces of the Army of the Czech Republic. This study developed a test model that has been validated in practice and that reflects the fact that the performance of endurance without and with a load varies considerably. Especially, if we focus on operators, as their activities are always performed with loads/full gear (equipment, weapons, equipment, etc.). ⋯ The designed weighted walking test proved to be fully functional and effective in measurement. The further established protocol corresponds to the requirements of the current needs of the Special Forces of the Army of the Czech Republic. Last but not least, the walking stress test is applied for the external and internal selection and screening of operators. Data obtained from testing were used to develop deployment requirements for patrol/nuclear combat missions.
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Successful employment is a functional outcome of high importance for veterans after military discharge. There is a significant rising concern regarding exposure to military sexual trauma (MST) and related mental health outcomes that can impair functional outcomes, such as employment. Although resilience training is a key component of preparing for military service, to date the impact of resilience on employment outcomes for veterans with exposure to MST has yet to be examined. We sought to examine the relationship between resilience and employment in a national sample of post-9/11 veterans with and without MST exposure. ⋯ Among MST(+) women and men post-9/11 veterans, higher resilience was associated with increased odds of employment, whereas resilience was not associated with employment in MST(-) veterans. These findings suggest that resiliency during and after military service is a key component for potentially improving long-term outcomes. Improving resilience using evidence-based approaches among post-9/11 veterans exposed to MST may be an important avenue for increasing successful functional outcomes such as employment. Moreover, MST(+) women and men veterans may benefit from trauma-informed care as a substantial proportion of these individuals also report exposure to CST, AST, PTSD, and depression.
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Considering the potential of weaponized opioids, evaluating how prophylactic countermeasures affect military-relevant performance is necessary. Naltrexone is a commercially available Food and Drug Administration-approved medication that blocks the effects of opioids with minimal side effects. However, the effects of naltrexone on the health and performance of non-substance abusing military personnel are not well described in the existing literature. ⋯ Temporary (7-day) daily use of naltrexone was safe and did not negatively affect physical performance, cognitive functioning, marksmanship ability, or sleep in a healthy cohort of U.S. Army Soldiers.