MSMR
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Among non-service member beneficiaries of the Military Health System, there were 79,820 cases of appendicitis and 98,385 appendectomies during 2002 to 2011; from the fi rst to last year of the period, the annual number of appendicitis cases increased by 61.1 percent. Perforated acute appendicitis occurred in one quarter of all cases; the proportion of perforated cases was higher among males (30.2%) than females (23.3%). ⋯ During the period, the number of nonincidental appendectomies that were not associated with diagnoses of appendicitis ("negative appendectomies") decreased by 65 percent, and the mean number of inpatient bed days per appendicitis case decreased by one day (21.1%). The findings likely reflect more frequent uses of and advances in diagnostic imaging to detect and characterize appendicitis and a shift in surgical treatment to the outpatient setting with increasing use of laparoscopy for appendectomies.
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This report estimates the health care burden related to the wars in Iraq and Afghanistan by calculating the difference between the total health care delivered to U. S. military members during wartime (October 2001 to June 2012) and that which would have been delivered if pre-war (January 1998 to August 2001) rates of ambulatory visits, hospitalizations, and hospital bed days of active component members of the U. S. ⋯ Army and Marine Corps members and service members older than 30 accounted for the majority of excess medical care during the war period. The illness/injury-specific category of mental disorders was the single largest contributor to the total estimated excesses of ambulatory visits, hospitalizations, and bed days. The total health care burdens associated with the wars in Afghanistan and Iraq are undoubtedly greater than those enumerated in this report because this analysis did not address care delivered in deployment locations or at sea, care rendered by civilian providers to reserve component members in their home communities, care of veterans by the Departments of Defense and Veterans Affairs, preventive care for the sake of force health protection, and future health care associated with wartime injuries and illnesses.
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From July 2011 through June 2012, the number of active and reserve component service members treated for cold injuries (n=499) was lower than the number in each of the four previous one year periods. Over the last five years, frostbite was the most common type of cold injury in all the Services except for the Marine Corps, in which hypothermia was slightly more frequent. ⋯ Army personnel accounted for the majority of cold injuries. Service members who train in and deploy to areas with wet and freezing conditions - and their supervisors at all levels - should be able to recognize the signs of cold injury and should know and implement the standard countermeasures against the threat of cold injury.
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During 2002-2011, active component U. S. service members sustained 4,657 firearm-related injuries in circumstances other than deployment to the wars in Iraq/Afghanistan; 35 percent of the injuries were fatal. The highest firearm-related injury rates reflected service members in law enforcement/security and combat occupations. ⋯ However, firearm-related fatality rates were stable among civilians but increased among military members. The increase in rates of firearm-related fatalities among non-deployed military members reflects the increase in rates of suicides by firearms. Rates of injuries due to BB, pellet or paintball guns also increased during the period.