Military medicine
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This study aims to examine whether having a sibling and/or a parent on active duty in the military is associated with suicidality-think about death, better off dead, think about suicide, plan suicide, and attempt suicide-among 12- to 17-year-old adolescent girls and boys in the United States. ⋯ Those working clinically with military families should be mindful of the association between suicidality and sibling military service, as well as parental military service. Programs aiming to reduce the negative impact of sibling deployment need to be developed and tested empirically. The current findings suggest the need for targeted family-centered approaches to suicide prevention among youth with siblings, parents, and potentially other relatives currently serving in the armed forces.
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Lower extremity fractures and musculoskeletal injuries are among the leading causes of morbidity for Special Operations Forces (SOF), frequently resulting in prolonged immobilization and weeks of therapeutic exercises and strength training to return to full status. This is a case of a 34-year-old Caucasian combat rescue officer with a stable right distal fibula (Weber B) fracture managed with early mobilization and assisted plantarflexion using a Dephy Exoboot device. ⋯ This case highlights the novel use of a commercially available exoskeleton device to minimize recovery time and speed return to duty for an injured SOF operator. Although further study is required to determine thresholds of safety and applicability, it suggests a potential role for assistive exoskeleton devices in the recovery of injured operators.
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The U. S. Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act expands benefits and services to U. ⋯ U. S. Veteran health care and policy are strengthened and informed by collaborative scientific knowledge, research, and innovation generated by bringing together stakeholders for effective implementation and sustained improvement of Veterans' health.
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Glycemic monitoring via Hemoglobin A1(HbA1c) proves to be inaccurate when a patient is diagnosed with a hemoglobinopathy/erythrocyte disorder. Moreover, any acute changes of glycemic intake within 6 weeks of blood sampling have been noted to impart a greater effect on HbA1c than the remaining days of the supposed overall 3-to-4-month average of glycemic control. Fructosamine, an alternative to HbA1c, allows physicians to analyze glycemic control in the presence of an underlying hemoglobinopathy/erythrocyte disorder. Fructosamine analyzes glycemic control over a two-to-three week period, compared to a 3-to-4-month period with HbA1c. Studies indicate that fructosamine is significantly correlated with HbA1c in various population types. Given the increased likelihood of hemaglobinopathies/erythrocyte disorders in the veteran population accompanied by the the necessity for tighter glycemic evaluation, fructosamine offers an assay for physician when analyzing glycemic control in veterans. The aim of our study was to evaluate the correlation of HbA1c and fructosamine in the veteran community. We hypothesize that fructosamine is significantly correlated with HbA1c in the veteran community and therefore can be used as an alternative assay in the Veterans Affairs. ⋯ Given that both correlation coefficient and coefficient of variance were considered significantly strong and the paired t-test indicated no significant difference between assay HbA1c and predicted HbA1c, fructosamine can be considered as an alternative assessment of glycemic control compared to HbA1c in the veteran community. We advise physicians at the Veterans Affairs to use fructosamine as an assessment of glycemic control when a veteran is diagnosed with an underlying hemoglobinopathy/erythrocyte disorder or requires stringent analysis of glycemic control. Yet, at this point of time, fructosamine does not have the necessary data to indicate complete replacement of HbA1c with fructosamine.
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Wounds are colonized frequently by heterogeneous microflora. Pseudomonas aeruginosa (PA) and Staphylococcus aureus (SA) are two of the most isolated bacterial species from wounds, and both typically form highly organized biofilms. Nitric oxide (NO) is a short-lived, diatomic, lipophilic gas with antimicrobial activity. Recently, NO and its derivatives have been shown to exhibit broad-spectrum antimicrobial activity against bacteria, viruses, and parasites. ⋯ These studies demonstrate that NO-releasing topical formulations effectively reduce the MRSA burden in established biofilms composed of multiple microorganisms. Minimal efficacy against PA was observed. It has been demonstrated that MRSA bioburden is significantly reduced when inoculated together with P. aeruginosa. A better understanding of mechanisms of host-bacteria interactions, in single or mixed species biofilms, may lead to the development of novel therapeutic approaches. Overall, NO offers a promising alternative treatment against MRSA in polymicrobial infections.