Military medicine
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Orthopedic injuries comprise a majority of combat injuries seen in recent U. S. military conflicts. Interventions in the forward deployed area have played an important role in improving mortality rates of soldiers as well as outcome at a medical center level. ⋯ The number of procedures performed did not affect the evacuation time. Fifty-six percent of casualties required operative intervention after arrival at WRAMC. With the unavoidable evacuation time that all casualties must endure regardless of severity of the injury, early operative intervention in forward deployed medical assets, such as the forward surgical team and combat support hospital, remains a necessity for rehabilitative and reconstructive efforts of the soldiers at the medical center level.
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The purpose of this study was to determine the factors associated with false-positive medial branch blocks (MBB), the nerve blocks used to diagnose facet arthropathy, in soldiers and retirees. ⋯ Although a high incidence of epidural and foraminal spread occurs during the performance of MBB, this is unlikely to be a significant cause of false-positive blocks.
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This study prospectively validated the Ottawa Ankle Rules (OAR) in patients presenting with acute ankle trauma to a deployed military clinic at Prince Sultan Air Base in Saudi Arabia. The treating physician determined whether the patient met OAR criteria. The decision to obtain radiographs was left to the discretion of the physician. ⋯ The sensitivity of the OAR was 1.0 and specificity was 0.40. Negative predictive value was 1.0, positive predictive value was 0.17, likelihood ratio positive value was 1.67, and likelihood ratio negative value was 0.0. The OAR correctly predicted all ankle fractures in the military population studied.
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The purpose of this study was to assess changes in alcohol, tobacco, and other drug use after the terrorist attacks of September 11 among a cohort of young military personnel consisting of 661 active duty Navy personnel, including 164 women. Paired sample t tests were computed to assess mean differences in substance use in the 30 days before and after September 11. ⋯ Significant increases in the usual number of cigarettes smoked and in the number of days using prescription drugs after September 11 were observed among enlisted personnel, but not among officers. Increased use of cigarettes and prescription drugs among enlisted personnel after September 11 suggests that some sectors of the military may turn to tobacco and other substances to cope with traumatic circumstances such as the events of September 11.