Military medicine
-
Case Reports
Prepatellar septic bursitis: a case report of skin necrosis associated with open bursectomy.
Patients with prepatellar septic bursitis are typically successfully managed nonoperatively with rest, compression, immobilization, aspiration, and antibiotics. Rarely, surgical excision of the bursa may be required for recalcitrant cases. Prepatellar bursectomy, however, has been associated with considerable risk of surgical-site morbidity. Although skin necrosis is frequently cited as a complication of open bursectomy, there is limited information in the medical literature on the etiology and management of this rare but serious complication.
-
Randomized Controlled Trial
Cardiopulmonary resuscitation in the combat hospital and forward operating base: use of automated external defibrillators.
Time to defibrillation (t(defib)) directly correlates with survival from cardiac arrest. We investigated whether automated external defibrillators (AED) in a combat setting would improve this crucial variable. ⋯ In simulated cardiac arrest, the AED model demonstrated significantly improved t(defib) compared to the standard response for both training and combat settings.
-
Comparative Study
Recovery of multidrug-resistant bacteria from combat personnel evacuated from Iraq and Afghanistan at a single military treatment facility.
U. S. combat casualties from Iraq and Afghanistan continue to develop infections with multidrug-resistant (MDR) bacteria. This study assesses the infection control database and clinical microbiology antibiograms at a single site from 2005 to 2007, a period when all Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) casualties admitted to the facility underwent initial isolation and screening for MDR pathogens. ⋯ There were remarkable changes in resistance profiles for Acinetobacter, K. pneumoniae, and S. aureus over time. Despite aggressive infection control procedures, there is continued nosocomial transmission within the facility and increasing antimicrobial resistance in some pathogens. Novel techniques are needed to control the impact of MDR bacteria in medical facilities.
-
Phytophotodermatitis is a phototoxic dermatologic reaction that occurs with exposure to ultraviolet light after contact with certain plant chemicals. Recognition is vital to proper management and avoidance of unnecessary distress for patients. Sun-sensitizing compounds, known as furocoumarins, are found in many plants (limes, celery, and natural grasses) and are excited by ultraviolet A (UVA) irradiation. ⋯ Accurate diagnosis avoids unnecessary concern by patients and potential misdiagnosis of abuse. Consider phytophotodermatitis when hyperpigmentation in bizarre streaks on sun-exposed areas with vesicles in a nondermatomal distribution is present. Presented is an illustrative case.
-
to evaluate the treatment of the acute coronary syndrome (ACS) among soldiers stationed on a theater of operations by structures usually conceived to treat combat-related trauma. ⋯ the medical structures deployed in a theater of operations were able to provide first treatment in ACS. The use of powerful diagnosis test, like troponine assay, must allow a better selection of the patients justifying a medical evacuation.