Military medicine
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Significant mental health symptoms are reported in troops deployed to Iraq and Afghanistan (OEF/OIF). Symptomatic troops are more likely to be discharged and become eligible for Department of Veterans Affairs (DVA) care. Prevalence and predictors of mental health symptoms were assessed in 339 OEF/OIF veterans and reservists registering at the San Diego DVA. ⋯ Using a hierarchical logistic regression model, gender, age, race, and rank were not significantly related to PTSD caseness, whereas most recent branch of service and report of injury during combat were. Follow-up analyses revealed that trauma history and combat exposure varied by branch of service. Knowledge of base rates and vulnerability factors can aid in rapid detection of "at risk" individuals.
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Cerebral air embolism occurs very seldom as a complication of central venous catheterization. We report a 57-year-old female with cerebral air embolism secondary to removal of a central venous catheter (CVC). The patient was treated with supportive measures and recovered well with minimal long-term injury. The prevention of air embolism related to central venous catheterization is discussed.
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Comparative Study
Physician attire in the military setting: does it make a difference to our patients?
To examine patient preference regarding physician attire and whether perception of medical competence was influenced by the physician's clothing style. ⋯ Overall, female patients in a military setting do not have a preference for specific physician attire and attire does not influence their perception of the doctor's competence. However, a greater number of dependent wives report physician attire has no influence on their comfort level discussing both general and personal topics when compared with active duty women. This finding highlights the unique role of the military uniform in the eyes of active duty women and their potential discomfort in discussing personal medical issues with a physician in military uniform.
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We describe identified injuries, effectiveness of treatment, and triage categories for combat casualties at echelon 1 from April 1 to June 30, 2005 from western Iraq. A total of 133 casualties were evaluated including 12 who were killed in action and 7 who died of wounds. A medic or corpsman treated 75% of the remaining patients, 9% were treated by bystanders, 2% were seen by a physician or physician assistant, and 15% administered self-aid. ⋯ Field triage categories at echelon I and casualty evacuation categories at echelon II were congruent. No significant injuries were missed and there were no detrimental interventions. In conclusion, combat casualties were assessed, treated, and evacuated appropriately by echelon I providers during this time frame.