Military medicine
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Chronic tendon pain from overuse is a common condition, with limited options for ongoing pain management. Two cases are presented in which pulsed radio frequency energy (PRFE) therapy was used for pain relief following surgical intervention for chronic tendinopathy-associated pain, unresponsive to conventional therapies. ⋯ Recent molecular evidence suggests a possible mechanism underlying PRFE-mediated pain relief. Further study into this promising technology is warranted.
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Randomized Controlled Trial
Emergency physician evaluation of a novel surgical cricothyroidotomy tool in simulated combat and clinical environments.
We sought to investigate the performance of a novel cricothyroidotomy CRIC device compared to the traditional surgical in both simulated combat environments and the emergency department (ED) setting. Twenty U. S. ⋯ Time to incision, time to procedural completion, and rate of major and minor complications were not significantly different between the standard surgical method and the CRIC device (p > 0.05). In the simulated ED setting, 60% of participants preferred the standard surgical method (95% confidence interval: 38.5-81.5), whereas in the simulated combat settings, 50% of participants preferred each device (95% confidence interval: 28.1-71.9). In our population, we observed similar operator performance characteristics and physician preferences between the 2 methods in all simulated cricothyroidotomy settings.
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Many veterans returning from Afghanistan and Iraq experience serious mental health (MH) concerns including substance use disorders (SUD), post-traumatic stress disorder, traumatic brain injury, depression, or serious psychological distress (SPD). This article uses data from the 2004 to 2010 National Survey on Drug Use and Health to examine the prevalence of unmet MH needs among veterans aged 21 to 34 in the general population. ⋯ These findings suggest that reducing unmet need for MH treatment for veterans in the general population may require improving outreach to all Americans and creating greater acceptance for MH treatment. The need for further analyses of reasons for not obtaining treatment is discussed.
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Traumatic brain injury patients are susceptible to secondary insults to the injured brain. A retrospective cohort study was conducted to describe the occurrence of secondary insults in 63 combat casualties with severe isolated traumatic brain injury who were transported by the U. S. ⋯ The hyperthermia rate increased across the continuum, which has implications for en route targeted temperature management. Hypoxia occurred most frequently within the area of responsibility, but was rare during CCATT flights, suggesting that concerns for altitude-induced hypoxia may not be a major factor in the decision when to move a patient. Similar research is needed for polytrauma casualties and analysis of the association between physiological status and care across the continuum and long-term outcomes.