Military medicine
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One challenge clinicians face is determining when a military Service Member (SM) can return to duty after an injury that affects the postural control. The gold standard to measure postural control is the Sensory Organization Test (SOT). This test measures the amount of sway present in an individual's static stance that may be used to examine range of function and monitor recovery from injury. Normative values currently available were developed using a sample of clinically normal adults from the general population (i.e., civilian non-aviator). Previous research suggests that these values should not be used as a comparative cohort for high-performing populations in the military. However, normative values, specific to military SMs, do not exist. The aim of this study was to develop a normative clinical database for functional balance (i.e., the SOT) for military-trained aviators, an occupational specialty that may consist of high performers. ⋯ Army-trained aviators are high-functioning performers whose SOT scores differ from that of the general civilian population, particularly for the more challenging test conditions. New normative values were developed from this study population. Use of the developed normative values could be used as a comparative cohort in screening aviators who are recovering from injuries that affect postural stability.
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Critical Care Air Transport Teams (CCATTs) transport critically ill patients within and out of theaters of combat operations. Studies of the CCATT population reveal as many as 35% of patients have a non-trauma diagnosis, of which more than half are cardiac.The purpose of this retrospective study was to describe the epidemiology of critically ill patients with cardiac diagnoses evacuated from theater via CCATT. ⋯ Critically ill cardiac patients make up a significant portion of patients transported out of the combat theater. These patients are older, overweight and have identified risk factors for cardiac morbidity. More strenuous pre-deployment screening for risk factors and prevention strategies could minimize the use of military resources to evacuate these patients from the combat theater.
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Case Reports
Latent Lyme Disease Resulting in Chronic Arthritis and Early Career Termination in a United States Army Officer.
Lyme disease is a continuing threat to military personnel operating in arboriferous and mountainous environments. Here we present the case of a 24-year-old Second Lieutenant, a recent graduate from the United States Military Academy, with a history of Lyme disease who developed recurrent knee effusions following surgery to correct a hip impingement. ⋯ This case illustrates the profound effect that latent Lyme disease can have on the quality of life and the career of an active duty military member. It highlights the need for increased surveillance for Borrelia burgdorferi (B. burgdorferi) in military training areas and for the early and aggressive diagnosis and treatment of military personnel who present with the symptoms of acute Lyme disease.