Military medicine
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Obstetric fistulae are a leading scourge for women in developing countries resulting, in severe individual suffering and devastating socio-economic repercussions for her family and community. The underlying causes of obstetric fistula stem from multiple factors to include poor nutrition, early marriage, insufficient education and inferior social status of women as well as substandard medical care. The US Agency for International Development (USAID) has invested more than $100 million globally since 2004 to address these factors as well as support women suffering with fistulae. The ultimate goal is to eradicate obstetric fistula in Bangladesh in the next 20 years. Despite these efforts, nearly 20,000 women in Bangladesh, still suffer with this malady. ⋯ This IAA was the first USAID funded and DoD-executed health mission in the US Indo-Pacific Command Area of Responsibility. Direct participation in the IAA enabled TAMC to support the US Indo-Pacific Command Theater Campaign Plan, the Department of Defense Instruction 2000.30 on Global Health Engagements, the USAID Country Development Cooperation Strategy, and the US Ambassadors Integrated Country Strategy Objectives in Bangladesh. This effort can serve as a model for future cooperation between USAID and the DoD.
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A 25 year-old male presented with penetrating chest trauma to a split forward surgical team located in an austere setting. Due to limited resources and a minimal monitoring in-transit a regional anesthetic was placed for pain control. This is the first description of an Erector Spinae Block utilized in a far forward combat setting.
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Lyme arthritis is the most common manifestation of late Lyme disease in children. Lyme disease is known to be endemic to Japan, but is rarely diagnosed. ⋯ This case highlights the importance of obtaining a travel history from military members and their families who frequently relocate due to military orders. Military medical providers must be aware of tropical and travel-related illnesses and infections that may have been acquired at a prior duty station.
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For the past few decades, there has been an emphasis on encouraging the partnership of civilian and military trauma care systems which would allow military personnel to maintain competency in life-saving skills and gain experience prior to or in between deployments. Currently, there are only five primary military-civilian training centers in the United States. Thus, the majority of service members do not get the opportunity to train at these facilities prior to scheduled deployments. To bridge this gap, a joint military-civilian hands-on supplemental training program was established to allow deploying National Guard Combat Medics to practice life-saving techniques on human cadaver tissue. The purpose of this report is to provide the feedback survey from this pilot training session in hopes to expand and improve the curriculum and encourage partnerships between military and civilian trauma centers. ⋯ This collaboration between military and civilian trauma care system was successful in giving National Guard combat medic specialists the opportunity to practice life-saving techniques on human tissue prior to deployment. This type of partnership can assist in maintaining readiness for trauma care and increasing the confidence of military pre-hospital providers in performing life-saving techniques.
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Resilience is a psychometric construct of a patient's ability to recover from adversity and has been used to predict outcomes but its use in orthopedics has been limited. The purpose of this study was to examine the association between resilience and outcomes. ⋯ Active-military patients with high preoperative resilience appear to have significantly better early postoperative outcomes following sports knee surgery in terms of PROMIS-43, KOOS, and IKDC. There was also a lower rate of changing MOS secondary to sports knee surgery in patients with high resilience.