Military medicine
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The goal of this study is to update the incidence of hyphema in Operation Iraqi (OIF) and Enduring Freedom (OEF). We wanted to assess associated ocular injuries and final visual acuity (VA) in open-globe versus closed-globe injuries with a hyphema. ⋯ Close follow-up in patients with hyphema is important due to the associated development of traumatic cataract and retinal detachment and poor final visual outcome.
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Case Reports
Recurrent Herpes Gladiatorum: Should we be Screening Our Service Members Prior to Close Combat Training?
A 19-year-old active duty Marine presented to clinic with a history of a reoccurring vesicular rash on left side of his forehead. The lesion was cultured and identified as herpes simplex virus 1 (HSV-1). Herpes gladiatorum is a recurrent cutaneous infection caused by HSV-1 and spread by skin-to-skin contact. ⋯ Outbreaks of herpes gladiatorum have been observed in the high school and collegiate wrestling community for years and to prevent the spread, screening, and treatment guidelines have been implemented by governing bodies of these organizations. Active duty members who participate in the Marine Corps Martial Arts Program and the Army and US Air Force Combatives programs are exposed to similar conditions; however, no uniform screening or treatment protocol exists. To minimize the spread of skin infections, we propose adopting a uniform screening procedure and implementing a standardized form to assist primary care providers in the evaluation and treatment of herpes gladiatorum and other communicable skin diseases commonly seen in close combat training.
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Solid abdominal organ hemorrhage remains one of the leading causes of death both on the battlefield of modern warfare and in the civilian setting. A novel, temporary hemostatic device combining CELOX and direct intra-abdominal physical compression was invented to control closed SAOH during transport to a medical treatment facility. ⋯ The device, which combined 20 g of CELOX particles and 20 pieces of CELOX (8 g) sponge tablets with 50-mmHg intra-abdominal compression for 10 minutes, prolonged the ST by an average of 30 minutes with less BL. It was not markedly different from the full four quadrants gauze packing of liver in hemostatic effect, with no CELOX clot formation in other organs.
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In patients with prior myocardial infarction (MI), cardiac rehabilitation (CR) has been shown to reduce all-cause mortality, cardiac mortality, and risk of recurrent MI. Medically supervised cardiac rehab has challenges such as increased patient and center cost, patient transportation issues, patient time commitment, and increased need for resources. Home-based cardiac rehabilitation (HBCR) is an innovative alternative to medically supervised CR which can help to address some of the aforementioned issues. HBCR has been shown to have similar patient outcomes when compared to medically supervised CR; however, implantation efforts and experiences within Veteran Affair (VA) facilities were limited. Thus, we sought to describe our implementation efforts and outcomes of HBCR at our VA medical center, since our VA medical center does not offer an on-site medically supervised CR program. ⋯ HBCR is an effective alternative to facility-based CR. Veterans who completed the program showed improvement in physical capacity and functional status. Compared to those who were eligible but did not complete the program, hospitalization for heart failure was reduced after completing HBCR.
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Empty bullet-related ocular injuries (EBOI) are rare and may result in unfavorable visual outcomes due to both open globe and closed globe injuries. To our knowledge, no reports of such injuries in terms of outcomes have been previously described in the literature. The aim of this study was to describe the treatment performed and ocular outcomes of such injuries. ⋯ The prognosis of EBOI is unpredictable and is dependent on the severity of ocular damage. The best treatment option is prevention of EBOI with protective eyewear.