Military medicine
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The US Department of Defense (DoD) has adopted a model concept of the warrior athlete. Identifying latent disease that could compromise the military operator is critical to the warrior athlete concept. Cardiovascular complaints are the important problem recognized in service members evacuated from combat zones, and the incidence of sudden cardiac death in U.S. military recruits is comparable to or greater than that among National Collegiate Athletic Association Athletes. Nevertheless, the mandatory electrocardiogram (ECG) was removed from official U.S. military accession screening policy in 2002. Inclusion of ECG screening in high risk athletics is increasingly recognized as appropriate by professional organizations such as the American Heart Association and American Medical Society for Sports Medicine, though neither recommends ECG for generalized screening in large, low-risk populations. ⋯ Prospective study of ECG screening is needed to determine the impact on cardiovascular outcomes in U.S. military populations.
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Virtual Health (VH) is posited to be a force multiplier for Military Medicine, delivering digital healthcare to the point of need for the warfighter. To date, there are no studies on the impact of both synchronous and asynchronous VH modalities during a deployment. VH usage by the 1st Squadron, 2nd Cavalry Regiment (1/2 CR) during a 6 month deployment to rural Poland was evaluated prospectively to identify mission days saved for Commanders. ⋯ Operational VH is a force multiplier that brings the resources of the Medical Center to the Warfighter at the point of need. The full spectrum of VH modalities offers the greatest benefit for deployed units. Expansion of these technologies throughout the Department of Defense will reduce medical evacuations, increase Active Duty Service Member time on mission, and reduce risks for Commanders.
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Psychological stress is associated with sedentary behavior, which may impair exercise performance. The aim of our study was to examine the association between psychological stress and physical fitness in military personnel. ⋯ Our findings suggest that the presence of higher psychological stress on military personnel may reduce their cardiorespiratory fitness but not affect the anaerobic fitness.
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Three important but neglected principles of evaluation of global health engagement missions are stakeholder engagement, impact, and relative value. Implementing better M&E programs could be carried out in this fiscal year, without new appropriations or manpower. The result would be cost savings and improved security cooperation.
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Prehospital care in the combat environment has always been of great importance to the U.S. military, and trauma resuscitation has remained a cornerstone. More evidence continues to demonstrate the advantages of intervention with early transfusion of blood products at the point of injury. The military has recognized these benefits; as such, the Department of Defense Joint Trauma System and the Committee on Tactical Combat Casualty Care have developed new advanced resuscitation guidelines, which now encourage the use of whole blood (WB) in the prehospital setting. ⋯ WB has become the favored transfusion product as it provides all of the components of blood in a convenient package that is easy to store and transport. Specifically, group O WB containing low titers of anti-A and -B antibodies has become the transfusion product of choice, offering the ability to universally fluid resuscitate patients despite not knowing their blood group. This new ability to obtain low titer group O WB has transformed the approach to the management of hemorrhagic shock in the prehospital combat environment.