Military medicine
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Long-coronavirus disease (COVID) is an ill-defined set of symptoms persisting in patients following infection with COVID-19 that range from any combination of persistent breathing difficulties to anosmia, impaired attention, memory, fatigue, or pain. Recently, noninvasive transcutaneous electrical brain stimulation techniques have been showing early signs of success in addressing some of these complaints. We postulate that the use of a stimulation technique with transcranial magnetic stimulation may also similarly be effective. ⋯ Brain stimulation techniques appear to be showing early signs of success with long-COVID symptoms. This is the first case describing the use of a magnetic stimulation technique with quantitative test results and recorded EEG changes. Given the early success in this patient with cognition, dyspnea, and anosmia, this noninvasive treatment modality warrants further research.
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Balance deficits in people with chronic mild traumatic brain injury (mTBI; ≥3 months post-mTBI), thought to relate to central sensory integration deficits, are subtle and often difficult to detect. The purpose of this study was to determine the sensitivity of the instrumented modified clinical test of sensory integration for balance (mCTSIB) in identifying such balance deficits in people with symptomatic, chronic mTBI and to establish the associations between balance and mTBI symptom scores in the chronic mTBI group. ⋯ People with chronic mTBI appear to have central sensory integration deficits detectable by instrumented measures of postural assessment. These findings suggest that central sensory integration should be targeted in rehabilitation for people with chronic mTBI.
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Loneliness is a powerful predictor of several medical and psychiatric conditions that are highly prevalent in Veterans, including depression and PTSD. Despite this, few studies have examined loneliness in Veterans or how best to intervene upon Veteran loneliness. Additional empirical research is needed in these areas in order to define clear intervention targets and improve Veteran care. ⋯ This pilot study demonstrates the value of a publicly available PTSD measure for identifying lonely Veterans and highlights how reducing negative alterations in mood and cognition may serve as a potentially critical target for future Veteran loneliness interventions.
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Repetitive exposure to blast overpressure waves can be a part of routine military and law enforcement training. However, our understanding of the effects of that repetitive exposure on human neurophysiology remains limited. To link an individual's cumulative exposure with their neurophysiological effects, overpressure dosimetry needs to be concurrently collected with relevant physiological signals. Eye tracking has shown promise for providing insight into neurophysiological change because of neural injury, but video-based technology limits usage to a laboratory or clinic. In the present work, we show capability for using electrooculography-based eye tracking to enable physiological assessment in the field during activities involved repetitive blast exposures. ⋯ This study successfully demonstrated that eye tracking can be performed during training activities, such as explosive breaching, and that the modality may provide insight into neurophysiological change across periods of overpressure exposure. The results presented herein show that electrooculography-based eye tracking may be a useful method of assessing individualized physiological effects of overpressure exposure in the field. Future work is focused on time-dependent modeling to assess continuous changes in eye movements as this will enable building dose-response curves.
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As the landscapes of war have evolved, so too has the role of the military medical officer (MMO). Colonel (Retired) Barry Wolcott developed a "vector" model in the 1990s, illustrating the dual professional role of the MMO. Since then, propelled by the War on Terror, MMOs have adapted to treating patients in volatile, uncertain, complex, and ambiguous operational environments. This study, therefore, aimed to explore modern-day aspects of the MMO's role in order to enhance Wolcott's depiction of the MMO's professional identity in contemporary operational environments. ⋯ The role of the MMO is complex and multifaceted. The recognition of the contemporary MMO's unique skill set is essential for the effective education and training of future military health care leaders. The value of capitalizing on this unique skill set has been demonstrated in recent civ-mil responses. Because their intricate skill set is specialized for the operational environment, long-term retention of MMOs is key to force readiness.