Military medicine
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Musculoskeletal (MSK) injuries make up a significant proportion of conditions treated by military healthcare providers during wartime. Though many common MSK injuries may benefit from corticosteroid injection (CSI), a shortage of qualified military clinicians has led to diminished access to appropriate care. Longer wait times to receive treatment pose detrimental effects on military readiness and have garnered the attention of military leaders. One solution was the development of advanced training for United States Air Force physical therapists (USAF PTs) to gain clinical privileges in administering CSI. The objectives of this study were to determine in USAF PTs (1) the prevalence of those with privileges to administer CSI; (2) the type and (3) safety of MSK CSI administered; (4) incidence of CSI complications; (5) healthcare utilization following CSI; and (6) barriers to obtaining and practicing CSI privileges. ⋯ Nine percentage of USAF PTs held CSI privileges. United States Air Force PTs were equally safe as AHPs who administered CSI and associated with a lower rate of healthcare utilization following the intervention. Training USAF PTs to administer CSI could be the standard for all USAF PTs who meet qualification requirements. Adoption of similar training and credentialing policies for civilian PTs warrants further exploration.
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Global Health Engagements can be more effective if better evaluation is done and if both line and diplomatic leaders are better educated by deploying medical personnel. To achieve better outcomes, these tasks should be a high priority for global health engagements. Integrity demands it.
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Multisystem inflammatory syndrome in children (MIS-C), which is associated with coronavirus disease 2019 (COVID-19) and occurs in the immediately post-infectious period, has never-before been reported within the active duty population. It typically affects children, aged 5-13 years, but has been shown to affect those up to 20 years old. We present an 18-year-old active duty male that arrived at a military treatment facility emergency department with headache, neck pain, and shock without evidence of meningoencephalitis on cerebrospinal fluid analysis and with a negative COVID-19 test. ⋯ It is a rare but potentially fatal condition that has been shown to affect patients up to the age of 20, encompassing a large part of the junior enlisted population. Multisystem inflammatory syndrome in children (MIS-C) can lead to death, yet mimic other diseases leading to delay of care. Thus, it should be considered when faced with the appropriate constellation of symptoms.
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Finland's security policy relies heavily on its own independent national defense, which is based on conscription. In 2011, 26,492 conscripts started their military service in Finland. Of these, 1,706 interrupted their military service and 191 changed to civilian service. Conscripts who interrupt their service seem to have an increased tendency to smoking, alcohol consumption, and taking snuff, which previous studies suggest to have strong associations with the need for restorative dental treatment and with lower socioeconomic status. The aim of this study was to compare the general and oral health habits between Finnish conscripts who interrupt their service and those who completed their military service and to find out what general- and oral-health-related factors could be used in predicting interruption of service. ⋯ As a conclusion, a set of statistically chosen anamnestic questions could help identify conscripts who have an increased risk of interruption of military service in addition to a risk of dental problems.
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Following suspected sonic attacks on U.S. Embassies, a subset of individuals presented with a unique cluster of symptoms believed to have resulted from exposure to directed energy. Directed energy has been described as exposure to a unique sound/pressure phenomenon such as infrasonic or ultrasonic acoustic or electromagnetic energy. The Joint Force does not have an established protocol to guide vestibular physical therapy for individuals exposed to directed energy. Therefore, we have provided evidence-based guidance for the treatment of oculomotor- and vestibular-related impairments from similar populations. ⋯ Evidence-based guidance for prescribing a comprehensive vestibular physical therapy regimen for individuals exposed to directed energy may aid in their rehabilitation and return to duty. This standardized approach can help physical therapists to treat complaints that do not match any previously known medical conditions but resemble brain injury or vestibular pathology.