Military medicine
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Injuries sustained during basic combat training (BCT) result in large economic costs to the U.S. Army. The inclusion of athletic trainers (ATs) in other military branches has reduced Troop Medical Clinic (TMC) referrals. However, the inclusion of ATs during BCT has yet to be studied. The purpose of this study was to describe the frequency and nature of sick call visits during BCT and determine how the presence of an AT affects referrals to the TMC. ⋯ Injuries were common in BCT, particularly in females. Soldiers in both the PAT and FTM conditions were more likely to be RTD compared to those in the CON condition. Athletic trainers (ATs) are effective at reducing potentially unnecessary referrals, demonstrating their value as healthcare providers in the BCT environment. Understanding variables associated with recruit disposition may aid medics and ATs in the development of triage protocols and further reduction of potentially unnecessary soldier referrals. The Certified Athletic Trainer-Forward Program resulted in significant return on investment, further supporting the inclusion of ATs in BCT.
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To examine the impact of military service on health literacy. ⋯ Both history of and current military service predict higher health literacy rates for patients treated at military otolaryngology clinics. Widely accessible health care and mandatory health evaluations for service members to maintain deployment readiness may contribute to this finding but warrant additional study.
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The U.S. DoD is a multidimensional agency of the government that employs health engagement activities within partner nations for medical operations, humanitarian assistance, threat reduction, and improved health outcomes toward sustainable global health and security. The composition and size of a health engagement team is critical for effective implementation; however, an ideal team makeup to achieve optimal operational readiness, health outcomes, and security cooperation objectives has not been established. This study was conducted to retrospectively describe and analyze medical mission activities in relation to ideal team characteristics in El-Salvador, Guatemala, and Honduras between 2012 and 2017. ⋯ Findings from this study reveal a broad spectrum of health and medical missions conducted in El Salvador, Guatemala, and Honduras between 2012 and 2017 by DoD. Critical elements indicative of overall team capability for successful engagement such as team size, team member skillset, global health expertise, and appropriate language capability were rarely documented. Team characteristics could not be well-correlated with the Global Health Engagement type or desired mission outcomes. In the future, deliberate crafting and preparation of health engagement teams aimed at attaining desired security cooperation impact, operational readiness development, and positive health outcomes is essential for more effective Global Health Engagement.
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We describe a case of prolonged shedding of live Severe Acute Respiratory Syndrome Coronavirus, 2 in the setting of a mild novel Coronavirus Disease 2019 (COVID-19) infection in a healthy young adult male. The patient did not require hospitalization or any supplemental oxygen. ⋯ The extended duration of positive viral culture with his concurrent mild symptomatology is at odds with current CDC and DOD isolation policies for positive COVID-19 patients. This case is important as health agencies around the world grapple with how to advise patients and create protocols for isolation precautions after positive COVID-19 results.
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Esophageal adenocarcinoma develops when normal squamous epithelia are replaced by dysplastic intestinal columnar cells in response to chronic gastroesophageal reflux disease (GERD). In addition to squamous cell carcinoma, the two malignancies account for over 95% of esophageal malignancies. ⋯ Upon return to homeport, he was diagnosed with stage III gastroesophageal junction adenocarcinoma. This case emphasizes the difficulty in identifying and diagnosing a rare and dangerous pathology in the resource-limited, operational environment.