Military medicine
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Cognitive-motor interference is the decrease in cognitive performance and/or physical performance occurring when a cognitive task and a physical task are performed concurrently (dual task) compared to when they are performed in isolation (single task). The aim of this study was to investigate the construct validity and test-retest reliability of two cognitive-motor interference tests in military contexts. ⋯ These findings suggest that the Running + Word Recall Task test is a valid and reliable dual-tasking test that could be used to assess cognitive-motor interference in military contexts.
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Thyrotoxic periodic paralysis (TPP) is an acute complication of hyperthyroidism. Thyrotoxic periodic paralysis is treatable, and the management consists of potassium correction, beta-blockers, and antithyroid drug (ATD) therapy. While TPP is well described in the literature, we describe a case of TPP with urticarial dermographia (UD) that resolved with a short course of antihistamines while continuing ATD therapy. ⋯ Current recommendations are that minor cutaneous reactions can be treated with antihistamines for the management of Graves' disease. However, this case and others show that even moderate reactions can be managed in this manner. In a patient with TPP with UD after treatment with MMI, it is reasonable to attempt a trial of antihistamine before changing to another ATD.
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Over the last 200 years, the "medic" has demonstrated its value at the point of injury care. Unfortunately, when medics leave military service with their medical skills, they have limited direct employment options available to them without added educational requirements. Fortunately, the Veterans Health Administration's (VHA) innovation of the Intermediate Care Technician (ICT) Program has a solution for that problem. This article will look at the Veterans Affairs' creation of the ICT Program, investigate its origins, evaluate where it is today through the lens of the WHO Task-Shifting Model for healthcare system implementation, and address the ICT Programs' potential for tomorrow. ⋯ The VHA ICT Program demonstrates to the U.S. Healthcare System a validated and reliable program to address healthcare worker shortages, reduce healthcare costs, increase access to care, and manage increasing demand for healthcare.
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Exposure to chemical warfare agents results in long-term biopsychosocial complaints. A recent study has revealed an association between exposure to a low dose of Sarin and Gulf War illness in American veterans from the Gulf War. ⋯ In light of recent research results, Iraqi chemical warfare agent survivors' multiple physical and mental illnesses should be highlighted. For this reason, establishing both legislation and medical commissions is most needed.
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Case Reports
Hashimoto's Encephalopathy with Use of Intravenous Immunoglobulin as First-Line Therapy.
Hashimoto's encephalopathy is an uncommon cause of altered mental status in hospitalized patients and is challenging to diagnose, particularly in the presence of other psychiatric comorbidities. Corticosteroids are the primary treatment. ⋯ He was treated with intravenous immunoglobulin (IVIG) instead of the standard steroid course because of concerns for worsening agitation. The patient had improvement with IVIG infusions, returned to a functional state, and has remained on IVIG therapy monthly since the initial episode without any disease recurrence.