Military medicine
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Approximately 9 million veterans receive health care at the Veterans Health Administration, many of whom have psychiatric illnesses. The military continues to have higher rates of psychiatric illness compared to the civilian population. Having a diagnosis such as posttraumatic stress disorder or depression may create challenges in using health care services, such as surgery. The aim of this study was to evaluate eye surgery cancellation, risk factors for cancellation, and areas for intervention within the VA. ⋯ There was a significant amount of eye surgery cancellations in veterans with variation by subspecialty and comorbid conditions. Having a psychiatric illness was correlated with increased rates of surgery cancellation amongst veterans. Areas to improve surgical utilization include risk stratification and increased support of vulnerable patients before surgery.
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Tobacco use is prevalent and has traditionally been higher in the U.S. Military population than in the civilian population, but studies are limited. The goal of this study was to evaluate tobacco use and tobacco cessation counseling within the US Military health system (MHS). ⋯ Tobacco use remains common in the United States but is more prevalent in both active duty military and military retirees than civilians. Tobacco cessation counseling within the MHS steadily declined from 2016 to 2022. While there has been an overall reduction in rates of tobacco use in the military population over the last 5 years there was an increase over the last 2 years. Further research is needed to elucidate tobacco use, the effect of tobacco cessation counseling in the military, and the potential role of tobacco cessation medications in reducing tobacco use within the MHS.
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A challenge confronting health care is the national physician shortage, notably impacting the DoD's recruitment of military physicians. To address this, the Health Professions Scholarship Program is annually awarded to medical students to facilitate their transition into the U.S. Armed Forces. There is a glaring absence of military medical education in civilian schools to accommodate the unique interests of these students. While medical schools have adapted with interest groups and specialty tracks, the current presence of military medicine interest groups (MMIGs) and military medicine specialty tracks (MMSTs) remains under-explored. This study aimed to (1) update the prevalence of MMIGs in U.S. medical institutions, (2) identify the presence of MMSTs, and (3) compare military medicine involvement between allopathic and osteopathic programs. ⋯ This research underscores the need for comprehensive military medical training in medical schools to meet the interests and career aspirations of their students. Future studies should also evaluate the efficacy of MMIGs and MMSTs in preparing students for military medical roles.
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Movement quality screening in early-career military populations, like Army Reserve Officers' Training Corps (AROTC) cadets, could decrease the negative impact of musculoskeletal injury observed within the military. Movement quality screening techniques should be valid before being pursued in the field. Normative data describing movement quality of AROTC cadets are also needed. Therefore, the aims of this study were to determine criterion validity of several movement quality assessments and report normative jump-landing kinematics of AROTC cadets. ⋯ The normative values of 3D jump-landing kinematic data indicate that movement quality varies greatly within AROTC cadets, and some cadets display potentially injurious movements. Therefore, screening movement quality could be beneficial to determine musculoskeletal injury risk in AROTC cadets. Based on the correlations discovered in this study, we recommend the 2D techniques used in this study be researched further as they may serve as alternatives to expensive, timely 3D techniques that could be better utilized in military environments.
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Case Reports
Delayed Pressure Urticaria Associated With Altitude Chamber Training Responsive to Cyclosporine and Omalizumab.
Delayed pressure urticaria (DPU) is a subset of chronic inducible urticaria. It is characterized by the formation of wheals anytime between 30 minutes and 24 hours after stimulus exposure of localized pressure application. In this case report, we discuss a military flight crew member with no significant past medical history who developed DPU following rapid decompression in an altitude chamber. ⋯ Control of symptoms was achieved through combination treatment of a second-generation antihistamine, a leukotriene receptor antagonist, and an immunosuppressant (cyclosporine). His waiver to return to flight status was denied while on cyclosporine. He was transitioned to a monoclonal antibody that binds free immunoglobin E (omalizumab) with resolution of symptoms and was cleared to return to active duty.