Military medicine
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This case study presents the successful treatment of a 26-year-old male who experienced profuse bleeding from a gunshot wound to his thigh 4 days after the initial injury. The patient underwent surgery performed by a military vascular surgeon, during which previously undetected injuries to the femoral artery and vein were identified. The surgeon conducted a femoral artery alloprosthesis and sutured the damaged femoral vein. ⋯ In this case, the role of the endovascular balloon was played by a hematoma. As a result, the lower extremity survived 4 days before the arterial blood flow reconstruction was done. Although such a model of bleeding control is absolutely unacceptable for planned specialized surgery or even military surgery at a medical assistance level of II-III, it may be considered as a lifesaving measure when surgical intervention is not immediately available.
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Military body fat standards were implemented in the 1980s to prevent obesity and associated poor military readiness. In the past 2 decades, enforcement of existing Army body composition standards has been eroded by the steady increase in national obesity rates, the demand for new recruits especially during the 2007 surge in Iraq, and the COVID epidemic in 2020. The diminishing qualified recruit pool puts a new focus on accession standards. The purpose of accession standards is to ensure that recruits will meet soldier standards, but accession standards have been relaxed to improve recruitment with an assumption that most recruits will achieve the retention standards during initial entry training. A new method of percent body fat estimation (%BF) adopted by the Army in 2024 further liberalizes both accession and retention standards. This study examined the impact of current accession and retention %BF standards on the proportion of the US population that would be disqualified from Army service. ⋯ Army body composition standards are generous, extending to the limits of increased metabolic health risks and providing underestimates of actual %BF based on the behavior of circumference-based methods of body fat estimation. However, current standards do not accurately select or track physical readiness, especially for women, and should be updated. Modernization of physical readiness standards to meet the needs of the Army of 2030 could include adoption of new technologies that directly assess central adiposity, adequate muscle mass, and replace fitness testing with cardiac output metrics. With half of US adults projected to be obese by 2030, it is time for a review of the strategic goals of modernized military readiness standards.
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The present study aimed to identify the physical demands of Brazilian Air Force (BAF) critical Combat Tasks (CTs) and investigate the occurrence of differences in their difficulty perceived ratings, considering aspects such as sex, military experience, and academic degree of the evaluators. ⋯ The evaluations of the biomotor skills involved in the performance of the critical CTs of the BAF demonstrated that the profile required of the BAF's tactical athletes is predominantly related to the components of muscular strength, muscular endurance, and aerobic fitness. Although further research is required to fully understand the physiological demands of CTs, the biomotor skills identified can inform the design of training programs, allowing for a more targeted approach.
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Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is associated with the development of genital warts, precancerous lesions, and cancers of the oropharynx, anus, penis, vulva, vagina, and cervix. HPV-associated diseases are preventable through vaccination. An Australian nationwide vaccination program will effectively eliminate cervical cancer as a public health concern by the year 2035. ⋯ Providers should use every opportunity to recommend HPV vaccination, including recommending HPV vaccines for individuals who do not have a record of HPV vaccination. The electronic health record can be utilized to generate prompts for vaccine reminders, and clinics should stock HPV vaccines to allow for easy administration. Additionally, adoption of an opt-out policy for HPV vaccines rather than mandatory vaccination may be an acceptable alternative to increase HPV vaccination while allowing active duty service members to retain autonomy.