Military medicine
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Wounds are colonized frequently by heterogeneous microflora. Pseudomonas aeruginosa (PA) and Staphylococcus aureus (SA) are two of the most isolated bacterial species from wounds, and both typically form highly organized biofilms. Nitric oxide (NO) is a short-lived, diatomic, lipophilic gas with antimicrobial activity. Recently, NO and its derivatives have been shown to exhibit broad-spectrum antimicrobial activity against bacteria, viruses, and parasites. ⋯ These studies demonstrate that NO-releasing topical formulations effectively reduce the MRSA burden in established biofilms composed of multiple microorganisms. Minimal efficacy against PA was observed. It has been demonstrated that MRSA bioburden is significantly reduced when inoculated together with P. aeruginosa. A better understanding of mechanisms of host-bacteria interactions, in single or mixed species biofilms, may lead to the development of novel therapeutic approaches. Overall, NO offers a promising alternative treatment against MRSA in polymicrobial infections.
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Glycemic monitoring via Hemoglobin A1(HbA1c) proves to be inaccurate when a patient is diagnosed with a hemoglobinopathy/erythrocyte disorder. Moreover, any acute changes of glycemic intake within 6 weeks of blood sampling have been noted to impart a greater effect on HbA1c than the remaining days of the supposed overall 3-to-4-month average of glycemic control. Fructosamine, an alternative to HbA1c, allows physicians to analyze glycemic control in the presence of an underlying hemoglobinopathy/erythrocyte disorder. Fructosamine analyzes glycemic control over a two-to-three week period, compared to a 3-to-4-month period with HbA1c. Studies indicate that fructosamine is significantly correlated with HbA1c in various population types. Given the increased likelihood of hemaglobinopathies/erythrocyte disorders in the veteran population accompanied by the the necessity for tighter glycemic evaluation, fructosamine offers an assay for physician when analyzing glycemic control in veterans. The aim of our study was to evaluate the correlation of HbA1c and fructosamine in the veteran community. We hypothesize that fructosamine is significantly correlated with HbA1c in the veteran community and therefore can be used as an alternative assay in the Veterans Affairs. ⋯ Given that both correlation coefficient and coefficient of variance were considered significantly strong and the paired t-test indicated no significant difference between assay HbA1c and predicted HbA1c, fructosamine can be considered as an alternative assessment of glycemic control compared to HbA1c in the veteran community. We advise physicians at the Veterans Affairs to use fructosamine as an assessment of glycemic control when a veteran is diagnosed with an underlying hemoglobinopathy/erythrocyte disorder or requires stringent analysis of glycemic control. Yet, at this point of time, fructosamine does not have the necessary data to indicate complete replacement of HbA1c with fructosamine.
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Older adults are at increased risk of severe illness and mortality from Coronavirus disease of 2019 (COVID-19) infection. However, public health strategies aimed at reducing spread of COVID-19 may have resulted in increased mental health symptoms, particularly among older adults. Currently, little is known about whether older Veterans were more likely to experience persistent mental health symptoms during the COVID-19 pandemic than non-Veterans. The objectives of the current study were to (1) compare differences in persistent symptoms of anxiety, depression, and loneliness among a sample of Canadian Armed Forces Veterans and non-Veterans ≥55 years of age and (2) to evaluate potential sex-specific differences in persistent mental health symptoms. ⋯ Qualitative, but statistically nonsignificant sex-specific differences in persistent symptoms of anxiety, depression, and loneliness during the early months of the COVID-19 pandemic were observed in this study comparing Veterans and non-Veterans. Additional sex-stratified analyses using larger samples or qualitative interviews may be useful in understanding the unique mental health experiences of older men, women, and gender diverse Veterans during the COVID-19 pandemic.
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Musculoskeletal (MSK) injury can negatively affect service members by compromising job performance and readiness. These injuries can impact the service member's physical health, functional abilities, and quality of life (QoL). Rehabilitation therapies for MSK injuries can reduce these impacts. One approach is home use rehabilitative therapy, usable during deployment and at home stations. The purpose of this updated systematic review with meta-analysis was to broaden our scope of pain/symptoms, disability, and QoL as outcome measures for nonpharmaceutical MSK therapies in a military population versus controls. ⋯ This analysis demonstrated modest improvement in pain and physical well-being with therapy, with low certainty across diverse military cohorts. The impact on overall health-related disability and QoL was limited, with little change in mental well-being. The substantial heterogeneity and low certainty across diverse military cohorts limit generalizability, suggesting that further research in homogeneous environments is important for guiding clinical decisions. The study's findings suggest that nonpharmacological home use interventions may offer modest improvements in pain relief, particularly early in treatment, and in strength and function, according to our previous report. These interventions could complement standard care, providing options that may benefit service members during deployment and at home.
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Service academy members are at high risk for concussions as a result of participation in both sports and military-specific training activities. Approximately 17% of active duty service members are female, and they face unique challenges in achieving timely recovery from concussions. Understanding the unique characteristics affecting return to unrestricted activity (RTA) among female service academy members is imperative for the ever-growing proportion of females across the U.S. military. The goal of this analysis was to determine how specific injury and individual characteristics of concussion affect 2 RTA protocol events in female service academy members: time to protocol initiation and time to protocol completion. ⋯ A greater proportion of female service academy members who sustained SRCs and were NCAA athletes reported their injuries immediately, which was associated with a greater likelihood of RTA protocol initiation and completion on any given day after injury. This may be attributable to easy and timely access to medical personnel (e.g., athletic trainers) or the presence of individuals trained in identifying concussion (e.g., coaches). Future initiatives among female service academy members should include improved access to medical care across a variety of injury settings and education on the importance of early reporting after concussion.