Military medicine
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Health facility planning is a key global health engagement capability that assesses the health needs of a population and identifies the combination of services, equipment, facilities, and infrastructure necessary to support them. Collaboration with local health care and building professionals is essential to achieving local buy-in and sustainable solutions.
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War-related burns are common injuries, also among the civilian population. Additional trauma such as fractures or shrapnel wounds may add significant morbidity. Burn injuries in war zones are furthermore frequently undertreated and hence prone to complications. We report a case of a young female victim of war, whose severely infected burn wounds could be successfully healed using a combination of targeted antimicrobial therapy, wound conditioning using decellularized fish skin, and subsequent skin grafting.
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Secular trend of increasing musculoskeletal injuries (MSKIs) across all branches of the U.S. Military is a critical limiting factor in the effective and efficient process of preparing military personnel for combat. The need to evaluate functional capacity beyond current physical fitness test (PFT) standards is the key in understanding an individual's risk of noncombat-related injury. The purpose of this study is to evaluate the relationship between Functional Movement ScreenTM (FMS) scores, incidence of musculoskeletal injuries, and standardized PFT scores among freshman Cadets during their first 10 weeks of enrollment at a senior military college. ⋯ No significant difference between FMS scores and injury and pain was found within both sex groups. Therefore, use of the composite FMS score as an indicator for risk of injury or to predetermine PFT performance is not recommended for this study's population. The rate of incidence of injury or pain in Cadets during a 10-week enrolment period is high. Females outperformed males in the FMS and PFT and reported higher rates of injury and pain. The utility of the FMS may be limited when substantially scaled for implementation across entire military populations. Future research should evaluate performance associations of the FMS with Army Combat Fitness Test components in a population of equally distributed sex and race.
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Acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE) is a rare cause of exertional acute kidney injury. The proposed mechanism of injury in ALPE is renovascular spasm, in the setting of oxidative stress and muscular damage, which creates a characteristic wedge-shaped infarction pattern on delayed imaging. Patients present with nausea, vomiting, loin or abdominal pain, and fatigue within 1-2 days of anaerobic exercise, associated with an acute rise in serum creatinine, which generally plateaus within 3 days. ⋯ Military medical providers should be aware of this diagnosis when evaluating service members with acute renal injury after exercise. The clinical course is benign, and affected service members are at increased risk of recurrence, with subsequent intense exercise. Service members should engage in a graduated exercise program, before intense exercise activities, and should be monitored closely for recurrent renal injury.
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Behavioral health disorders are the leading category of evacuations from the U.S. Central Command (USCENTCOM) area of responsibility. Understanding the relative risk of behavioral health conditions associated with all-cause evacuation is important for the allocation of resources to reduce the evacuation burden. ⋯ There is a broad array of behavioral health-specific diagnoses used initially in the care of behavioral health disorders with a great variation in their association with evacuation risk. Variations of diagnoses associated with anxiety, depressive, and adjustment disorders are most associated with eventual evacuation.