Military medicine
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Endovascular techniques for managing vascular trauma have become increasingly more common. However, these techniques have had limited application in recent conflicts. Using lessons from 20th century conflicts, the present study aims to highlight how advances made in the past may provide a roadmap to improving surgical capabilities in the future.
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This was an in vivo animal study designed to investigate the interaction between dexamethasone (Dex) and microRNA-204 (miR-204) in a mouse alkali burn-induced corneal neovascularization (CNV) model. The function of miR-204 was then investigated in human mammary epithelial cells (HMECs) in vitro. ⋯ The role of Dex in attenuating CNV may be partly attributed to miR-204. MiR-204 may be a potential therapeutic target in alkali burn-induced CNV.
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Over the past 20 years, military medicine made great strides in the medical management of traumatically injured patients. Significant advancements were made in the treatment and rehabilitation after limb loss. These advancements can be attributed to the large number of complex patients presenting to military treatment facilities and the demand for medical professionals to provide care to patients with complex injuries and multiple traumatic amputations. The concern now is to maintain the skills needed to be prepared for the next conflict. To meet this demand, the Extremity Trauma and Amputation Center of Excellence (EACE) initiated the documentation of knowledge, skills, and abilities (KSAs) to ensure that the skill sets needed to treat this unique population are not lost. The EACE developed KSAs to sustain advanced clinical practice for physical therapists, occupational therapists, and prosthetists and is in the process of developing KSAs for orthotists and physical medicine physicians. The learning objectives [terminal and enabling learning objectives (TLOs and ELOs)] derived from each set of KSAs will drive curricula development for enduring education, residencies, and fellowships. This article describes the KSAs and learning objectives for advanced physical therapist competencies in amputation care. ⋯ The KSAs and the learning objectives describe the skills expected of an advanced practice physical therapist treating patients with traumatic limb loss. Weaknesses of this document include the focus on traumatic amputation and military specific needs. However, many of the central advanced practices are universal to all physical therapists working in amputation. Thus, this document should serve as a starting point and can evolve to include dysvascular, oncology, and other etiologies. To our knowledge, this is the first paper to describe the KSAs for the advanced practice physical therapist working with traumatic limb loss population. This work will form the framework for physical therapist advanced practice training programs.
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The Advanced Medical Technology Initiative (AMTI) program solicits research proposals for technology demonstrations and performance improvement projects in the domain of military medicine. Advanced Medical Technology Initiative is managed by the U.S. Army Telemedicine and Advanced Technology Research Center (TATRC). Advanced Medical Technology Initiative proposals span a wide range of topics, for example, treatment of musculoskeletal injury, application of virtual health technology, and demonstration of medical robots. The variety and distribution of central topics in these proposals (problems to be solved and technological solutions proposed) are not well characterized. Characterizing this content over time could highlight over- and under-served problem domains, inspire new technological applications, and inform future research solicitation efforts. ⋯ A semi-supervised document clustering approach was applied to a repository of proposals to partially automate the process of document annotation. By applying this process, we successfully extracted thematic content from the proposals related to problems to be addressed and proposed technological solutions. This analysis provides a snapshot of the research supply in the domain of military medicine over the last 12 years. Future work should seek to replicate and improve the document clustering process used. Future efforts should also be made to compare these results to actual published work in the domain of military medicine, revealing differences in demand for research as determined by funding and publishing decision-makers and supply by researchers.
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Spontaneous pneumomediastinum (SPM) is a rare but described complication of exercise-induced bronchoconstriction (EIB), more commonly observed in children with asthma. We present a 23-year-old active duty military male and avid distance runner who developed progressive radiating retrosternal chest pain preceded by wheezing and coughing paroxysm. A chest computed tomography revealed extensive pneumomediastinum. ⋯ After thorough evaluation, undiagnosed asthma was determined to be the inciting etiology. The patient is now well controlled and symptom free on a daily low-dose inhaled corticosteroid without SPM reoccurrence. In young adult patients presenting with SPM, EIB and asthma should be considered on the differential diagnosis as appropriate medical therapy will improve symptoms and reduce risk of reoccurrence.