Military medicine
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Readiness of military health care providers is essential to maintain a prepared fighting force and remains a central issue for today's military. Maintaining skills regarding operative management of trauma is becoming more difficult if not located at an urban trauma center. Live tissue training may be used to practice skills in a facility that does not have exposure to high acuity trauma. The goal of our live tissue skills course is to train health care providers and ancillary staff in the management of various injury complexes and improve confidence and familiarity with management using a porcine model. ⋯ Perceived as highly beneficial, live tissue training increased comfort with operative trauma management by surgical residents, attendings, and technicians supporting continued utilization. Further evaluation of live tissue courses would be advantageous in assessing surgical skill improvement, including comparison with simulation training.
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Recruitment, training, and retention of wartime critical specialty physicians may be stymied by discrimination and abuse. It is unclear to what extent the US combat specialty physicians witness or experience discrimination and abuse, whether they or others intervene, and if they would subsequently discourage people from entering their field. ⋯ Although reported intervening confidence, likelihood, and importance were high, it is unclear whether perceptions correspond to awareness of intervention need and behaviors. Bivariate differences in burnout levels between men and women were fully explained by the number of comment types in the mediation model. Annual trainings may not effectively address workplace climate optimization; institutions should consider targeted policy and programmatic efforts to ensure effective, structurally responsive approaches.
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Using data from the large and geographically diverse Military Health System (MHS) beneficiary population, we aimed to characterize and update the epidemiology and microbiology of pediatric orbital cellulitis given previous data are limited to small, single-center studies. ⋯ Orbital cellulitis occurs most frequently in males with sinusitis. Likelihood of positive wound culture is increased with a more advanced CS. Staphylococcus and Streptococcus spp. and anaerobes are the most identified pathogens in orbital cellulitis, while gram-negative organisms are rare. Empiric antibiotic selection should include an anti-methicillin-resistant S. aureus agent combined with a broad-spectrum beta-lactam and anaerobic coverage.
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Bone stress injuries are well-documented injury patterns among U. S. Armed Forces recruits because of the rapid increase in frequency and intensity of bone-impacting activities throughout training. ⋯ He was also found to have bilateral grade 4 femoral neck stress fractures with concomitant effusions and was similarly operated on. To the best of our knowledge, this is the first reported operative bilateral femoral neck stress fracture case series in a military-aged patient in the literature. A high clinical suspicion for femoral neck stress injuries with early diagnostic imaging for high-risk groups was important in these cases and ultimately led to timely definitive management for this patient.
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The conflict in Ukraine, ongoing since 2014 and escalating with the Russian invasion in 2022, has unveiled profound challenges in prehospital care essential for the survival and recovery of warfighters and civilians alike, necessitating a detailed examination of the current medical response mechanisms and their effectiveness. ⋯ The study underscores the critical role of international collaboration and standardized protocols in bolstering prehospital medical responses in conflict settings, highlighting the need for continuous adaptation and support to mitigate the complexities of modern warfare. The insights gained from the Ukraine conflict offer valuable lessons for future military and humanitarian medical responses in similar conflict settings.