Military medicine
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Endometrial cancer is the most prevalent gynecologic cancer in the United States and has rising incidence and mortality. Endometrial intraepithelial neoplasia or atypical endometrial hyperplasia (EIN-AEH), a precancerous neoplasm, is surgically managed with hysterectomy in patients who have completed childbearing because of risk of progression to cancer. Concurrent endometrial carcinoma (EC) is also present on hysterectomy specimens in up to 50% of cases. ⋯ If on subsequent pathology, EC is identified, the patient should be referred to a GO for further treatment considerations and counseling. Determining the optimal treatment for patients with EIN-AEH is nuanced and, within the military health care system, is complicated by varied access to expert management by a GO subspecialist. Military beneficiaries with this diagnosis present a unique challenge and warrant a standardized approach to maximize clinical outcomes.
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This study aims to analyze the characteristics of hip region stress fractures (HSFs) within a South Korean military cohort and identify the associated risk factors to provide insights for treatment and prevention strategies. Additionally, we will report the epidemiologic data and clinical outcomes of treating HSF within the second largest military hospital. ⋯ Hip region stress fractures can also be termed as "private's fractures," which accurately describe their nature. It is crucial to identify cases that necessitate early diagnosis and surgical intervention. Epidemiologically, HSF demonstrates high bilaterality and a bimodal distribution throughout the year. During this period, unit commanders and military doctors should be cautious of HSF among soldiers and conduct appropriate screenings.
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Shoulder stabilization surgery is common among military personnel, causing severe acute postoperative pain that may contribute to the development of chronic pain, thereby reducing military readiness. Battlefield Acupuncture (BFA) has shown promise as a non-pharmaceutical intervention for acute postoperative pain. The purpose of this study was to determine the effectiveness of BFA combined with standard physical therapy on pain, self-reported mood, self-reported improvement, and medication use in patients after shoulder stabilization surgery. ⋯ ClinicalTrials.gov, NCT04094246. Registered September 16, 2019, http://clinicaltrials.gov/NCT04094246.
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Cardiovascular disease (CVD) is the leading cause of death for women in the United States, and U.S. female Veterans have higher rates of CVD compared to civilian women. With an increasing number of women joining the military, the number of female Veterans is expected to rise; therefore, providing appropriate cardiovascular care must be a top priority for the DoD and the Veterans Health Administration (VHA). This scoping review will answer the question: "Among U.S. female Veterans, what are the challenges faced in cardiovascular health, and what are potential future implications and interventions?" We designed this scoping review to identify common themes and gaps in the literature, guide further investigations, and contribute to developing targeted interventions and policies to enhance cardiovascular outcomes among female Veterans. ⋯ This review highlighted 3 main challenges female Veterans face in accessing CVD care from the VHA: perceived barriers, unique risk factors, and gender/racial disparities. It emphasized the need for improved CVD research, screening, education, and social support for female Veterans. The authors propose two main strategies to address these challenges: (1) pre-transition education from the DoD and (2) enhanced CVD training in the VHA. Cardiovascular disease risk factor recognition and prevention education should occur in military settings, allowing medical providers in DoD clinics to engage female service members in discussions and screenings before transitioning to VHA care. The VHA should educate providers on the barriers female Veterans face, the identification of nontraditional risk factors, and existing health care disparities. Additionally, it should continue to support successful initiatives focused on improving CVD care for female Veterans, such as the Women's Health Research Network, the Quality Enhancement Research Initiative, and the Enhancing Mental and Physical Health of Women through Engagement and Retention program.