Military medicine
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Case Reports
Suspected Mal de Debarquement Syndrome: A Case Report Highlighting the Difficulty in Diagnosis and Management.
MdDS is syndrome of oscillating vertigo following cessation of passive motion. The pathogenesis of this disorder is not well understood, but functional imaging studies suggest cortical connectivity dysfunction in feedback loops of the vestibulo-ocular system and visuo-spatial system. Patients go through multiple appointments and often specialist referrals before being diagnosed. ⋯ We present the case of a young, female active duty Air Force Captain who developed symptoms while deployed. She underwent multiple treatments with variable success. Her clinical course highlights the difficulties for patients and providers posed by suspected MdDS.
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Military service members rely on upper body strength and power to accomplish tasks such as carrying heavy weapons and gear, rappelling, combat grappling, and marksmanship. Early identification of the factors that lead to reduced upper body strength and power would enable leadership to predict and mitigate aspects that decrease military operational readiness and increase injury risk. The purpose of this study was to investigate the relationship between grip strength and upper body power in U.S. Infantry Marines. We hypothesized that dominant arm grip strength would show a strong positive correlation with upper body power and that the dominant arm would be more powerful than the non-dominant arm. ⋯ The results of this study suggest that grip strength is not predictive of upper body power and cannot be used as a stand-alone measure of physical readiness in a military unit. These findings do not, however, degrade the potential of both measures to predict and inform health status and physical readiness. Future prospective research should be conducted to determine if either of these measures can be used as indicators of performance and/or injury susceptibility and if limb dominance plays a role in injury incidence within the upper extremity.
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There have been nearly 1,600 new diagnoses of Human Immunodeficiency Virus (HIV) across the US Armed Forces between 2017 and 2022. While treatment has improved overall survival, self-perception of acquiring HIV may not align with actual risk of acquiring HIV, thus slowing diagnosis and treatment. We aim to evaluate self-perceived risk (SPR) versus calculated risk (CR) of HIV infection in US Air Force (USAF) members with incident HIV diagnosis. ⋯ The majority of USAF members with incident HIV infection reported a low SPR despite risk factors and CRs identical to high SPR patients. In order to inform HIV prevention strategies in the military, further efforts are needed to educate the military population and providers about HIV risk perception.
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Veterans have a higher national suicide rate than non-veterans (31.6 versus 18.0 per 100,000). Psychotherapy and other treatments are effective at reducing suicidality, yet stigma and barriers to care reduce willingness to seek help. For veterans who do seek help, they are often undertreated leaving them still in need of help. Online mental health tools (OMHTs) provide another option for obtaining help; however, there is limited research regarding the relationship between stigma and barriers to care, OMHT use, and suicidality. We hypothesized that stigma and barriers are related to higher likelihood of OMHT use and OMHT use is related to lower likelihood of suicidality. ⋯ Findings reinforce the need for research aimed at identifying ways to reduce stigma and barriers toward seeking help. Online mental health tools are a viable option for individuals experiencing stigma and barriers and for individuals who previously experienced suicidality.
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Many veterans with serious illnesses, such as end-stage kidney disease requiring dialysis and advanced cancer requiring treatment infusions, must make complex decisions about their current and future medical care. Advance care planning (ACP) is a process where individuals identify, express, and communicate their personal values, life goals, and preferences for care. ACP may be feasible in chemotherapy infusion centers or chronic dialysis centers during patient treatment. ⋯ This pilot study demonstrates that using PREPARE as an ACP tool for veterans may be feasible for patients during hemodialysis and chemotherapy infusion. Patients required considerable assistance from the LVN to complete PREPARE. Hemodialysis and chemotherapy infusion are opportunities when patients have time and space to consider ACP.