Military medicine
-
Musculoskeletal injuries have long been a problem in general purpose forces, yet anecdotal evidence provided by medical, human performance, and training leadership suggests musculoskeletal injuries are also a readiness impediment to Special Operations Forces (SOF). The purpose of this study was to describe the injury epidemiology of SOF utilizing self-reported injury histories. Data were collected on 106 SOF (age: 31.7 ± 5.3 years, height: 179.0 ± 5.5 cm, mass: 85.9 ± 10.9 kg) for 1 year before the date of laboratory testing and filtered for total injuries and those with the potential to be preventable based on injury type, activity, and mechanism. ⋯ Physical training (PT) was the most reported activity for total/preventable injuries (PT Command Organized: 46.2%/60.0%, PT Noncommand Organized: 7.7%/10.0%, PT Unknown: 3.8%/5.0%). Musculoskeletal injuries impede optimal physical readiness/tactical training in the SOF community. The data suggest a significant proportion of injuries are classified as preventable and may be mitigated with human performance programs.
-
Comparative Study
Prevalence, health care utilization, and costs of fibromyalgia, irritable bowel, and chronic fatigue syndromes in the military health system, 2006-2010.
We compared prevalence, health care utilization, and costs over time for nonelderly adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) in relation to timing of federal approvals for FMS drugs. ⋯ Although cause and effect cannot be established, the advent of federally approved drugs for FMS in concert with pharmaceutical industry marketing of these drugs coincide with the observed changes in prevalence, health care utilization, and costs of FMS relative to IBS and CFS.
-
Observational Study
2-point ultrasonography to confirm correct position of the gastric tube in prehospital setting.
X-ray remains the "gold standard" test to control the gastric tube (GT) position. The aim of this study is to estimate the diagnostic accuracy of a 2-point ultrasonography to confirm GT placement in the prehospital setting. ⋯ The 2-point ultrasonographic live control of the GT position has a better sensitivity and a much higher specificity than the syringe test but similar to the xiphoid ultrasound control. However, our method allows to show the GT in the esophagus and to use the dynamic ultrasound fogging to reveal an intragastric position that was not obvious with the common techniques.
-
Adjuvant radioactive iodine (RAI) for the treatment of differentiated thyroid cancer has been associated with better prognosis, but no consensus has been reached on the best practices for RAI. Limited data on RAI use and factors associated with the receipt of postoperative RAI in the general population are available and, to our knowledge, no data on RAI use among the U.S. Department of Defense (DoD) beneficiaries. ⋯ Among DoD beneficiaries, adjuvant RAI use was associated with clinical and nonclinical factors. Although evidence of effect modification between the recipient of RAI by tumor size was apparent, future research with a larger sample size is warranted to confirm results of this study.