Military medicine
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Comparative Study
Evaluation of hemostatic field dressing for bacteria, mycobacteria, or fungus contamination.
Infectious complications have a major impact on wounded warriors. Pathogens causing infections include multidrug-resistant bacteria, fungi, and mycobacteria. The potential sources for these pathogens include nosocomial transmission, the environment (e.g., dirt), or the patients (skin flora) themselves. ⋯ No bacteria, fungi, or mycobacteria were recovered from the dressings. It does not appear that hemostatic field dressings are contaminated, even after subjected to field conditions. Further research is needed to identify inoculation sources of fungi and mycobacteria, which cause infections.
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Review Case Reports
Stellate ganglion block improves refractory post-traumatic stress disorder and associated memory dysfunction: a case report and systematic literature review.
The prevalence of post-traumatic stress disorder (PTSD) has reached epidemic proportions among U. S. veterans, many of whom also have concurrent alcohol use disorder. This case report describes improvements in PTSD symptom severity and memory dysfunction in a combat-exposed veteran with persistent PTSD and alcohol use disorder following two treatments of stellate ganglion block (SGB). ⋯ Following a second SGB, PTSD severity decreased by 57.7% and memory function substantially improved, with pronounced changes in immediate memory (50%), recent memory (58%), and recognition memory (36%). One year after SGB treatments, the patient has stopped drinking alcohol, continues to have sustained relief from PTSD, has improved memory function, and has become gainfully employed. Future studies that employ robust epidemiologic methodologies are needed to generate confirmatory evidence that would substantiate SGB's clinical utility as an adjunctive treatment option for PTSD.
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This study examined sleep histories associated with resilience after trauma defined as a continuous lack of psychiatric illness across 37 years. Data were drawn from a 37-year follow-up examination of the effects of the Vietnam prisoner of war (POW) experience. The Robert E. ⋯ Odds ratios examining presence of sleep symptoms show resilient RPWs reporting fewer symptoms compared to nonresilient RPWS before, during, and after captivity. Logistic regression comparing before, during, and after indicates fewer reported sleep disturbance symptoms after captivity was the strongest predictor of resilience (b = -0.82, Wald chi2 (1) = 16.70, p < 0.000). Reporting fewer sleep complaints, but not necessarily an absence of them before, during, and after the trauma predicts resilience across time.
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The Patient Protection and Affordable Care Act recently passed into law is poised to profoundly affect the provision of medical care in the United States. In today's environment, the foundation for most ongoing comparative effectiveness research is financial claims data. ⋯ That alternative, uniquely positioned to serve as a test system for national health reform efforts, is the Department of Defense Military Health System. This article describes how to leverage the Military Health System and provide effective solutions to current health care reform challenges in the United States.
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Chronic tendon pain from overuse is a common condition, with limited options for ongoing pain management. Two cases are presented in which pulsed radio frequency energy (PRFE) therapy was used for pain relief following surgical intervention for chronic tendinopathy-associated pain, unresponsive to conventional therapies. ⋯ Recent molecular evidence suggests a possible mechanism underlying PRFE-mediated pain relief. Further study into this promising technology is warranted.