Military medicine
-
Comparative Study
Recovery of multidrug-resistant bacteria from combat personnel evacuated from Iraq and Afghanistan at a single military treatment facility.
U. S. combat casualties from Iraq and Afghanistan continue to develop infections with multidrug-resistant (MDR) bacteria. This study assesses the infection control database and clinical microbiology antibiograms at a single site from 2005 to 2007, a period when all Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) casualties admitted to the facility underwent initial isolation and screening for MDR pathogens. ⋯ There were remarkable changes in resistance profiles for Acinetobacter, K. pneumoniae, and S. aureus over time. Despite aggressive infection control procedures, there is continued nosocomial transmission within the facility and increasing antimicrobial resistance in some pathogens. Novel techniques are needed to control the impact of MDR bacteria in medical facilities.
-
Phytophotodermatitis is a phototoxic dermatologic reaction that occurs with exposure to ultraviolet light after contact with certain plant chemicals. Recognition is vital to proper management and avoidance of unnecessary distress for patients. Sun-sensitizing compounds, known as furocoumarins, are found in many plants (limes, celery, and natural grasses) and are excited by ultraviolet A (UVA) irradiation. ⋯ Accurate diagnosis avoids unnecessary concern by patients and potential misdiagnosis of abuse. Consider phytophotodermatitis when hyperpigmentation in bizarre streaks on sun-exposed areas with vesicles in a nondermatomal distribution is present. Presented is an illustrative case.
-
to evaluate the treatment of the acute coronary syndrome (ACS) among soldiers stationed on a theater of operations by structures usually conceived to treat combat-related trauma. ⋯ the medical structures deployed in a theater of operations were able to provide first treatment in ACS. The use of powerful diagnosis test, like troponine assay, must allow a better selection of the patients justifying a medical evacuation.
-
the long-term outcomes of wartime transtibial amputations have not been well documented. The purpose of this case series is to present the long-term functional, social, and psychological outcomes of modern-day military unilateral transtibial amputees. ⋯ at long-term follow-up, most military transtibial amputees experienced phantom sensation or some type of stump pain. More than half had persistent psychiatric problems, but only about half of these patients were receiving psychological treatment. Although this case series reports the status of these amputees, the next step would be to prospectively follow modern wartime amputees using standardized, validated outcome measures. With the goal of optimizing long-term amputee outcomes, researchers should correlate outcomes with demographics, injury characteristics, and treatments to identify and modify factors affecting the amputees' prognosis.