Military medicine
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To determine whether controlled resuscitation with pyruvate-fortified Ringer's (PR) solution vs. conventional lactate Ringer's (LR) more effectively stabilizes mean arterial pressure (MAP) and suppresses myocardial inflammation postresuscitation. ⋯ Relative to LR, resuscitation with PR more effectively stabilized MAP, suppressed myocardial nitrosative stress and minimized systemic inflammation after hemorrhagic shock with hindlimb ischemia-reperfusion.
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The objective of this study was to determine whether health care providers at the Department of Veterans Affairs Medical Center (VAMC) in Salem, Virginia were adherent to lipid-lowering medication guidelines over a 5-year period. Five hundred randomly chosen electronic medical records of veterans with diabetes, congestive heart failure, and/or coronary artery disease were examined for the use of HMG-CoA reductase inhibitors as part of a larger study on patient-provider adherence to cardiovascular risk-reduction guidelines. Study findings indicated that health care providers prescribed HMG-CoA reductase inhibitors to patients at high risk per evidence-based guidelines. Provider adherence to guidelines rose each year of the study, which coincided with the Department of Veterans Affairs Medical Center efforts to educate health care providers about the evidence-based guidelines, utilization of computer-generated reminders, open access appointment scheduling, and increased collaboration with patients.
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A young adult male suffered a combat gunshot wound to his anterior trachea, which resulted in bullet migration, via aspiration, to the point of lodgment in the right upper lobe bronchus. He subsequently spontaneously expectorated the intact bullet, a first report of such events. A bronchoscopy was then performed confirming the site of entry, position of previous lodgment, and lack of further pathology. A brief discussion of expected findings, management, and complications are discussed.
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Soldiers from the Republic of Korea and the United States conduct armistice military operations at Twin Bridges Training Area (TBTA) located near the demilitarized zone (DMZ) and are exposed to zoonotic disease pathogens that small mammals and their potentially disease-carrying ectoparasites transmit. TBTA is a 36 km2 rural training site with small villages and various forms of agriculture along its boundary. At TBTA, rodents, insectivores, and their ectoparasites are commonly found in association with unmanaged habitats of various densities of tall grasses, herbaceous plants, shrubs, briars, and crawling vegetation. ⋯ A. agrarius (56.1%), M. musculus (66.7%), M. minutus (25%), and R. rattus (100%) were positive for scrub typhus antibodies. Only A. agrarius (14.7%) and C. lasiura (4.5%) were positive for murine typhus antibodies, whereas only A. agrarius (1.5%) was seropositive for leptospirosis. Seroprevalence rates of scrub typhus and murine typhus based on weight and sex of A. agrarius are presented.
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This study aimed to determine whether preventive health assessment currency and medical nondeployability rates were the same for all active duty members in the U.S. Air Force. ⋯ Evidence of disparities in medical deployability rates for Asian/Pacific Islanders, non-Hispanic Blacks, and senior enlisted active duty members suggest that further investigation is warranted to ensure existing policy and procedures do not contribute to health disparities.