Military medicine
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Much like their counterparts in private industry, federal medical officers, particularly preventive and occupational medicine physicians, must ensure a workforce fit to perform their duties. Meeting this objective often requires balancing competing interests between employers and employees. ⋯ This is needed to foster an equitable, compliant decision for both federal employers and employees. Using the Department of Defense as an example, this article provides a legal road map for the practitioner by defining medical standards and physical requirements, discussing medical examinations, and examining disability determinations.
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Bombs aimed at civilian populations are the most common weapon used by terrorists throughout the world. Over the last decade, we have been involved in the management of more than 20 mass casualty incidents, most of which were caused by terrorist bombings. Commonly, in these events, there may be many victims and many deaths. ⋯ Due to the complex mechanism of injury seen in these scenarios, treatment of victims injured by explosions is somewhat different from that exercised in blunt and penetrating trauma from other causes. The intention of this article was to outline the initial medical treatment of the injured victim arriving at the emergency department during a mass casualty incident caused by a terrorist bombing. Treatment protocols for stable, unstable, and in extremis patients are presented.
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A case report is presented for a 22-year-old male Marine who developed clinical symptoms of malaria while on terminal leave. His exposure history has included operational deployments to Liberia and Iraq. His care was complicated by his terminal leave status, which required detailed coordination with civilian providers as well as military authorities.
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The U. S. food supply is vulnerable to contamination with chemicals and toxins. Public health officials and clinicians may misdiagnose patients with acute chemical-associated foodborne illness (CAFI) due to unfamiliarity with chemical illness, increased familiarity with infectious foodborne illness, nonspecific presentation of most foodborne chemical poisoning, lack of readily available analytic methodologies to detect chemicals, and lack of education on how to develop a differential diagnosis for CAFI. This article will review the unique features of CAFI in the acute setting, address important questions to help differentiate CAFI from other foodborne illness, discuss laboratory features of CAFI, and provide health officials and clinicians with a clinical symptom-based approach to assist with proper identification and differentiation of acute CAFI.
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It is a popularly held belief that psychiatric behavior worsens during a full moon. Research in this area has yielded mixed results. Records from Naval Medical Center San Diego for 1993-2001 were examined to see whether there were higher rates of psychiatric admission associated with particular phases of the moon. ⋯ Records from 1,909 emergency psychiatric evaluations that occurred between 2002 and 2003 were also examined to see whether a higher percentage of patients might present, but not require hospitalization, during a particular phase of the moon. Once again, no significant effect was found. In summary, lunar phase was not associated in any significant way with psychiatric admissions or emergency presentation.