Military medicine
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A 51-year-old woman was admitted to the intensive care unit for exacerbation of chronic obstructive pulmonary disease. She received antibiotics, neuromuscular blocking agents, and steroids. ⋯ Her weakness rapidly improved within 1 month after treatment of her hyperthyroidism with iodine-131 and methimazole. The metabolic alterations associated with hyperthyroidism may enhance the risk of developing critical illness myopathy after the administration of antibiotics, neuromuscular blocking agents, and steroids in the intensive care unit.
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The aim of this study was to understand the mechanism of nitrogen mustard on skin. ⋯ One of the major mechanisms of injury by nitrogen mustard may be the disruption of cytoskeletal filament network.
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The purpose of this study was to evaluate the impact of nursing telephone triage on the appropriateness of emergency department (ED) use among 563 patients at a military hospital by comparing 286 ED patients referred by the Tel-a-Nurse Line (TAN) with 277 non-TAN-referred patients from October 2000 to November 2000. When controlling for confounding factors, TAN-referred patients had less appropriate ED use than non-TAN-referred patients, although this was not statistically significant (odds ratio = 0.87, p = 0.452). ⋯ TAN patients directed to the ED because of clinic appointment unavailability contributed significantly to inappropriate ED use with 62% having low acuity. This finding underscores the need to evaluate clinic availability for the TAN line and possibly for all patients as well.
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The U. S. Department of Defense (DoD) conducts humanitarian assistance missions under the Overseas Humanitarian Disaster and Civic Aid program for the statutory purposes of training military personnel, serving the political interests of the host nation and United States, and providing humanitarian relief to foreign civilians. ⋯ Recommendations for improving the effectiveness of DoD HA under Overseas Humanitarian Disaster and Civic Aid programs include: ensuring adequate staffing to meet the complex, dynamic nature of humanitarian missions and measuring the effectiveness of each project in mandatory, standardized AARs. For medical HA projects, application of public health strategies would compliment the patient care approach of the majority of medical projects to date. This offers possibilities for enhancing host nation infrastructure, allowing improvements beyond the short period of most military humanitarian projects.