Military medicine
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The prevalence and incidence of HIV-1 infection in the U. S. military has been higher in minorities than in whites. In order to understand the reason for this disproportionate impact of the epidemic, military HIV research efforts were reviewed for race/ethnic-specific differences in a conference held in July 1993. ⋯ This report summarizes the presentations made at that conference. Few race/ethnic-related differences were identified in this setting of early diagnosis of HIV-1 infection and equal access to a quality health care system. More information of this type will be needed to allow the targeting of interventions for maximal effect in decreasing the risk of HIV infection.
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Epilepsy is a frequent consequence after missile wounds of the brain. So far, no epilepsy cases with missile injury have been described in which epilepsy ensued without direct missile injury of the brain. During World War II, in 1941, our patient, then a soldier in the German army, suffered a bullet injury to the head; the bullet entered the cranium at the base of the nose. ⋯ High-velocity missiles are increasingly used in armed conflicts around the world. In light of the case reported here, in which the initial epilepsy was exacerbated more than 50 years after the wounding event, physicians must consider this possibility when dealing with veterans presenting with seizures. This case also has implications for the payment of benefits and pensions.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of rectal to intranasal administration of midazolam for premedication of children.
Sixty children aged 3 to 9, undergoing minor surgical procedures, were studied to compare 0.5 mg/kg intranasal with 0.5 mg/kg rectal midazolam as a premedication. The children were evaluated for their ability to tolerate the medication, preanesthetic sedation, and alertness after anesthesia. ⋯ Rectal midazolam was much better tolerated by the children than the intranasal route (30 versus 3, p < 0.0001). We advocate the rectal over the intranasal route for premedication with midazolam in children, and anesthetic induction should occur no more than 30 minutes after administration of premedication.
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Detailed knowledge of anticipated casualties is essential for the medical officer preparing to support a mission. To accurately describe the injuries inflicted upon the 2/75th Ranger Battalion involved in Operation Just Cause, 471 (75.5%) Rangers were personally interviewed. The average Ranger was 23 years old, an E-4 with 3 years of active duty service, and in a good to excellent fitness category. ⋯ Most of the injuries were musculoskeletal (sprains) and non-surgical, with 90% occurring during the insertion. The lower extremity, particularly the ankle, was the most frequently injured area. It is hoped that this study will assist those who are planning to support future, similar nighttime parachute operations.