Military medicine
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A realistic approach to humanitarian principles in the field of the Law of Armed Conflict should take into account "military necessity." Does military necessity also play a role in the medical field? The provisions regarding the treatment of the wounded and sick seem definite because they are at the core of International Humanitarian Law. The conduct of military medical personnel, the attention to be paid to the wounded and sick, as well as to medical equipment or facilities are provisions that derive from unyielding principles of care, respect, protection, and equality of treatment. To what extent may this analysis be considered as contrary to the common realism of LOAC? How far should medical personnel be requested to implement the Geneva standards in any circumstance? In fact, unless otherwise specified, military necessity can never lead to a reduction in these standards in the course of battle.
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War is the ultimate form of human relations. From a Christian and Jewish point of view, it negates the most important of the Ten Commandments: "Thou shallt not kill." Is it pure illusion to believe that war may be subject to legal rules? Was Cicero possibly right when he wrote inter arma silent leges (in war, the law is silent)? The horrors of wars in the last decades have made it clear that Cicero's approach would lead us to the ultimate catastrophe, simply because the destructive potential of modern weaponry is so overwhelming that we need rules governing warfare. ⋯ Finally, we would like to show ways to implement Law of Armed Conflict in peacetime and during armed conflict. Where appropriate, reference is also made to the complementary body of human rights law and to standards of medical ethics.
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This study examines race-specific military service effects on outpatient care utilization in the Department of Veterans Affairs (VA) using data from the 1992 National Survey of Veterans. The study population consisted of 4,791 male veterans. After controlling for predisposing, enabling, and need variables, black veterans were 3.7 times more likely than white veterans to use VA outpatient care. ⋯ Hispanic veterans discharged for medical release were 5.3 times more likely than white veterans discharged for the same reason to use VA outpatient care. Korean conflict and mixed war period veterans were more likely to use VA outpatient care than World War II veterans. Racial/ethnic differences in military service characteristics influence the use of VA outpatient care and should be understood in delivering outpatient care to veterans.
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Regional anesthesia of the hand can be used in a vast array of hand injuries and minor operations. Local infiltration techniques require multiple injections and higher doses of anesthetic the that make them less preferable to peripheral nerve blocks. Regional anesthesia can be safe and effective as long as the provider has a firm understanding of the anatomy and technique. Multiple peripheral nerve blockade at the wrist can be a safe means of exploring complex wounds to the hand in both the emergency department and the operating room with minimal tissue distortion.
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In this study, patients with acute renal failure as a result of crush syndrome after the Marmara earthquake were evaluated retrospectively. Six hundred thirty injured patients were evaluated after the Marmara earthquake at Gülhane Military Medical Academy. Acute renal failure in association with crush syndrome developed in 31 patients. ⋯ Seventy-seven patients underwent fasciotomy, and 6 underwent extremity amputation. The total number of hemodialysis sessions was 173. Six patients died as a result of crush sepsis and adult respiratory distress syndrome.