Military medicine
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Emphasis on cost reduction, national standardization of medical care, and quality improvement initiatives have led to reduced postoperative hospital stays after cardiac surgery. The present study was designed to verify the observation that valve patients have longer lengths of stay than bypass patients and to identify possible reasons. ⋯ Cardiac valve procedures are associated with prolonged lengths of stay compared with isolated coronary bypass procedures. Despite recent trends toward earlier operation, valve patients tended to present with advanced disease. More than half of the valve patients required complex surgical procedures. This is reflected in longer bypass times, increased bleeding complications, and more postoperative support. The proportion of valvular surgery patients should be considered when analyzing lengths of stay for cardiac surgery cohorts.
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WR-2721, the leading compound that has emerged from the U. S. Army's Drug Synthesis and Development Program, has become the first clinically used cytoprotector in cancer therapy. ⋯ At these lower drug concentrations, phosphorylation levels and subsequent activities on intracellular enzymes are also inhibited. These observations suggest that the mechanisms of action of WR-2721 and its metabolites to protect against cell killing are different from those that protect against mutagenesis and cancer formation. The ability to affect these postexposure processes makes WR-2721 an important agent in the reduction of the carcinogenic risks of environmental exposure to radiation or deleterious chemicals.
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Case Reports Comparative Study
Bystander cricothyroidotomy performed with an improvised airway.
We report a roadside cricothyroidotomy successfully performed with only a pocketknife and the drinking straw from a sports bottle. Our study compared the adequacy of standard medical airway devices with some readily available nonmedical items that might be used as temporary tracheostomy tubes (TT). ⋯ This is the first study to compare available nonmedical items that might be used as temporary TTs for bystander cricothyroidotomy. Two types of straws found on sports bottles had relatively low Raw compared with standard TTs. However, the barrel from a ballpoint pen had a much higher Raw and is an unacceptable choice.
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The general public, the mass media, and many government officials believe that the use of weapons of mass destruction (WMD) will inevitably lead to mass panic and/or mass hysteria. However, studies of disasters and wars show that disorganized flight in the presence of a real or perceived danger (i.e., mass panic) is rare. On the other hand, in a real or perceived WMD scenario, outbreaks of multiple unexplained symptoms (i.e., mass psychogenic illness, mass sociogenic illness, mass hysteria, or epidemic hysteria) may be prevalent. Many of the symptoms (fatigue, nausea, vomiting, headache, dizziness/lightheadedness, and anorexia) are common in combat and after toxic chemical exposure, chemical weapon exposure, prodromal infectious illness, and acute radiation sickness.
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Securing the airway of a wounded soldier while operating in a light-restricted combat environment may be required of forward-deployed military medical personnel. The best method of obtaining such an airway has not been addressed. In this pilot study, the objective was to examine the use of endotracheal intubation using an infrared filtered laryngoscope and night vision goggles. ⋯ This study demonstrates that endotracheal intubation can be performed using a laryngoscope with an infrared filter and night vision goggles with a high success rate in a select population in a darkened environment.