Military medicine
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Barbiturate anesthesia for cesarean section was well described by Kosaka almost 20 years ago. However, light balanced anesthesia has become the unofficial standard general anesthesia for cesarean section in this country. ⋯ The dilemma posed by cesarean section of a young woman with posterior fossa brain tumor led us to revive use of Kosaka's higher doses of thiobarbiturate. Together with regional and topical anesthesia of the larynx and trachea, this method resulted in stable maternal hemodynamics without resulting in neonatal depression.
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There will always be a need for some kind of rapidly deployable, easy to assemble, temporary shelter for use in military conflicts, large-scale military disasters, industrial accidents, major construction projects in remote areas, refugee relocation centers, military hospitals, and any temporary outdoor event requiring cover. The history of tenting is essentially a history of man's ingenuity in creating portable, rapidly erected, temporary shelter. This article will be limited to the stages of development of the latest in military tent hospitals.
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Combat casualty care research on far-forward resuscitation is necessary for optimizing the future care of the wounded soldier. Present legal directives pertaining to the use of humans as subjects in Department of Defense (DOD)-funded research require that prior informed consent from the subjects or their legal representatives be obtained. ⋯ This article reviews the medical considerations surrounding resuscitation research that make obtaining traditional informed consent impossible, the present legal directives pertaining to DOD-funded research and informed consent, and the ethical issues that influence the conduct of human research. The necessary changes required to continue resuscitation research without informed consent, while still safeguarding the welfare of the patient, are suggested.
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Side-effects and immunogenicity of the Haemophilus influenzae type B polysaccharide vaccine (Hbpv) were reported following introduction in a multi-ethnic border population of 2- to 6-year-old U. S. military dependents. Eighty percent of 659 vaccinees were reported by parents to have no reactions within 48 hours following vaccination; 20% were reported to have local and/or systemic reactions. ⋯ Of the 114 vaccines with serologic data, those with side-effects had serologic changes comparable to those without side-effects. There was no difference in side-effects or immunologic response across ethnic groups. Therefore, side-effects, immunologic responses, and ethnic group appear to be independent variables.