Military medicine
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Sulfur mustard has been used as a vesicant chemical warfare agent. To investigate the ocular damage it causes, we studied the effects on chemical casualties in the Iran-Iraq War. The patient population consisted of more than 5,000 chemical casualties, both military and civilian. ⋯ Ocular injuries generally heal completely. In severe cases, blindness may occur. The need for corneal transplantation is rare.
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Comparative Study
A comparison of morbidity in the Australian Defence Force with Australian general practice.
This study was designed to examine morbidity patterns among Australian Defence Forces members and to compare them with civilian general practice. The study was conducted in the outpatient departments of the Royal Australian Air Force (RAAF) No. 6 Hospital, Melbourne, Australia. The patients studied were male and female members of the RAAF (66%), Army (25%), and Navy (9%). ⋯ In the 6 Hospital study, 21,910 problems were managed at 19,909 consultations. The main differences found between the two studies were that service personnel had more medical examinations, more musculoskeletal and respiratory problems, and fewer psychological and cardiovascular problems. Most of the differences observed may reflect the Defence Force's recruitment selection criteria and the emphasis on physical fitness and diet.
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The optimal training of physicians should prepare them for the environment in which they will practice. During the past several years, the practice of internal medicine has shifted from a focus on the inpatient setting to one that includes an emphasis on the ambulatory clinic. Military internists must be further prepared to practice medicine with forward units, at field hospitals, and in other operational settings. ⋯ The program is driven by the residents and chief resident and requires little additional funding. Resident research continues to increase, morale remains high, and the first class to complete the 3-year operational curriculum achieved a 100% pass rate on the American Board of Internal Medicine certification examination. We describe our 3-year experience of implementing this program, with an emphasis on curriculum design and execution, qualitative assessment, and initial lessons learned.
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This study evaluates patient reasons and preferences for gender selection of their obstetrician-gynecologist. ⋯ Although a majority of our study population preferred female obstetrician-gynecologist providers, experience and reputation were more frequently cited than gender as the most important factors in selecting a provider. Patients felt that female physicians understand their problems better.
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Clinical Trial Controlled Clinical Trial
The COPE program: treatment efficacy and medical utilization outcome of a chronic pain management program at a major military hospital.
This study presents a treatment efficacy and medical utilization evaluation of a cognitive-behavioral, outpatient, chronic pain management program in a military hospital setting. A total of 61 nonmalignant chronic pain patients with heterogeneous pain syndromes who participated in sequential group programs were included in the study. Comprehensive and multi-dimensional outcome criteria were used, including pain ratings, relaxation skills, quality of life, satisfaction ratings, and medical utilization. ⋯ This reduction amounts to a projected net annual saving of $78,960 in the first year after behavioral medicine intervention. In light of the increasing cost of health care for chronic pain patients, psychological approaches as an adjunct to traditional medical care seem to present a sound solution for cost savings. This study also supports the notion that a strategic biopsychosocial pain program, which targets the multiple dimensions of persistent pain, provides effective treatment and increases patient satisfaction.