首页 > 最新文献

Military Medicine最新文献

英文 中文
Review of the U.S. Air Force Academy Hepatitis C Virus Screening Program to Ensure High-Value Care. 审查美国空军学院丙型肝炎病毒筛查计划以确保高价值护理。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae273
Devin C Kelly, Bryant Webber

Introduction: Hepatitis C virus (HCV) is primarily transmitted through blood-to-blood contact. Leading health agencies have called for the elimination of HCV as a public health threat, with universal screening considered a part of the strategy. Hepatitis C virus screening among incoming cadets and cadet candidates at the United States Air Force Academy (USAFA) was implemented in 2023. The purpose of this quality improvement project was to determine the results of this screening and the associated fiscal costs, benefits, and harms to make a recommendation for future incoming classes.

Materials and methods: The prevalence of HCV antibody positivity and confirmed HCV infections were calculated among the incoming cadets and cadet candidates at USAFA in summer 2023. Screening was conducted with a highly sensitive HCV total antibody test, and those who screened positive were further tested with a quantitative HCV polymerase chain reaction. The screening and follow-up care costs were calculated, and the potential harm of receiving a false positive notification was considered.

Results: Of the 1,360 persons screened at USAFA in 2023, no confirmed HCV infections were identified. There was one false positive on screening in the cadet population (n = 1,131) and one false positive in the cadet candidate population (n = 229). The fiscal cost of universal HCV screening upon accession of cadets and cadet candidates, including medical follow-up, was at least $5,279. The opportunity cost was minimal because blood was drawn for other mandatory programs, although screening may have caused social and psychological harm to those receiving a false positive notification.

Conclusions: The prevalence of chronic HCV infection among incoming USAFA cadets and cadet candidates was 0%, below the population screening threshold that warrants screening, according to the Centers for Disease Control and Prevention. The harms of screening, including fiscal costs and potential psychological harm to individuals with a false positive screen, likely outweigh the benefits. We recommend against universal HCV screening in 2024 upon accession of USAFA cadets and cadet candidates.

简介丙型肝炎病毒(HCV)主要通过血液接触传播。主要卫生机构呼吁消除丙型肝炎病毒对公共卫生的威胁,并将普遍筛查作为战略的一部分。美国空军学院(USAFA)于 2023 年开始对新生和候补学员进行丙型肝炎病毒筛查。本质量改进项目的目的是确定此次筛查的结果以及相关的财政成本、收益和危害,从而为未来的新生班级提出建议:材料和方法:计算了 2023 年夏季美国空军学院新生和候选学员中 HCV 抗体阳性和确诊 HCV 感染的流行率。筛查是通过高灵敏度的 HCV 总抗体检测进行的,筛查结果呈阳性的学员将进一步接受定量 HCV 聚合酶链反应检测。我们计算了筛查和后续治疗的成本,并考虑了收到假阳性通知的潜在危害:2023 年在美国空军进行筛查的 1360 人中,未发现确诊的 HCV 感染者。在学员群体(n = 1,131)和候选学员群体(n = 229)中,分别出现了一次筛查假阳性。在军校学员和军校候选人入校时普遍进行 HCV 筛查(包括医疗随访)的经济成本至少为 5,279 美元。尽管筛查可能会对那些收到假阳性通知的人造成社会和心理伤害,但由于抽血用于其他强制性项目,因此机会成本极低:结论:根据美国疾病控制与预防中心(Centers for Disease Control and Prevention)的数据,USAFA新生和候选学员中慢性丙型肝炎病毒感染率为0%,低于需要进行筛查的人群筛查阈值。筛查的弊端,包括财政成本和假阳性筛查对个人造成的潜在心理伤害,很可能会得不偿失。我们建议不要在 2024 年美国海军陆战队学员和候选学员入学时进行普遍的 HCV 筛查。
{"title":"Review of the U.S. Air Force Academy Hepatitis C Virus Screening Program to Ensure High-Value Care.","authors":"Devin C Kelly, Bryant Webber","doi":"10.1093/milmed/usae273","DOIUrl":"10.1093/milmed/usae273","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis C virus (HCV) is primarily transmitted through blood-to-blood contact. Leading health agencies have called for the elimination of HCV as a public health threat, with universal screening considered a part of the strategy. Hepatitis C virus screening among incoming cadets and cadet candidates at the United States Air Force Academy (USAFA) was implemented in 2023. The purpose of this quality improvement project was to determine the results of this screening and the associated fiscal costs, benefits, and harms to make a recommendation for future incoming classes.</p><p><strong>Materials and methods: </strong>The prevalence of HCV antibody positivity and confirmed HCV infections were calculated among the incoming cadets and cadet candidates at USAFA in summer 2023. Screening was conducted with a highly sensitive HCV total antibody test, and those who screened positive were further tested with a quantitative HCV polymerase chain reaction. The screening and follow-up care costs were calculated, and the potential harm of receiving a false positive notification was considered.</p><p><strong>Results: </strong>Of the 1,360 persons screened at USAFA in 2023, no confirmed HCV infections were identified. There was one false positive on screening in the cadet population (n = 1,131) and one false positive in the cadet candidate population (n = 229). The fiscal cost of universal HCV screening upon accession of cadets and cadet candidates, including medical follow-up, was at least $5,279. The opportunity cost was minimal because blood was drawn for other mandatory programs, although screening may have caused social and psychological harm to those receiving a false positive notification.</p><p><strong>Conclusions: </strong>The prevalence of chronic HCV infection among incoming USAFA cadets and cadet candidates was 0%, below the population screening threshold that warrants screening, according to the Centers for Disease Control and Prevention. The harms of screening, including fiscal costs and potential psychological harm to individuals with a false positive screen, likely outweigh the benefits. We recommend against universal HCV screening in 2024 upon accession of USAFA cadets and cadet candidates.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e11-e14"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141246857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Priority Competencies for Designated Education Officers in the Veterans Health Administration. 退伍军人健康管理局指定教育官员的优先能力。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae239
Duane R Bidwell, Anita Samuel, Ronald M Cervero, Steven J Durning, Sherri L Stephan, Erin L Patel, Marjorie A Bowman, Holly S Meyer

Introduction: Designated Education Officers (DEOs) at Veteran Health Administration (VHA) hospitals are senior educational leaders tasked with oversight of all clinical training at a particular facility. They prioritize dozens of tasks and responsibilities each day, from educational policy and strategy to staff management, financial planning, onboarding of trainees, and facility planning and management. Clarifying priority competencies for the role can help executives recruit, appoint, and evaluate capable personnel and promote effective, efficient performance.

Materials and methods: Using a federally developed method of competency analysis, researchers consulted a panel of subject-matter experts to identify priority competencies for DEOs, using data from a 2013 study that operationalizes competencies for more than 200 federal jobs.

Results: The research identified 25 primary competencies within 6 leadership domains. Five of the primary competencies cut across all leadership domains.

Conclusions: Veteran Health Administration subject-matter experts in educational leadership say the identified competencies are urgently needed, critical for effective leadership, and valuable for distinguishing superior DEO performance. The competencies are relevant to VHA and perhaps other senior academic leaders who develop health professions education programs, oversee clinical training, and manage educational change. In military training facilities, attending to these competencies can help Designated Institutional Officials responsible for graduate medical education become more credible partners to other hospital leaders and contribute to becoming a high reliability organization. Executives identifying, recruiting, and appointing VHA DEOs and Designated Institutional Officials at military training facilities should consider these competencies when assessing candidates.

导言:退伍军人健康管理局(VHA)医院的指定教育官员(DEOs)是高级教育领导者,负责监督特定机构的所有临床培训。他们每天要优先处理数十项任务和职责,从教育政策和战略到员工管理、财务规划、学员入职以及设施规划和管理。明确该角色的优先能力可以帮助管理人员招聘、任命和评估有能力的人员,并促进有效、高效的绩效:研究人员使用联邦开发的能力分析方法,咨询了一个主题专家小组,利用2013年一项研究中的数据,确定了DEO的优先能力,该研究对200多个联邦职位的能力进行了操作:研究确定了 6 个领导力领域中的 25 项主要能力。结论:退伍军人健康管理局的专题研究发现了 6 个领导力领域中的 25 种主要能力,其中 5 种能力横跨所有领导力领域:退伍军人健康管理局教育领导力方面的主题专家表示,所确定的能力是迫切需要的,是有效领导力的关键,对于区分卓越的 DEO 业绩非常有价值。这些能力与退伍军人健康管理局以及其他负责制定卫生专业教育计划、监督临床培训和管理教育变革的高级学术领导者息息相关。在军事训练设施中,对这些能力的关注可以帮助负责毕业医学教育的指定机构官员成为其他医院领导更可信的合作伙伴,并为成为一个高可靠性的组织做出贡献。在对候选人进行评估时,负责识别、招聘和任命 VHA DEO 和军事培训机构指定机构官员的管理人员应该考虑这些能力。
{"title":"Priority Competencies for Designated Education Officers in the Veterans Health Administration.","authors":"Duane R Bidwell, Anita Samuel, Ronald M Cervero, Steven J Durning, Sherri L Stephan, Erin L Patel, Marjorie A Bowman, Holly S Meyer","doi":"10.1093/milmed/usae239","DOIUrl":"10.1093/milmed/usae239","url":null,"abstract":"<p><strong>Introduction: </strong>Designated Education Officers (DEOs) at Veteran Health Administration (VHA) hospitals are senior educational leaders tasked with oversight of all clinical training at a particular facility. They prioritize dozens of tasks and responsibilities each day, from educational policy and strategy to staff management, financial planning, onboarding of trainees, and facility planning and management. Clarifying priority competencies for the role can help executives recruit, appoint, and evaluate capable personnel and promote effective, efficient performance.</p><p><strong>Materials and methods: </strong>Using a federally developed method of competency analysis, researchers consulted a panel of subject-matter experts to identify priority competencies for DEOs, using data from a 2013 study that operationalizes competencies for more than 200 federal jobs.</p><p><strong>Results: </strong>The research identified 25 primary competencies within 6 leadership domains. Five of the primary competencies cut across all leadership domains.</p><p><strong>Conclusions: </strong>Veteran Health Administration subject-matter experts in educational leadership say the identified competencies are urgently needed, critical for effective leadership, and valuable for distinguishing superior DEO performance. The competencies are relevant to VHA and perhaps other senior academic leaders who develop health professions education programs, oversee clinical training, and manage educational change. In military training facilities, attending to these competencies can help Designated Institutional Officials responsible for graduate medical education become more credible partners to other hospital leaders and contribute to becoming a high reliability organization. Executives identifying, recruiting, and appointing VHA DEOs and Designated Institutional Officials at military training facilities should consider these competencies when assessing candidates.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e5-e10"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Joint Trauma System Clinical Practice Guideline: Traumatic Brain Injury Management and Basic Neurosurgery in the Deployed Environment. 联合创伤系统临床实践指南:创伤性脑损伤管理和部署环境中的基础神经外科。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae298
Bradley Dengler, Randall McCafferty, Christopher Neal, Randy Bell, Brian J Sonka, Shane Jensen, Matthew D Tadlock, Jan-Michael Van Gent, Remealle A How, Jennifer Gurney

Management of the patient with moderate to severe brain injury in any environment can be time consuming and resource intensive. These challenges are magnified while forward deployed in austere or hostile environments. This Joint Trauma System Clinical Practice Guideline provides recommendations for the treatment and medical management of casualties with moderate to severe head injuries in an environment where personnel, resources, and follow-on care are limited. These guidelines have been developed by acknowledging commonly recognized recommendations for neurosurgical and neuro-critical care patients and augmenting those evaluations and interventions based on the experience of neurosurgeons, trauma surgeons, and intensivists who have delivered care during recent coalition conflicts.

在任何环境下对中度至重度脑损伤患者进行管理都需要耗费大量时间和资源。在艰苦或敌对环境中前沿部署时,这些挑战会更加严峻。本《联合创伤系统临床实践指南》提供了在人员、资源和后续护理有限的环境中对中度至重度颅脑损伤伤员进行治疗和医疗管理的建议。在制定这些指南时,我们参考了公认的神经外科和神经重症监护患者的建议,并根据神经外科医生、创伤外科医生和重症监护医生在近期联盟冲突中的救治经验,对这些评估和干预措施进行了补充。
{"title":"A Joint Trauma System Clinical Practice Guideline: Traumatic Brain Injury Management and Basic Neurosurgery in the Deployed Environment.","authors":"Bradley Dengler, Randall McCafferty, Christopher Neal, Randy Bell, Brian J Sonka, Shane Jensen, Matthew D Tadlock, Jan-Michael Van Gent, Remealle A How, Jennifer Gurney","doi":"10.1093/milmed/usae298","DOIUrl":"10.1093/milmed/usae298","url":null,"abstract":"<p><p>Management of the patient with moderate to severe brain injury in any environment can be time consuming and resource intensive. These challenges are magnified while forward deployed in austere or hostile environments. This Joint Trauma System Clinical Practice Guideline provides recommendations for the treatment and medical management of casualties with moderate to severe head injuries in an environment where personnel, resources, and follow-on care are limited. These guidelines have been developed by acknowledging commonly recognized recommendations for neurosurgical and neuro-critical care patients and augmenting those evaluations and interventions based on the experience of neurosurgeons, trauma surgeons, and intensivists who have delivered care during recent coalition conflicts.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"124-134"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adapting to the Rapidly Changing Landscape of Inflammatory Bowel Disease Management-An Opportunity to Medically Optimize Our Fighting Forces. 适应快速变化的炎症性肠病管理环境--医疗优化我们战斗力的机会。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae355
Jeffrey Kwan, Michael Sikes, Kevin Pak, Michael Skaret, Joshua McCarron, Thomas Mellor, Brian Park, Daryl Fick, Benjamin Fiore
{"title":"Adapting to the Rapidly Changing Landscape of Inflammatory Bowel Disease Management-An Opportunity to Medically Optimize Our Fighting Forces.","authors":"Jeffrey Kwan, Michael Sikes, Kevin Pak, Michael Skaret, Joshua McCarron, Thomas Mellor, Brian Park, Daryl Fick, Benjamin Fiore","doi":"10.1093/milmed/usae355","DOIUrl":"10.1093/milmed/usae355","url":null,"abstract":"","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"33-35"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the Phenotypic Patterns of Post-Traumatic Headache: A Systematic Review of Military Personnel. 评估创伤后头痛的表型模式:军事人员的系统回顾。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae353
Hannah S Lyons, Matilde Sassani, Mark Thaller, Andreas Yiangou, Olivia Grech, Susan P Mollan, Duncan R Wilson, Samuel J E Lucas, James L Mitchell, Lisa J Hill, Alexandra J Sinclair

Introduction: Mild traumatic brain injury (TBI) affects a significant number of military personnel, primarily because of physical impact, vehicle incidents, and blast exposure. Post-traumatic headache (PTH) is the most common symptom reported following mild TBI and can persist for several years. However, the current International Classification of Headache Disorders lacks phenotypic characterization for this specific headache disorder. It is important to appropriately classify the headache sub-phenotypes as it may enable more targeted management approaches. This systematic review seeks to identify the most common sub-phenotype of headaches in military personnel with PTH attributed to mild TBI.

Methods: We conducted a systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines, focusing on the military population. PubMed, Web of Science, Cochrane, and Clinicaltrials.gov databases were searched. Abstracts and full texts were independently reviewed by two authors using predefined inclusion and exclusion criteria. Data extraction was performed using a standardized form. The risk of bias was assessed using the Newcastle-Ottawa Scale.

Results: Eight papers related to the military population were included in this review. Migraine was the most commonly reported headache sub-phenotype, with a prevalence ranging from 33 to 92%. Additionally, one military study identified tension-type headaches as the most prevalent headache phenotype. Although not the primary phenotype, one military cohort reported that approximately one-third of their cohort experienced trigeminal autonomic cephalalgias, which were associated with exposure to blast injuries and prior concussions.

Conclusion: This systematic review demonstrated that PTH in the military population frequently exhibit migraine-like features. Tension-type headache and trigeminal autonomic cephalalgias also occur, although less commonly reported. Sub-phenotyping PTH may be important for initiating effective treatment since different phenotypes may respond differently to medications. The study populations analyzed in this systematic review display heterogeneity, underscoring the necessity for additional research features, more stringent criteria and comprehensive recording of baseline characteristics. Characterizing headaches following injury is crucial for an accurate diagnosis to enable effective management and rehabilitation planning for our armed forces.

导言:轻度创伤性脑损伤(TBI)影响着大量军人,主要原因是身体撞击、车辆事故和爆炸暴露。创伤后头痛(PTH)是轻度 TBI 后最常见的症状,可持续数年。然而,目前的《国际头痛疾病分类》缺乏对这种特殊头痛疾病的表型特征描述。对头痛亚表型进行适当分类非常重要,因为这样可以采取更有针对性的管理方法。本系统综述旨在确定因轻度创伤性脑损伤而患有 PTH 的军人最常见的头痛亚表型:我们按照《系统综述和荟萃分析首选报告项目》的报告指南进行了系统检索,重点关注军人群体。我们检索了 PubMed、Web of Science、Cochrane 和 Clinicaltrials.gov 数据库。摘要和全文由两位作者使用预定义的纳入和排除标准进行独立审核。数据提取采用标准表格进行。采用纽卡斯尔-渥太华量表对偏倚风险进行了评估:本综述共收录了八篇与军人有关的论文。偏头痛是最常报告的头痛亚型,发病率从 33% 到 92% 不等。此外,一项军事研究发现紧张型头痛是最常见的头痛表型。尽管不是主要表型,但一项军事队列研究报告称,其队列中约有三分之一的人患有三叉神经自律性头痛,这与暴露于爆炸伤害和之前的脑震荡有关:本系统综述表明,军人中的 PTH 常表现出偏头痛的类似特征。紧张型头痛和三叉神经自主性头痛也有发生,但报道较少。对 PTH 进行亚表型分析可能对开始有效治疗非常重要,因为不同的表型可能对药物产生不同的反应。本系统综述中分析的研究人群具有异质性,这说明有必要增加研究特征、制定更严格的标准并全面记录基线特征。描述受伤后头痛的特征对于准确诊断至关重要,这样才能为我们的武装部队提供有效的管理和康复计划。
{"title":"Evaluating the Phenotypic Patterns of Post-Traumatic Headache: A Systematic Review of Military Personnel.","authors":"Hannah S Lyons, Matilde Sassani, Mark Thaller, Andreas Yiangou, Olivia Grech, Susan P Mollan, Duncan R Wilson, Samuel J E Lucas, James L Mitchell, Lisa J Hill, Alexandra J Sinclair","doi":"10.1093/milmed/usae353","DOIUrl":"10.1093/milmed/usae353","url":null,"abstract":"<p><strong>Introduction: </strong>Mild traumatic brain injury (TBI) affects a significant number of military personnel, primarily because of physical impact, vehicle incidents, and blast exposure. Post-traumatic headache (PTH) is the most common symptom reported following mild TBI and can persist for several years. However, the current International Classification of Headache Disorders lacks phenotypic characterization for this specific headache disorder. It is important to appropriately classify the headache sub-phenotypes as it may enable more targeted management approaches. This systematic review seeks to identify the most common sub-phenotype of headaches in military personnel with PTH attributed to mild TBI.</p><p><strong>Methods: </strong>We conducted a systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines, focusing on the military population. PubMed, Web of Science, Cochrane, and Clinicaltrials.gov databases were searched. Abstracts and full texts were independently reviewed by two authors using predefined inclusion and exclusion criteria. Data extraction was performed using a standardized form. The risk of bias was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Eight papers related to the military population were included in this review. Migraine was the most commonly reported headache sub-phenotype, with a prevalence ranging from 33 to 92%. Additionally, one military study identified tension-type headaches as the most prevalent headache phenotype. Although not the primary phenotype, one military cohort reported that approximately one-third of their cohort experienced trigeminal autonomic cephalalgias, which were associated with exposure to blast injuries and prior concussions.</p><p><strong>Conclusion: </strong>This systematic review demonstrated that PTH in the military population frequently exhibit migraine-like features. Tension-type headache and trigeminal autonomic cephalalgias also occur, although less commonly reported. Sub-phenotyping PTH may be important for initiating effective treatment since different phenotypes may respond differently to medications. The study populations analyzed in this systematic review display heterogeneity, underscoring the necessity for additional research features, more stringent criteria and comprehensive recording of baseline characteristics. Characterizing headaches following injury is crucial for an accurate diagnosis to enable effective management and rehabilitation planning for our armed forces.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e90-e98"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Operation Baby Drop: Lessons Learned From Military International Air Transport of Critically Ill Neonate. 弃婴行动:军事国际空运危重新生儿的经验教训。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae578
Kaitlyn Mullin, Elizabeth Okonek, Jeanne Krick

Military medical transport is unique due to its frequent long-distance travel with limited supplies and capabilities. Military neonatal transport is perhaps even more niche, and descriptions in the literature are rare. A military neonatal team transported a 1-month-old former 26-week infant from a forward-deployed non-combat setting. Due to complications in-flight, the infant could only be safely transported from the deployed setting to the refueling stop. This report is a descriptive analysis of the transport, including lessons learned that may help future teams plan for possible complications that can occur during neonatal transports.

军事医疗运输的独特之处在于其频繁的长途旅行和有限的供应和能力。军事新生儿运输可能更小众,文献中的描述是罕见的。一个军事新生儿小组从前沿部署的非战斗环境中运送了一名1个月大的前26周婴儿。由于飞行中的并发症,婴儿只能安全地从部署设置运送到加油站。本报告是对转运的描述性分析,包括吸取的经验教训,可能有助于未来的团队计划新生儿转运过程中可能发生的并发症。
{"title":"Operation Baby Drop: Lessons Learned From Military International Air Transport of Critically Ill Neonate.","authors":"Kaitlyn Mullin, Elizabeth Okonek, Jeanne Krick","doi":"10.1093/milmed/usae578","DOIUrl":"https://doi.org/10.1093/milmed/usae578","url":null,"abstract":"<p><p>Military medical transport is unique due to its frequent long-distance travel with limited supplies and capabilities. Military neonatal transport is perhaps even more niche, and descriptions in the literature are rare. A military neonatal team transported a 1-month-old former 26-week infant from a forward-deployed non-combat setting. Due to complications in-flight, the infant could only be safely transported from the deployed setting to the refueling stop. This report is a descriptive analysis of the transport, including lessons learned that may help future teams plan for possible complications that can occur during neonatal transports.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Fascial Distortion Model in Military Aircrew with Chronic Neck Pain: A Case Study. 军事机组人员慢性颈痛的筋膜扭曲模型:案例研究。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae008
Allison J Fullenkamp

Musculoskeletal pain can be a significant safety risk to aircrew. Flight surgeons are the primary care providers for aircrew and are responsible for safely treating musculoskeletal pain. Certain medical interventions can be used to treat pain while maintaining the ability to fly safely. A previous F-18 Naval Flight Officer presented to the flight surgeon with chronic neck pain seeking noninvasive and nonpharmacological therapy. After one Osteopathic Manual Treatment session using the Fascial Distortion Model (FDM), the patient had improved pain and function. The aircrewman reported an 83% reduction in pain and a 200% improvement in cervical Range of Motion (ROM) immediately following treatment. Neck pain is a common complaint in aircrew. This pain can become an in-flight distraction, thus increasing the risk of aviation mishaps. FDM can decrease pain and increase ROM quickly, without equipment or a large amount of space and without the use of medications that may prohibit an aircrew member from flying. This case study shows the ability to treat a uniformed aircrewman with neck pain while onboard an aircraft. FDM is a technique that can be taught to all flight surgeons. Teaching future flight surgeons FDM techniques can improve the U.S. Navy's resources by decreasing time away from work along with decreasing medical costs. The use of osteopathic manipulation treatment significantly reduced an aircrewman's pain and increased ROM with one treatment while maintaining flight status per current aeromedical waiver guidelines.

肌肉骨骼疼痛可能对机组人员的安全构成重大威胁。飞行外科医生是机组人员的主要护理人员,负责安全治疗肌肉骨骼疼痛。某些医疗干预措施可用于治疗疼痛,同时保持安全飞行的能力。曾有一名 F-18 海军飞行军官因慢性颈部疼痛向飞行外科医生寻求非侵入性和非药物治疗。在使用筋膜扭曲模型(FDM)进行了一次骨科徒手治疗后,患者的疼痛和功能都得到了改善。这名空勤人员表示,治疗后疼痛立即减轻了 83%,颈椎活动范围(ROM)改善了 200%。颈部疼痛是空勤人员的常见病。这种疼痛会在飞行中分散注意力,从而增加航空事故的风险。FDM 可以快速减轻疼痛并增加活动度,无需设备或大量空间,也无需使用可能会导致空勤人员无法飞行的药物。本案例研究展示了在飞机上治疗一名颈部疼痛的制服空勤人员的能力。FDM 是一种可以传授给所有飞行外科医生的技术。向未来的飞行外科医生传授 FDM 技术可以减少工作时间,降低医疗成本,从而改善美国海军的资源状况。通过使用整骨疗法,空勤人员的疼痛明显减轻,一次治疗就能增加活动度,同时还能根据当前的航空医疗豁免准则保持飞行状态。
{"title":"The Fascial Distortion Model in Military Aircrew with Chronic Neck Pain: A Case Study.","authors":"Allison J Fullenkamp","doi":"10.1093/milmed/usae008","DOIUrl":"10.1093/milmed/usae008","url":null,"abstract":"<p><p>Musculoskeletal pain can be a significant safety risk to aircrew. Flight surgeons are the primary care providers for aircrew and are responsible for safely treating musculoskeletal pain. Certain medical interventions can be used to treat pain while maintaining the ability to fly safely. A previous F-18 Naval Flight Officer presented to the flight surgeon with chronic neck pain seeking noninvasive and nonpharmacological therapy. After one Osteopathic Manual Treatment session using the Fascial Distortion Model (FDM), the patient had improved pain and function. The aircrewman reported an 83% reduction in pain and a 200% improvement in cervical Range of Motion (ROM) immediately following treatment. Neck pain is a common complaint in aircrew. This pain can become an in-flight distraction, thus increasing the risk of aviation mishaps. FDM can decrease pain and increase ROM quickly, without equipment or a large amount of space and without the use of medications that may prohibit an aircrew member from flying. This case study shows the ability to treat a uniformed aircrewman with neck pain while onboard an aircraft. FDM is a technique that can be taught to all flight surgeons. Teaching future flight surgeons FDM techniques can improve the U.S. Navy's resources by decreasing time away from work along with decreasing medical costs. The use of osteopathic manipulation treatment significantly reduced an aircrewman's pain and increased ROM with one treatment while maintaining flight status per current aeromedical waiver guidelines.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e421-e425"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Underreporting Supplements: A Case of Drug-induced Liver Injury Due to a Testosterone Booster. 少报补充剂:睾酮增效剂导致药物性肝损伤的案例。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae136
Ashna Manhas, Casey Genevieve Arnold, Allison Marie Bush

Acute liver injuries (ALIs) are caused by a wide range of etiologies, and determining the cause can often be challenging. Detailed history taking is essential in patients with liver injuries to promptly determine the underlying source of injury and for timely treatment and prognosis. A 27-year-old active duty man presented to the emergency department (ED) with jaundice. On medication reconciliation, he only reported taking acetaminophen for a recent upper respiratory infection. The patient had an ALI and was treated with N-acetyl cysteine for presumed acetaminophen toxicity. Initially, his liver-associated enzymes (LAEs) improved, but 2 weeks after discharge, he returned to the ED upon referral from ship medical for jaundice and worsening liver injury. Repeated query into the patient's history revealed that he was using a testosterone booster supplement for 6 months preceding initial hospitalization. After evaluation of other etiologies for liver injury returned negative, drug-induced liver injury from the testosterone booster was determined to be the underlying etiology. With discontinuation of the supplement, his liver injury improved. Hepatotoxicity is a major concern in supplement use; however, it is largely underreported. Supplements are often not recognized or reported as medications by patients, leading to failure to identify them as potential toxicants. This case highlights the importance of including supplement education and questioning in the evaluation of ALI and maintaining a high index of suspicion when other common etiologies of liver disease are negative.

急性肝损伤(ALIs)由多种病因引起,确定病因往往具有挑战性。肝损伤患者必须详细询问病史,以便及时确定潜在的损伤源,及时治疗和预后。一名 27 岁的现役军人因黄疸到急诊科就诊。经核对用药,他只报告最近因上呼吸道感染服用了对乙酰氨基酚。患者出现了急性呼吸道感染,因推测对乙酰氨基酚中毒而接受了 N-乙酰半胱氨酸治疗。起初,他的肝脏相关酶(LAEs)有所改善,但出院两周后,他因黄疸和肝损伤恶化经船医转诊返回急诊室。对患者病史的反复询问发现,他在初次住院前的 6 个月里一直在使用睾酮增强剂。在对肝损伤的其他病因进行评估后,结果显示为阴性,因此确定睾酮增强剂导致的药物性肝损伤是根本病因。停用该增效剂后,他的肝损伤有所好转。肝毒性是使用营养补充剂的一个主要问题,但报告的情况却很少。补充剂通常不被患者视为药物或作为药物进行报告,导致无法将其识别为潜在的毒物。本病例强调了在评估 ALI 时纳入补充剂教育和询问的重要性,以及在其他常见肝病病因阴性时保持高度怀疑的重要性。
{"title":"Underreporting Supplements: A Case of Drug-induced Liver Injury Due to a Testosterone Booster.","authors":"Ashna Manhas, Casey Genevieve Arnold, Allison Marie Bush","doi":"10.1093/milmed/usae136","DOIUrl":"10.1093/milmed/usae136","url":null,"abstract":"<p><p>Acute liver injuries (ALIs) are caused by a wide range of etiologies, and determining the cause can often be challenging. Detailed history taking is essential in patients with liver injuries to promptly determine the underlying source of injury and for timely treatment and prognosis. A 27-year-old active duty man presented to the emergency department (ED) with jaundice. On medication reconciliation, he only reported taking acetaminophen for a recent upper respiratory infection. The patient had an ALI and was treated with N-acetyl cysteine for presumed acetaminophen toxicity. Initially, his liver-associated enzymes (LAEs) improved, but 2 weeks after discharge, he returned to the ED upon referral from ship medical for jaundice and worsening liver injury. Repeated query into the patient's history revealed that he was using a testosterone booster supplement for 6 months preceding initial hospitalization. After evaluation of other etiologies for liver injury returned negative, drug-induced liver injury from the testosterone booster was determined to be the underlying etiology. With discontinuation of the supplement, his liver injury improved. Hepatotoxicity is a major concern in supplement use; however, it is largely underreported. Supplements are often not recognized or reported as medications by patients, leading to failure to identify them as potential toxicants. This case highlights the importance of including supplement education and questioning in the evaluation of ALI and maintaining a high index of suspicion when other common etiologies of liver disease are negative.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e453-e455"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patterns of Use and Barriers to STI Point-of-care Tests for Military Obstetrician Gynecologists. 军队妇产科医生使用性传播感染护理点检测的模式和障碍。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae283
Jill E Brown, Kayla M Hudson, Anne M Rompalo, Charlotte A Gaydos

Introduction: Sexually transmitted infections (STIs) are commonly reported in military populations. Point-of-care tests (POCTs) are commercially available, but their use is variable in the civilian sector. Their use among military providers has not been evaluated. We sought to identify the pattern of use and barriers to using STI POCTs for military obstetrician/gynecologists (OBGYNs).

Materials and methods: We adapted a survey of civilian OBGYNs on patterns of use and barriers to STI POCTs for military OBGYNs. We sent an online questionnaire to 479 military OBGYNs via Army, Air Force, and Navy specialty leaders in May 2023. The questionnaire included 14 demographic questions and up to 52 questions regarding availability, use, and barriers to STI POCTs. The USU Institutional Review Board deemed the study exempt from Institutional Review Board review.

Results: Of the 479 solicited, 117 participated in the survey (24.4%). Of respondents, 64.1% were women and 79.5% non-Hispanic white. Sexually transmitted infections were detected once to twice weekly by 13.0% of respondents and once or twice monthly by 52.8%. The most available STI-related POCTs were wet mount prep (68.7%), rapid HIV (43.3%), and urine dipstick (38.6%). Gram stain was available for 30.3%, the Affirm VPIII (Becton, Dickinson and Company, Franklin Lakes, NJ) for 24.5%, and stat RPR for 16.3%. Economic barriers to using POCTs included cost of the test from manufacturer/distributor (57.9%) and military funding/stocking decisions (10.3%). The greatest barriers to use were the purchasing of an instrument (60.8%) and the interruption to workflow in clinic (57.8%).

Conclusions: Military OBGYNs rely on several STI-related POCTs. Economic factors and interruption to workflow were cited as the most significant barriers to using POCTs for military OBGYNs. Test cost and impact on workflow should be considered in future development and procurement of POCTs for the Military Health System.

导言:性传播感染(STIs)在军队人群中很常见。护理点检测(POCT)可在市场上买到,但在民用领域的使用情况却不尽相同。目前尚未对其在军队提供者中的使用情况进行评估。我们试图确定军队妇产科医生(OBGYN)使用 STI POCT 的模式和障碍:我们改编了一项关于军队妇产科医生使用 STI POCT 的模式和障碍的民间妇产科医生调查。我们于 2023 年 5 月通过陆军、空军和海军专业负责人向 479 名军事妇产科医生发送了一份在线问卷。问卷包括 14 个人口统计学问题和多达 52 个有关 STI POCT 的可用性、使用情况和障碍的问题。美国南加州大学机构审查委员会认为该研究免于机构审查委员会审查:在征集到的 479 位受访者中,有 117 位(24.4%)参与了调查。在受访者中,64.1% 为女性,79.5% 为非西班牙裔白人。13.0%的受访者每周检测一到两次性传播感染,52.8%的受访者每月检测一到两次。最常见的性传播感染相关 POCT 是湿装片预处理(68.7%)、快速 HIV 检测(43.3%)和尿液浸量尺(38.6%)。有 30.3% 的人可使用革兰氏染色法,24.5% 的人可使用 Affirm VPIII(Becton, Dickinson and Company, Franklin Lakes, NJ),16.3% 的人可使用 stat RPR。使用 POCT 的经济障碍包括制造商/经销商提供的检测成本(57.9%)和军方的资金/库存决定(10.3%)。使用的最大障碍是购买仪器(60.8%)和中断临床工作流程(57.8%):结论:军队妇产科医生依赖多种与性传播感染相关的 POCT。经济因素和工作流程中断被认为是军队妇产科医生使用 POCT 的最大障碍。在未来为军事卫生系统开发和采购 POCTs 时,应考虑测试成本和对工作流程的影响。
{"title":"Patterns of Use and Barriers to STI Point-of-care Tests for Military Obstetrician Gynecologists.","authors":"Jill E Brown, Kayla M Hudson, Anne M Rompalo, Charlotte A Gaydos","doi":"10.1093/milmed/usae283","DOIUrl":"10.1093/milmed/usae283","url":null,"abstract":"<p><strong>Introduction: </strong>Sexually transmitted infections (STIs) are commonly reported in military populations. Point-of-care tests (POCTs) are commercially available, but their use is variable in the civilian sector. Their use among military providers has not been evaluated. We sought to identify the pattern of use and barriers to using STI POCTs for military obstetrician/gynecologists (OBGYNs).</p><p><strong>Materials and methods: </strong>We adapted a survey of civilian OBGYNs on patterns of use and barriers to STI POCTs for military OBGYNs. We sent an online questionnaire to 479 military OBGYNs via Army, Air Force, and Navy specialty leaders in May 2023. The questionnaire included 14 demographic questions and up to 52 questions regarding availability, use, and barriers to STI POCTs. The USU Institutional Review Board deemed the study exempt from Institutional Review Board review.</p><p><strong>Results: </strong>Of the 479 solicited, 117 participated in the survey (24.4%). Of respondents, 64.1% were women and 79.5% non-Hispanic white. Sexually transmitted infections were detected once to twice weekly by 13.0% of respondents and once or twice monthly by 52.8%. The most available STI-related POCTs were wet mount prep (68.7%), rapid HIV (43.3%), and urine dipstick (38.6%). Gram stain was available for 30.3%, the Affirm VPIII (Becton, Dickinson and Company, Franklin Lakes, NJ) for 24.5%, and stat RPR for 16.3%. Economic barriers to using POCTs included cost of the test from manufacturer/distributor (57.9%) and military funding/stocking decisions (10.3%). The greatest barriers to use were the purchasing of an instrument (60.8%) and the interruption to workflow in clinic (57.8%).</p><p><strong>Conclusions: </strong>Military OBGYNs rely on several STI-related POCTs. Economic factors and interruption to workflow were cited as the most significant barriers to using POCTs for military OBGYNs. Test cost and impact on workflow should be considered in future development and procurement of POCTs for the Military Health System.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e15-e19"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141246777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of Polyunsaturated Fatty Acids as a Treatment for Post-traumatic Stress Disorder: A Systematic Review. 多不饱和脂肪酸治疗创伤后应激障碍的疗效:系统回顾。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.1093/milmed/usae319
Kathryn A Capple, Elizabeth A Kostas-Polston, Mary B Engler, Choang Lai, Erika Sivarajan Froelicher

Introduction: Post-traumatic stress disorder (PTSD) is a prevalent health condition among members of the military. Although the efficacy of pharmacological and psychiatric interventions for PTSD has been well studied, there are limited data on the effects of omega-3 (n-3) polyunsaturated fatty acid (PUFA) interventions on PTSD. The use of PUFAs shows promise because of their neuroprotective effects. Thus, this systematic review will synthesize the current state of the evidence regarding the effectiveness of PUFA treatment for PTSD.

Materials and methods: Using the PubMed, PsychINFO, Embase, and CINAHL databases, a search of the literature was conducted using the search terms "posttraumatic-stress-disorder, combat disorders, trauma-related-stress-disorder, omega-3, fatty acid, and polyunsaturated fatty acids" to identify articles published from January 1, 2008, to January 1, 2024, that focused on PUFA interventions for PTSD. A total of 281 articles were identified. Following exclusions and quality assessments using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria proposed by Cochrane, 6 randomized controlled trials (RCTs) and preclinical studies were chosen for inclusion, and data were then extracted into a data matrix for final synthesis and analysis.

Results: The RCTs (n = 3) showed no significant effect of PUFAs in the prevention of PTSD symptom onset. Among preclinical studies (n = 3), PUFAs resulted in a significant decrease in anxiety-like behavior and fear memory and an increase in spatial learning and memory. The quality of evidence among the 6 RCTs and preclinical studies using the Cochrane GRADE criteria ranged from low to high.

Conclusions: The results from this systematic review suggest that more evidence is needed before making any recommendations for the clinical use of dietary PUFAs in the management of PTSD symptoms.

简介创伤后应激障碍(PTSD)是军人中普遍存在的一种健康问题。尽管对创伤后应激障碍的药物和精神干预的疗效进行了深入研究,但有关欧米伽-3(n-3)多不饱和脂肪酸(PUFA)干预对创伤后应激障碍的影响的数据却很有限。由于多不饱和脂肪酸具有神经保护作用,因此使用多不饱和脂肪酸大有可为。因此,本系统综述将综合目前有关 PUFA 治疗创伤后应激障碍有效性的证据:使用 PubMed、PsychINFO、Embase 和 CINAHL 数据库,以 "创伤后应激障碍、战斗障碍、创伤相关应激障碍、ω-3、脂肪酸和多不饱和脂肪酸 "为检索词进行文献检索,以确定从 2008 年 1 月 1 日至 2024 年 1 月 1 日期间发表的关注 PUFA 对创伤后应激障碍干预的文章。共鉴定出 281 篇文章。根据科克伦提出的建议评估、发展和评价分级(GRADE)标准进行排除和质量评估后,选择纳入了 6 项随机对照试验(RCT)和临床前研究,然后将数据提取到数据矩阵中进行最终综合和分析:结果:随机对照试验(3 项)显示,PUFA 在预防创伤后应激障碍症状发作方面没有明显效果。在临床前研究(3 项)中,PUFAs 可显著减少焦虑样行为和恐惧记忆,增加空间学习和记忆。根据 Cochrane GRADE 标准,6 项 RCT 和临床前研究的证据质量从低到高不等:本系统综述的结果表明,在临床上使用膳食中的 PUFAs 治疗创伤后应激障碍症状之前,还需要更多的证据。
{"title":"Efficacy of Polyunsaturated Fatty Acids as a Treatment for Post-traumatic Stress Disorder: A Systematic Review.","authors":"Kathryn A Capple, Elizabeth A Kostas-Polston, Mary B Engler, Choang Lai, Erika Sivarajan Froelicher","doi":"10.1093/milmed/usae319","DOIUrl":"10.1093/milmed/usae319","url":null,"abstract":"<p><strong>Introduction: </strong>Post-traumatic stress disorder (PTSD) is a prevalent health condition among members of the military. Although the efficacy of pharmacological and psychiatric interventions for PTSD has been well studied, there are limited data on the effects of omega-3 (n-3) polyunsaturated fatty acid (PUFA) interventions on PTSD. The use of PUFAs shows promise because of their neuroprotective effects. Thus, this systematic review will synthesize the current state of the evidence regarding the effectiveness of PUFA treatment for PTSD.</p><p><strong>Materials and methods: </strong>Using the PubMed, PsychINFO, Embase, and CINAHL databases, a search of the literature was conducted using the search terms \"posttraumatic-stress-disorder, combat disorders, trauma-related-stress-disorder, omega-3, fatty acid, and polyunsaturated fatty acids\" to identify articles published from January 1, 2008, to January 1, 2024, that focused on PUFA interventions for PTSD. A total of 281 articles were identified. Following exclusions and quality assessments using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria proposed by Cochrane, 6 randomized controlled trials (RCTs) and preclinical studies were chosen for inclusion, and data were then extracted into a data matrix for final synthesis and analysis.</p><p><strong>Results: </strong>The RCTs (n = 3) showed no significant effect of PUFAs in the prevention of PTSD symptom onset. Among preclinical studies (n = 3), PUFAs resulted in a significant decrease in anxiety-like behavior and fear memory and an increase in spatial learning and memory. The quality of evidence among the 6 RCTs and preclinical studies using the Cochrane GRADE criteria ranged from low to high.</p><p><strong>Conclusions: </strong>The results from this systematic review suggest that more evidence is needed before making any recommendations for the clinical use of dietary PUFAs in the management of PTSD symptoms.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e74-e81"},"PeriodicalIF":1.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Military Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1