The impact of deployment on COPD in active duty military personnel.

Purpose: To identify trends in chronic obstructive pulmonary disease (COPD) diagnoses among active duty U.S. military personnel based on deployment history and whether International Classification of Disease, 9th edition (ICD-9) coding meet criteria for the diagnosis of COPD.

The impact of combat deployment on asthma diagnosis and severity.

Objectives: Environmental exposures during military deployments to Iraq and Afghanistan may lead to higher rates of respiratory complaints and diagnoses. This study investigates whether there is a relationship between rates of asthma diagnosis and severity associated with military deployment.

Methods: Retrospective review of active duty Army personnel underwent fitness for duty evaluation (Medical Evaluation Board) for asthma.

Military service and lung disease.

Objective: Lung diseases associated with military service are often a reflection of the conditions seen in the local civilian population, and with a few notable exceptions, are often related to unique environmental and occupational exposures.

Methods: This article reviews important pulmonary diseases that have been associated with military service in the past 100 years in a question-and-answer format.

Results: Traditionally, bacterial and viral pneumonias were the most common sources of military morbidity and mortality.

Study of active duty military for pulmonary disease related to environmental deployment exposures (STAMPEDE).

Rationale: Because of increased levels of airborne particulate matter in Southwest Asia, deployed military personnel are at risk for developing acute and chronic lung diseases. Increased respiratory symptoms are reported, but limited data exist on reported lung diseases.

Objectives: To evaluate new respiratory complaints in military personnel returning from Southwest Asia to determine potential etiologies for symptoms.

Prevalence of supranormal pulmonary function test values between a military and nonmilitary cohort.

Background: The study objective was to determine differences in the proportion of supranormal pulmonary function tests (PFTs) between active duty (AD) military personnel and a similar non-active duty (non-AD) population. Given the emphasis on cardiovascular fitness in the military, it has been hypothesized that regular exercise in this cohort leads to an increased proportion of supranormal PFTs. We hypothesized that a comparison of PFTs would identify no differences in the ratio of supranormal to normal PFTs between the AD and non-AD populations.

Diagnosis and management of chronic lung disease in deployed military personnel.

Military personnel are a unique group of individuals referred to the pulmonary physician for evaluation. Despite accession standards that limit entrance into the military for individuals with various pre-existing lung diseases, the most common disorders found in the general population such as asthma and chronic obstructive pulmonary disease remain frequently diagnosed. Military personnel generally tend to be a more physically fit population who are required to exercise on a regular basis and as such may have earlier presentations of disease than their civilian counterparts.

Investigating the respiratory health of deployed military personnel.

Recent news media articles have implied a direct relationship between environmental exposures such as burn pits during current deployments and the development of serious and debilitating chronic pulmonary disease. These articles suggest that the military is superficially investigating evidence that establishes a link between deployment and development of chronic lung disease. Anecdotal cases of military personnel with lung disease are detailed to suggest a systemic problem with undiagnosed and untreated pulmonary disease in deployed service members.

Intensive education on evidence-based evaluation of syncope increases sudden death risk stratification but fails to reduce use of neuroimaging.

Background: We sought to determine whether aggressive education on evidence-based guidelines would affect the use of resources. Specifically, we sought to educate providers about the role of neuroimaging as well as sudden death risk stratification.

Methods: We reviewed 1092 consecutive cases involving patients who were admitted for syncope.

Determination of the internal medicine service's role in emergency department length of stay at a military medical center.

Objectives: Increasing numbers of emergency department (ED) visits and higher leaving-without-being-seen rates resulted in an evaluation of the contribution of the internal medicine service to the admission process.

Methods: Standardized ED encounter sheets were completed by the medicine physician on duty (MOD) assessing various admission and consultative parameters.

Results: 304 patient encounters revealed a 44-minute mean time from MOD consultation to order submission; 49% in under 30 minutes and 76% in under an hour.

The prevalence and impact of respiratory symptoms in asthmatics and nonasthmatics during deployment.

Objective: The purpose of this study was to compare the prevalence, severity, and impact of respiratory symptoms in asthmatics and nonasthmatics during Operation Enduring Freedom and Operation Iraqi Freedom.

Methods: A survey was given to 1,250 active duty soldiers and Department of Defense contractors returning from Operation Enduring Freedom/Operation Iraqi Freedom. Subjects were asked about demographics, smoking habits, respiratory symptoms, and impact on job performance before and during deployment.

The demonstration of pulmonary neuroendocrine cell hyperplasia with tumorlets in a patient with chronic cough and a history of multiple medical problems.

A 58-year-old woman presented with chronic cough felt to be multifactorial secondary to asthma, gastroesophageal reflux disease, and chronic sinusitis. Additional medical history included obstructive sleep apnea, type 2 diabetes, and hypertension. She had a 40- year history of tobacco use, but quit 10 years ago.