Developing Military Doctors: An Institutional Approach to Medical Force Readiness in Graduate Medical Education.

Military physicians are required to not only meet civilian accreditation standards upon completion of their Graduate Medical Education (GME) training programs but also be proficient in the military-unique aspects of their field, including medical care in austere environments and management of combat casualties. They must also be familiar with the administrative and leadership aspects of military medicine, which are often absent from the training curriculum. The San Antonio Uniformed Services Health Education Consortium Military Readiness Committee, by incorporating questions of military relevance into each GME program's mandatory Annual Program Evaluation, identified curricular gaps upon which military readiness training objectives and opportunities were developed.

Critical Care Education and Skills Validation Course for Internal Medicine Physicians in the Military.

Introduction: Military internist and internal medicine (IM) subspecialist physicians must be prepared to function in both traditional inpatient and outpatient settings, as well as manage critically ill patients within a deployed austere environment. As many critical care procedures are not performed on a routine basis in general IM practice, many active duty IM physicians experience skills degradation and lack confidence in performing these procedures. In order to address this perceived deficiency, the U.

Intermittent gastric feeds lower insulin requirements without worsening dysglycemia: A pilot randomized crossover trial.

Introduction: We hypothesized that critically ill medical patients would require less insulin when fed intermittently.

Methods: First, 26 patients were randomized to receive intermittent or continuous gastric feeds. Once at goal nutrition, data were collected for the first 4-hr data collection period.

Treating COVID-19 Acute Severe Hypoxemic Respiratory Failure: First Case Report Utilizing Dexamethasone, Remdesivir, and Convalescent Plasma in Operation Inherent Resolve.

Coronavirus 2019 (COVID-19) has spread across the globe with a concerningly high infectivity resulting in the World Health Organization deeming it a pandemic. It has resulted in thousands of deaths and placed enormous strain on communities, healthcare systems and healthcare workers as they battle shortages of ventilators, supplies, and difficulties in protecting patients and hospital staff alike. Challenges in managing the disease have led to new treatment and management strategies as healthcare teams struggle to adapt.

Long-Term Outcomes of Thoracic Trauma in U.S. Service Members Involved in Combat Operations.

Introduction: Nearly 10% of all combat injuries during the most recent conflicts in Iraq and Afghanistan involve thoracic trauma. The long-term outcomes of these combat-related injuries with respect to lung function have not been fully evaluated. Limited research in civilian polytrauma patients have shown significant obstructive physiology in nearly half of their population without clear etiology.

Upper airway wheezing: Inducible laryngeal obstruction vs. excessive dynamic airway collapse.

There are multiple causes of dyspnea upon exertion in young, healthy patients to primarily include asthma and exercise-induced bronchospasm. (EDAC) describes focal collapse of the trachea or main bronchi with maintained structural integrity of the cartilaginous rings. It is commonly associated with pulmonary disorders like bronchiectasis, chronic obstructive pulmonary disease and asthma.

The use of lobectomy for management of clinically significant pulmonary vein stenosis and occlusion refractory to percutaneous intervention.

Pulmonary vein stenosis (PVS) is a serious complication of radiofrequency ablation (RFA) for the treatment of atrial fibrillation. The prevalence of this complication was reported to be as high as 42% in 1999 when RFA was first implemented [1]. However, with improvements in operator technique including wide area circumferential ablation, antral isolation, and the use of intracardiac ultrasound, the incidence of symptomatic severe PVS following RFA ranges from 0% to 2.

Comparison of Forced and Slow Vital Capacity Maneuvers in Defining Airway Obstruction.

Background: Obstructive lung disease is diagnosed by a decreased ratio of FEV to the vital capacity (VC). Although the most commonly used VC is FVC, American Thoracic Society guidelines suggest alternative VCs, for example, slow VC (SVC), may offer a more-accurate evaluation of breathing capacity. There is recent evidence that using only FEV/FVC underrecognizes obstruction in subjects at high risk and who are symptomatic.