This paper introduces three cardiovascular health evaluation and promotion projects targeting military families at Fort Polk, Louisiana. These studies examine dietary behavior and life-styles including tobacco and alcohol use of military wives, physical activity, cardiovascular disease risk factors of military personnel and their families, and other behavioral profiles with the goal of developing a healthy lifestyle modification program for families. Relevant biomedical background and rationale considerations are developed to support the current research. In addition, conclusions drawn from these studies indicate the opportunity for future health promotion programs at other military installations. The studies will provide the background for a manual of operations to conduct health promotions for families on a military base. Further, the model provides the opportunity for a social support mechanism for families during times of stress and military operations.
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The thin red line: Blood planning factors and the enduring need for a robust military blood system to support combat operations.
J Trauma Acute Care Surg
August 2024
From the Joint Trauma System (J.M.G., J.-M.V.G., J.D.S.), Defense Health Agency, Joint Base San Antonio-Fort, Sam Houston; US Army Institute of Surgical Research (J.M.G., A.P.C.), Fort Sam Houston, San Antonio, Texas; Department of Surgery, Trauma and Acute Care University of Alabama Medical Center (J.B.H.), Birmingham, Alabama; The Geneva Foundation at U.S. Army Institute of Surgical Research (A.M.S.), 3698 Chambers Pass, Joint Base San Antonio-Fort Sam Houston, Texas; Department of Surgery (M.D.T.), Naval Medical Center, San Diego; 1st Medical Battalion (M.D.T.), 1st Marine Logistics Group, Camp Pendleton, California; Director of Combat Casualty Care Research Program (T.M.P.), Medical Research and Development Command, Ft. Deetrick, MD; Armed Service Blood Program (C.D., M.A.S., L.E.R.), Falls Church, Virginia; Medical Capability Development Integration Directorate (J.B.C.), JBSA Fort Sam Houston, Texas; Donald D. Trunkey Center for Civilian and Combat Casualty Care (M.A.S.), Oregon Health & Science University, Portland, Oregon; Trauma and Acute Care Surgery, Faculty of Medicine (A.B.), St. Michael's Hospital, University of Toronto, Toronto; Canadian Forces Health Services (A.B.), Ottawa, Ontario, Canada; Defense Health Agency (S.A.S.), US Air Force Academy (S.A.S.), Colorado Springs, Colorado; and Department of Surgery (M.J.M.), Keck School of Medicine, University of Southern California, Los Angelos, California.
Battlefield lessons learned are forgotten; the current name for this is the Walker Dip. Blood transfusion and the need for a Department of Defense Blood Program are lessons that have cycled through being learned during wartime, forgotten, and then relearned during the next war. The military will always need a blood program to support combat and contingency operations.
View Article and Find Full Text PDFNational Emergency Tele-Critical Care in a Pandemic: Barriers and Solutions.
Crit Care Explor
May 2024
The Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO.
The COVID-19 pandemic caused tremendous disruption to the U.S. healthcare system and nearly crippled some hospitals during large patient surges.
View Article and Find Full Text PDFBuilding capacity for ATLS trauma education: role of nurse practitioners and physician assistants.
Trauma Surg Acute Care Open
March 2024
Combat Casualty Care Research Program, US Army Medical Research and Development Command, Fort Detrick, Maryland, USA.
Objectives: Advanced Trauma Life Support (ATLS) focuses on care of injured patients in the first hour of resuscitation. Expanded demand for courses has led to a concurrent need for new instructors. Nurse practitioners and physician assistants (NPs/PAs) work on trauma services and duties include patient, staff, and outreach education.
View Article and Find Full Text PDFSkin Antisepsis before Surgical Fixation of Extremity Fractures.
N Engl J Med
February 2024
From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.).
Article Synopsis
- A study conducted at 25 hospitals compared the effectiveness of two antiseptic solutions (iodine povacrylex and chlorhexidine gluconate) in preventing surgical-site infections during extremity fracture surgeries.
- Results showed that iodine povacrylex led to a lower rate of infections in patients with closed fractures (2.4% vs. 3.3%) but did not show a significant difference for open fractures (6.5% vs. 7.3%).
- Ultimately, the study concluded that iodine povacrylex is a more effective skin antiseptic for closed extremity fractures, resulting in fewer infections compared to chlorhexidine, though both had similar outcomes for reoperations and adverse events.
SAGES/AHPBA guidelines for the use of microwave and radiofrequency liver ablation for the surgical treatment of hepatocellular carcinoma or colorectal liver metastases less than 5 cm.
Surg Endosc
December 2023
Department of Surgery, University of California, San Francisco, CA, USA.
Background: Primary hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM) represent the liver's two most common malignant neoplasms. Liver-directed therapies such as ablation have become part of multidisciplinary therapies despite a paucity of data. Therefore, an expert panel was convened to develop evidence-based recommendations regarding the use of microwave ablation (MWA) and radiofrequency ablation (RFA) for HCC or CRLM less than 5 cm in diameter in patients ineligible for other therapies.
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