Air Force Critical Incident Stress Management outreach with Pentagon staff after the terrorist attack.

This article describes the Critical Incident Stress Management outreach to Pentagon staff conducted after the terrorist attack by a team of Air Force mental health and chaplain personnel. Also discussed are lessons learned from the author's experience while leading the mental health component and working in a larger tri-service outreach. Finally, the observed impacts of the outreach effort are examined along with recommendations for future postcritical incident outreach efforts.

Comparison of thin versus standard esophagogastroduodenoscopy.

Objective: To compare the tolerance, feasibility, and safety of ultrathin esophagogastroduodenoscopy (EGD) in unsedated patients with conventional EGD in sedated patients.

Study Design: This was an unblinded, randomized controlled trial.

Population: Diagnostic EGD was performed on 72 adult outpatients at a US Air Force community hospital residency.

Evaluation of spouse abuse treatment: description and evaluation of the Air Force Family Advocacy Programs for spouse physical abuse.

Data are reported from a sample of 2,991 spouse physical abusers who received Air Force Family Advocacy Program (FAP) services and who volunteered to complete program evaluation measures that were administered before and after treatment and at a 6-month follow-up. As expected, after treatment compared with before treatment, professionals rated offenders as less at risk, and the offenders indicated general satisfaction with the Family Advocacy Program services. Additionally, as predicted, objective measures indicated that offenders showed significant (p < 0.

Insulinoma in pregnancy: a case report and review of the literature.

Unlabelled: Insulinomas are rare tumors with an incidence of approximately four cases per million person-years. Nineteen cases of insulinoma during pregnancy have been reported. Hypoglycemic symptoms usually appear during the first trimester.

Using continuous quality improvement techniques to determine the causes of hospital readmission.

This 6-month retrospective study provided our medical center with a profile of the population of patients readmitted within 31 days of discharge. We found that chronic illness and age greater than 65 years were the high risk factors related to patient readmissions. These 2 attributes are common in critical care patients.

Adolescent idiopathic scoliosis: review and current concepts.

Adolescent idiopathic scoliosis is present in 2 to 4 percent of children between 10 and 16 years of age. It is defined as a lateral curvature of the spine greater than 10 degrees accompanied by vertebral rotation. It is thought to be a multigene dominant condition with variable phenotypic expression.

Attitudes and practices of military family physicians regarding obesity.

This study's objective was to define the current attitudes and practices of military family physicians regarding obesity. The authors mailed a cross-sectional survey to 267 military family physicians selected randomly from the 1997 Uniformed Services Academy of Family Physicians membership database. A total of 214 surveys (80%) were returned.

Provider gender preference in obstetrics and gynecology: a military population.

Objective: This study evaluates patient reasons and preferences for gender selection of their obstetrician-gynecologist.

Methods: A written survey was given to patients attending a military obstetrics and gynecology clinic (N = 203). Mean age was 36 years, with 69% of patients between 20 and 40 years.

The use of anticholinergics in asthma.

Anticholinergic medications have been accepted as an important treatment modality in chronic bronchitis and chronic asthma, but their use in acute asthma is more controversial. A brief historical context of anticholinergics is given. The innervations of the lung that govern bronchoconstriction and bronchodilatation are reviewed.

The misuse of behavioral genetics in prevention research, or for whom the "bell curve" tolls.

In recent years, prevention research has increasingly emphasized the role of biological and genetic factors in the etiology of numerous mental health related problems (e.g. violence, conduct and school problems, mood disorders, and substance abuse) rather than viewing them as complex biopsychosocial phenomena.

Universal newborn hearing screening: feasibility in a community hospital.

Background: The National Institutes of Health and the Joint Committee on Infant Hearing have recommended universal newborn hearing screening. The feasibility of universal newborn hearing screening in a community hospital, however, has not been demonstrated. We initiated a universal newborn hearing screening program using transient evoked otoacoustic emissions (TEOAE) at a community hospital to assess the feasibility of universal hearing screening in this setting.

Medical care of women deployed during Desert Storm.

The Desert Shield/Desert Storm troop deployment included record numbers of women and highlighted the vacuum of planning and information regarding medical care for women deployed to a theater of war. I review the retrievable literature from that conflict and discuss the data regarding resource management and clinical significance. The literature and my observations as an active-duty female gynecologist are presented to prompt a thorough systemwide evaluation of medical wartime readiness in light of the changing demographics of the military force.

Safety and efficacy of transaortic renal endarterectomy as an adjunct to aortic surgery.

Purpose: A study was undertaken to assess the safety and efficacy of transaortic endarterectomy for orificial atherosclerotic renovascular disease (ASRD), particularly in conjunction with surgery for concomitant aortic disease.

Methods: Forty-three consecutive patients with ASRD treated with transaortic orificial eversion endarterectomy were studied retrospectively to identify surgical indications, technical features, operative morbidity and mortality rates, and efficacy.

Results: A total of 76 renal arteries underwent transaortic endarterectomy for hypertension (88% of patients) or serum creatinine of 1.

Mycobacterium marinum arthritis.

Mycobacterium marinum is an atypical acid-fast organism that is rarely associated with septic arthritis. Most often this is seen in patients with monarticular synovitis of the hands or wrists, especially in association with a history of periarticular trauma or exposure to marine environments. From tissue obtained by aspiration or synovectomy, Mycobacterium marinum can be identified by Ziehl-Nielson stain and has optimal growth in Lowenstein-Jenson medium.

Quinidine-induced rheumatic syndromes.

Quinidine is a commonly used antiarrhythmic agent that is rarely associated with rheumatologic toxicity. However, quinidine-induced lupus, antinuclear antibody negative lupus-like syndrome, polymyalgia rheumatica-like illness, muscle weakness, and isolated creatine phosphokinase elevation have all been reported. We present one case of quinidine drug-induced lupus and another of a quinidine-induced polymyalgia rheumatica-like illness, and review the English literature for rheumatologic toxicity due to quinidine.

The systemic treatment of onychomycosis.

The systemic treatment of fungal infections has changed considerably over the past 10 to 20 years. Griseofulvin, the only drug approved by the Food and Drug Administration for the systemic treatment of onychomycosis, has a cure rate that seldom exceeds 40%. Many new drugs are targeting the three main kinds of drug therapy for fungal nails: reduction of treatment times, improvement of cure rates with a minimum of side effects, and the achievement of long-term remissions in recalcitrant infections.

Aortic dissection presenting as superior vena cava syndrome.

Aortic dissection usually presents with chest pain, abnormal pulses, and a widened mediastinum on chest radiograph. It is rarely associated with the superior vena cava syndrome (SVCS), which more commonly occurs in the setting of malignant disease. A patient who had SVCS as a result of a painless aortic dissection is presented and compared with other previously reported cases of simultaneous SVCS and aortic dissection.

Oral methotrexate for persistent ectopic pregnancy. A case report.

Persistent ectopic pregnancy complicates a significant percentage of conservative tubal pregnancy procedures. The optimal treatment of persistent trophoblast has yet to be determined. Most reported cases have been treated by reoperation and removal of the affected tube.