Evaluating Decision Regret in Patients Who Have Undergone Sacral Neuromodulation.

Objective: To quantify decision regret in individuals who had undergone sacral neuromodulation (SNM). Secondary objectives evaluated for correlation of subjects' regret score with symptom relief, complications, device explant status, or military deployment status.

Methods: Each subject's decision regret was assessed via a telephone survey utilizing a validated decision regret tool, and regret scores were calculated.

Distributed Maritime Operations and the Medical Challenge: How a Medical Common Operating Picture Can Help Bridge the Gap.

This work explores the challenges of delivering medical care in the geographically dispersed and resource-constrained environment of Distributed Maritime Operations (DMO) and Expeditionary Advanced Base Operations (EABO). Traditional medical planning approaches may struggle to adapt to the vast operational space, extended evacuation times, and limited medical force present in these scenarios. The concept of a Medical Common Operating Picture (COP) emerges as a potential solution.

Evaluation of a Military Global Health Engagement Mission for Critical Wartime Surgical Specialty Readiness.

Introduction: Surgical volume at Military Treatment Facilities (MTFs) has been gradually decreasing for roughly the past 2 decades. The Knowledge, Skills, and Abilities (KSA) Clinical Readiness Program linked surgical volume and readiness using a tool known as the KSA metric. However, the extent to which military medical missions contribute to the readiness of critical wartime specialties has not been evaluated using this metric.

Evaluating WIC Engagement and Food Insecurity Among Active Duty Military Families.

Introduction: Nearly a quarter of active duty service members identified as food insecure in a 2022 Department of Defense report. Food insecurity impacts military readiness, retention, and recruitment. The Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federal food supplementation program that can mitigate food insecurity for service members with children less than 5 years of age.

Long-Term Health Outcomes of Limb Salvage Compared with Amputation for Combat-Related Trauma.

Background: There are little long-term health data, particularly in terms of body composition and development of metabolic syndromes, to help surgeons to guide the decision between limb salvage and amputation in patients with limb-threatening trauma. The purpose of this study was to compare long-term health outcomes after high-energy lower-extremity trauma between patients who underwent attempted flap-based limb salvage or amputation.

Methods: We performed a retrospective review of servicemembers with a minimum 10-year follow-up who underwent flap-based limb salvage followed by unilateral amputation or continued limb salvage after combat-related, lower-extremity trauma between 2005 and 2011.

A Case of Whipple's Disease With Concomitant Esophageal Candidiasis.

Whipple's Disease (WD) is a rare disease caused by the infection of Tropheryma whipplei. It can lead to immunosuppression and a multitude of effects on different organ systems, resulting in a constellation of seemingly unrelated findings. Although treatment may appear straightforward, T.

Postoperative opioid protocol: A 5-year resident-led effort to standardize prescribing patterns.

Objectives: The combined impact of variable surgeon prescribing preferences and low resident prescribing comfort level can lead to significant disparity in opioid prescribing patterns. We report an update on the expanded scope of this now 5-year, resident led initiative to standardize postoperative prescription practices within the Department of Otolaryngology.

Methods: With Institutional Review Board approval, performed a retrospective review of 12 months before (July 2016 - June 2017) and 48 months after (July 2019-June 2021) implementation of the Expanded Postoperative Analgesia Protocol.

Consistency and applicability of return to function guidelines in tactical-athletes with exertional heat illness. A systematic review.

Objective: To assess the consistency of return to sport and occupation recommendations following EHI provided in published clinical practice guidelines, consensus statements, position statements, and practice alerts. The agreement between medical policies governing the return to duty following EHI between the branches of the United States Armed Forces and published recommendations was assessed.

Methods: Ovid MEDLINE, Web of Science, and CINAHL databases were searched for clinical practice guidelines and position statements published at any time that guided return to activity in individuals with EHI.

The Cotton Osteotomy as an Adjunct Procedure in Hallux Valgus and Hallux Limitus Surgery.

The Cotton osteotomy, as described in 1936 by Frederic Cotton, consisted of a medial cuneiform opening base wedge osteotomy. This Cotton osteotomy served to restore the "triangle of support" of the foot. In his address to the New England Surgical Society, he described this osteotomy as being multipurpose; it can be used for plantarflexion in hallux valgus surgery and has use in hallux rigidus conditions.

Hyperbaric effects on cold stored whole blood following a military dive mission profile.

Background: Whole blood (WB) is carried by special operations forces as part of a remote damage control resuscitation strategy. The effects of an underwater mission on the quality and coagulation profile of WB were simulated by exposure to hyperbaric pressures in a chamber.

Methods: WB units collected in CPDA-1 were exposed to three different combinations of hyperbaric pressure and duration of exposure: Group A 153.