Multisite evaluation of fire ant venom immunotherapy safety and efficacy.

Background: Imported fire ant (IFA) venom immunotherapy (VIT) is the only disease-modifying treatment reported to be effective at decreasing the risk of systemic reactions (SRs) to IFA stings.

Objective: Our aims were to determine the baseline rates of IFA sensitization in subjects, describe IFA VIT prescribing patterns across the military health system (MHS), and retrospectively evaluate the safety and efficacy of IFA VIT.

Methods: We prospectively compared IFA sensitization in participants with and without an SR to flying Hymenoptera venom.

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility in Children: A Systematic Review.

Objective: To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility in children.

Data Sources: Ovid Medline, Embase, Web of Science, and CENTRAL databases.

Review Methods: A systematic review of the medical literature was performed following the PRISMA guidelines.

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta-analysis.

Objective: To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility (UVFI) in adults.

Data Sources: Ovid MEDLINE, Embase, Web of Science, and Cochrane Central.

Review Methods: A structured literature search was utilized, and a 2-researcher systematic review was performed following PRISMA guidelines.

Combating the Current Pandemic and Preparing for the Next: Lessons Learned From the COVID-19 Pandemic From the Perspective of Deployed Special Operations Forces.

The coronavirus 2019 (COVID-19) pandemic continues to be a threat to global health, including the health of deployed armed forces. Servicemembers had to adjust to the "new normal" while maintaining the interests of the nation's security as well as that of our host nation partners. This commentary examines how Special Operations Forces operating within four different regions worldwide leveraged the challenges presented by the onset of this pandemic in maintaining stability, sustaining a ready force, and operating forward deployed.

Lesbian Gay Bisexual Transgender and Queer Health-Care Experiences in a Military Population.

ABTRACTThis study aimed to understand the experiences of lesbian, gay, bisexual, transgender, and queer of former military service members. Data for this analysis was collected from the two open-ended survey questions as part of a larger online survey. The analysis was performed using the web-based data analysis application Dedoose.

Identification and initial treatment of involuntary psychogenic movement (conversion) disorder in a 25-year-old male patient.

Psychogenic movement disorders present a diagnostically challenging entity that is often frightening for patients. Differentiating movement disorders, providing clear explanations, and addressing underlying conditions with a multidisciplinary approach are essential to successful treatment.

Prehospital shock index and systolic blood pressure are highly specific for pediatric massive transfusion.

Background: While massive transfusion protocols (MTPs) are associated with decreased mortality in adult trauma patients, there is limited research on the impact of MTP on pediatric trauma patients. The purpose of this study was to compare pediatric trauma patients requiring massive transfusion with all other pediatric trauma patients to identify triggers for MTP activation in injured children.

Methods: Using our level I trauma center's registry, we retrospectively identified all pediatric trauma patients from January 2015 to January 2018.

Training Program for Ultrasound-Guided Intravenous Catheter Insertion.

Introduction: Ultrasound guidance is now widely available in military treatment facilities and civilian hospitals alike, both in the USA and in forward-deployed military environments. Technical mastery of ultrasound-guided peripheral intravenous (USGPIV) catheter insertion can be easily achieved through a short training course. Mastery can be achieved even when trainees have a limited medical background before course attendance.

Sex and occupation are salient factors associated with lateral ankle sprain risk in military tactical athletes.

Objectives: To assess the risk of lateral ankle sprain (LAS) in male and female tactical athletes across different military occupations in the US military.

Design: Retrospective cohort.

Methods: The Defense Medical Epidemiology Database was queried for the number of individuals with ICD-9 diagnosis codes 845.

Quantification of Blood Loss Improves Detection of Postpartum Hemorrhage and Accuracy of Postpartum Hemorrhage Rates: A Retrospective Cohort Study.

Objective To evaluate the ability of estimated blood loss (EBL) and quantitative blood loss (QBL) to predict the need for blood transfusion in postpartum patients. Methods This is a retrospective observational study involving all deliveries one year before and after the change from EBL to QBL assessment in June 2017. Blood loss, need for blood transfusion, admission hematocrit, and postpartum nadir hematocrit were collected.

Below-Knee Cast Immobilization for Distal Tibial Physeal Fractures.

Distal tibial physeal injuries are one of the most commonly reported fractures in children. Traditionally, treatment recommendations consist of utilization of a long leg cast for initial immobilization. The purpose of this study was to evaluate the efficacy of below-knee cast immobilization in the closed treatment of distal tibial physeal fractures.

Pain Is Inevitable But Suffering Is Optional: Relationship of Pain Coping Strategies to Performance in Multistage Ultramarathon Runners.

Introduction: Ultramarathon runners commonly endure musculoskeletal pain during endurance events. However, the effect of pain coping skills on performance has not been examined.

Methods: A prospective observational study during three 250 km (155 mi), 6 stage ultramarathons was conducted.

Trauma Management Therapy and Prolonged Exposure Therapy for PTSD in an active duty sample: Design and methodology of a randomized clinical trial.

Posttraumatic stress disorder (PTSD) resulting from military service is a common, yet often chronic condition. Treatment outcome often is attenuated by programs that are (a) lengthy in nature and (b) constricted in their target outcomes. These limitations leave much of the emotional and behavioral impairment that accompanies PTSD unaddressed and/or unassessed.

Head & neck cancers: What you'll see, how to proceed.

What physical findings should raise your suspicion? How are tumors treated and what follow-up care can you provide? Here's what you need to know.

Interobserver Analysis of Standard Foot and Ankle Radiographic Angles.

Standard foot and ankle radiographs have long been studied and averages formulated in an attempt to provide a common framework for understanding the relationships of the foot and ankle, not only for surgical planning but also to determine normal versus abnormal relationships. The authors describe 8 angles measured on 100 patients by up to 18 observers (4 attending physicians, 12 residents, and 2 students). This study validates the previously documented normal angles using a significantly larger observer group as well as a greater number of analyzed angles.

Osteomyelitis Risk Factors Related to Combat Trauma Open Upper Extremity Fractures: A Case-Control Analysis.

Objective: To determine risk factors for osteomyelitis in US military personnel with combat-related, extremity long bone (humerus, radius, and ulna) open fractures.

Design: Retrospective observational case-control study.

Setting: US military regional hospital in Germany and tertiary care military hospitals in the United States (2003-2009).

Fingernail Abnormalities After a Systemic Illness.

Examining a patient's nails and understanding nail growth mechanics can provide helpful clues to help treat past injuries or underlying diseases.