Reported stressors and health care needs of active duty Navy personnel during three phases of deployment in support of the war in Iraq.

Literature has generously documented the stress of military members and their families during deployments in noncombat periods. Deployment has been shown to increase the needs of family members for health care, both physical and psychological. The purpose of this study was to describe the health care needs and perceived stressors of active duty members deployed to Iraq during the predeployment, mid-deployment, and postdeployment phases.

Pseudoporphyria as a result of voriconazole use: a case report.

Voriconazole, a second-generation triazole, has recently been approved by the Food and Drug Administration (FDA) to treat invasive aspergillosis and refractory infections with Scedosporium apiospermum or Fusarium spp. The reported side-effects of voriconazole include visual changes, headaches, elevated hepatic enzymes, Steven-Johnson syndrome, toxic epidermal necrolysis, chelitis, photosensitivity, discoid lupus erythematosus and anaphylactoid infusion reactions. Pseudoporphyria was first described in association with nalidixic acid.

Treatment options in overuse injuries of the knee: patellofemoral syndrome, iliotibial band syndrome, and degenerative meniscal tears.

Overuse injuries of the knee, particularly those of the extensor mechanism and iliotibial band, are commonplace in primary care and musculoskeletal practices. Effective treatment requires identification of all pertinent biomechanical factors contributing to overload and implementing measures to correct them.

Diagnosis and current treatment options of shoulder impingement.

A comprehensive review of shoulder impingement reveals numerous causes, contributing factors, and therapeutic options for the resolution of symptoms and return to optimal shoulder function. The clinical diagnosis of shoulder impingement is rather straightforward, but the challenge arises in identifying causative factors and directing treatment options to alleviate symptoms and restore normal function. Shoulder impingement occurs when the space between the proximal humerus and the coracoacromial arch is narrowed such that the transversing tendons, primarily the supraspinatus and to a lesser degree, the infraspinatus, are injured.

A comparative analysis of amlodipine and felodipine in a military outpatient population: efficacy, outcomes, and cost considerations.

Background: This retrospective study compared the efficacy, tolerability, and cost of two dihydropyridine calcium channel blockers.

Methods: Charts of patients who had been on continuous antihypertensive therapy with amlodipine or felodipine for at least 6 months were reviewed. Analyses include mean changes in blood pressure, percentage of patients achieving blood pressure (BP) < 140/90 mm Hg, average dose, and cost per day of the two calcium channel blockers, average cost of additional medication, total medication cost per day, and cost to achieve BP control.

Current progress in meniscal repair and postoperative rehabilitation.

The understanding and treatment of meniscal injury has evolved at a rapid pace over the past 20 years. With the realization of the meniscus as a vital structure to proper knee integrity, function, and longevity, the sports medicine and orthopedic communities have shifted the focus of conservative and surgical treatment to that of meniscal conservation. Hand-in-hand with this increased understanding, advances in surgical procedures, techniques, and equipment have followed.

Computerized telephone nurse triage. An evaluation of service quality and cost.

The current reimbursement structure of health care in the United States motivates the providers of health care services to deliver these services with a cost-conscious mentality without compromising quality. This has led to the development of alternative methods of delivering health care services, one of which is computerized telephone nurse triage. This study investigates service quality from the perception of callers who used this system on behalf of a pediatric client.

Secondary erythermalgia in an HIV-1-positive patient.

This report describes an HIV-1-positive patient who presented to the dermatology clinic with a 2-year history of secondary erythermalgia. A review of salient clinical features, disease classification, associated diseases, pathogenesis, and treatment of this disorder is presented.

The implementation and use of the standardized assessment of concussion at the U.S. Naval Academy.

The Standardized Assessment of Concussion (SAC), a sideline mental status assessment tool, was used for the U.S. Naval Academy football team.

Rupture of the peroneus longus tendon in a military athlete.

A 38-year-old active-duty Marine Corps officer with a history of ankle instability presented to the orthopedic clinic complaining of left lateral ankle and leg pain. A diagnosis of rupture of the tendon of the peroneus longus was made. This is an unusual diagnosis in an active Marine Corps officer.

Contraceptive knowledge, contraceptive use, and self-esteem among Navy personnel.

This study evaluated the sexual knowledge (including contraceptive and reproductive knowledge), contraceptive use, and self-esteem among a sample of 158 male and female United States Navy sailors assigned to Navy ships. In spite of the fact that men and women viewed themselves as relatively knowledgeable with respect to contraception, results showed substantial knowledge deficits. Women demonstrated significantly greater sexual knowledge than men, and contraceptive/ reproductive knowledge was highly correlated with self-reported use of contraceptives.

Salient personality characteristics among Navy divers.

This study evaluated the personality characteristics of U.S. Navy divers.

Case report on a diver with type II decompression sickness and viral meningitis.

A 33-yr-old man came to the emergency department with the chief complaint of a severe headache and decreased sensation in his right hand following a deep dive on scuba. Physical examination before recompression treatment was remarkable only for hypesthesia on the right hand. We diagnosed type II decompression sickness and the patient underwent standard recompression therapy.

Photosensitivity reactions: a case report involving NSAIDs.

Photosensitivity reactions associated with the use of prescription or over-the-counter drugs may be classified as phototoxic (caused by potentiation of solar energy by a drug) or photoallergic (in which the combination of a photosensitizing agent and light evokes a true cell-mediated hypersensitivity response). A case of a photoallergic response related to the use of piroxicam is included to illustrate the presentation and management of photosensitivity reactions to nonsteroidal anti-inflammatory drugs.

High-density lipoprotein-cholesterol: determining hygienic factors for intervention.

Current guidelines of the Adult Treatment Panel on High-Density Lipoprotein-Cholesterol (HDL-C) emphasize the protective effect of HDL-C in reducing one's risk for coronary heart disease and recommend that individuals with serum HDL-C levels below 35 mg/dL utilize hygienic means to raise them. A cross-sectional study was performed to examine the relationship of the hygienic factors obesity (measured by percent body fat and body mass index), smoking, and aerobic exercise to HDL-C. The sample, consisting of 1701 male employees of a large aerospace hardware assembly plant, were evaluated by health risk appraisal and anthropometric measurement.

Black widow spider bite.

These two cases illustrate many classical features of latrodectism. A subclinical bite followed by extensive systemic signs and symptoms in a recognizable pattern is strongly suggestive of the diagnosis. Pain and muscle spasms are refractory to standard therapy but are relieved by intravenous calcium.

Shifts of dependency in the resolution of folie à deux.

We have presented a case of folie à deux in which the wife was the primary (dominant) partner and the husband the secondary (submissive) partner. The husband's symptoms seemed to have resolved as his dependency shifted from his wife back to his mother. Treatment is recommended by deliberately shifting dependencies only when there is advantage in doing so.

Color vision testing for the U.S. Naval Academy.

Normal color vision is a prerequisite for admission to the United States Naval Academy. The Farnsworth Lantern (FALANT) is the Navy's definitive test for color vision. A FALANT is not available at many locations where candidates are examined, so satisfactory performance on pseudoisochromatic plates has been considered an acceptable alternative.

Klippel-Feil syndrome.

The triad of short neck, low posterior hairline and severe restriction of cervical motion is a classic definition of Klippel-Feil syndrome. The anatomic and clinical expressions of this syndrome vary widely, ranging from mild cosmetic deformity to severe disability. The diagnosis is usually apparent on lateral cervical radiographs.

Glaucoma screening in primary care: the role of noncontact tonometry.

Background: Guidelines for glaucoma screening by the primary care physician have not been firmly established. Despite its limitations as a screening test, intraocular pressure measurement by tonometry remains the mainstay of glaucoma monitoring but is not widely used in the primary care setting. The purpose of this study was to compare the effectiveness of noncontact tonometry using the Pulsair instrument with that of conventional tonometry using the Goldmann applanation tonometer as a screening tool for glaucoma.

Spontaneous abortion.

Spontaneous abortion, or the early termination of pregnancy without outside interference, may be caused by fetal, maternal or external factors. In many cases, a specific etiology may never be identified. A variety of clinical presentations are possible, ranging from imperceptible loss to profound life-threatening shock.