Comparison of Pavlik Harness treatment regimens for reduced but dislocatable (Barlow positive) hips in infantile DDH.

Objective: Although the Pavlik Harness (PH) is the most utilized treatment for developmental dysplasia of the hip (DDH), the ideal treatment protocol (frequency of clinic visits in the first month and daily wear duration) for Barlow ​+ ​hips (reduced but dislocatable) has yet to be defined.

Methods: This study compared DDH patients with Barlow hips who were treated with 23 vs 24 h per day PH wear and weekly vs every other week visits. Clinical success was defined as a stable hip that did not require closed or open reduction, or the use of an abduction orthosis prior to achieving clinical stability.

Battlefield Acupuncture and Physical Therapy Versus Physical Therapy Alone After Shoulder Surgery.

Opioid pain medications are commonly prescribed postsurgically for pain. Few studies have investigated the effects of Battlefield Acupuncture (BFA) on postsurgical pain and pain-medication use. To date, no studies have investigated BFA's effectiveness for reducing postoperative shoulder pain and pain-medication use post surgery.

Trauma Associated Sleep Disorder: Clinical Developments 5 Years After Discovery.

Purpose Of Review: We review recent and growing evidence that provides support for a novel parasomnia, trauma associated sleep disorder (TASD). Based on these findings, we further develop the clinical and polysomnographic (PSG) characteristics of TASD. We also address factors that precipitate TASD, develop a differential diagnosis, discuss therapy, and propose future directions for research.

Point-of-Care Urinary Biomarker Testing for Risk Prediction in Critically Injured Combat Casualties.

Background: Risk prediction is important during combat operations because resources are limited and triage decisions must be rapid and accurate. We evaluated 2 point-of-care urinary biomarker tests for risk prediction in combat casualties.

Study Design: This was an observational cohort study of critically injured military personnel admitted to Craig Joint Theater Hospital in Afghanistan from October 2012 to December 2013.

Implementation of Tele-Critical Care at General Leonard Wood Army Community Hospital.

Introduction: Tele-Intensive Care Unit (tele-ICU) is care provided to critically ill patients by remote clinicians using audio, and video communications and network resources to access real-time patient information from physiologic monitors and the electronic medical record. Tele-ICU has been demonstrated in civilian healthcare to reduce mortality, improve care quality and safety, decrease intensive care unit (ICU) length of stay (LOS) and ventilator days, and save money. General Leonard Wood Army Community Hospital (GLWACH) is a small medical treatment facility with limited resources with respect to subspecialists and ancillary services.

Open globe trauma in a military hospital: a review of the Ocular Trauma Score to help predict enucleation or evisceration.

Purpose: The aim of this study was to use the Ocular Trauma Score (OTS) to review and analyze all the open globe injuries (OGIs) that presented to Brooke Army Medical Center (BAMC) from July 2011 to March 2017, and whether or not the OTS can be used to predict enucleation or evisceration.

Methods: Retrospective chart review was performed through the medical record systems at BAMC for all OGIs from July 2011 to March 2017. This study was not performed on wartime patients.

The Epworth Sleepiness Scale in Service Members with Sleep Disorders.

Introduction: Excessive daytime sleepiness affects an estimated 20% of the general population. While the prevalence of sleepiness in the military is largely unknown, it is well established that short sleep duration is endemic. The reasons for this include: the demanding nature of their duties, shift work and 24-hour duty periods, deployments and exigencies of military service as well as sleep disorders.

Perceptions and Response to Conservative Treatment of Low Back Pain in Soldiers During Initial Entry Training: A Convergence Mixed Methods Study.

Low back pain (LBP) is a common condition suffered by military personnel. Psychosocial factors play a role in LBP prognosis and can be addressed with self-management tools. This study's purpose was to (1) describe clinical changes in psychosocial factors of LBP following a self-management intervention and (2) explore the LBP experience of military trainees.

The Role of CT Angiography in Evaluating Lower Extremity Trauma: 157 Patient Case Series at a Military Treatment Facility.

Introduction: Physical exam and angiography have important roles in the diagnosis of traumatic lower extremity vascular injury with similar reported high rates of sensitivity and specificity. It has been previously shown that CTA is not universally indicated in the setting of acute lower extremity trauma when a reliable physical examination is obtained. As such, the purpose of this study was to determine if obtaining a CTA following physical examination altered the clinical care of patients following high-energy lower extremity trauma and the generalizability to the military population.

N-Acetylcysteine (NAC) for the Prevention of Liver Failure in Heat Injury-Mediated Ischemic Hepatitis.

Exertional Heat Illness with associated ischemic hepatitis (IH) is a common occurrence among military trainees; however, few specific therapies exist if unresponsive to appropriate supportive measures. A 27-year-old basic combat trainee presented with altered mental status, renal insufficiency, rhabdomyolysis, and a core temp of 107.9 °F after collapsing during a run, leading to the diagnosis of heat stroke.

THE MUSCULOSKELETAL READINESS SCREENING TOOL- ATHLETE CONCERN FOR INJURY & PRIOR INJURY ASSOCIATED WITH FUTURE INJURY.

Background: The Musculoskeletal Readiness Screening Tool (MRST) was developed in an effort to consistently predict injury among military personnel. Current injury prediction tools have not consistently predicted injury in this population. The MRST is comprised of the weight bearing forward lunge, modified deep squat, closed kinetic chain upper extremity stability test (CKCUEST), forward step down with eyes closed, stationary tuck jump, unilateral wall sit hold, and subjective, individual perceived level of risk for injury.

SHORT-TERM EFFECTS OF TRIGGER POINT DRY NEEDLING ON PAIN AND DISABILITY IN SUBJECTS WITH PATELLOFEMORAL PAIN SYNDROME.

Background: Patellofemoral pain syndrome (PFPS) is a prevalent knee disorder. A novel yet increasingly popular treatment for PFPS is trigger point dry needling (DN).

Purpose: The purpose of this study was to determine if DN is more effective at reducing pain and disability than a sham treatment in individuals with PFPS.

Posterior Shoulder Dislocation During Morning PT: A Case Report.

Posterior shoulder dislocation should be considered in the differential diagnosis of acute shoulder pain and immobility following trauma. Although far less common then the anterior dislocation, it is associated with high rates of comorbidity. Seventy-nine percent of posterior shoulder dislocations are missed on initial presentation, which is partially responsible for the high rate of comorbidity associated with these injuries.

Injury Surveillance and Reporting for Trainees with Bone Stress Injury: Current Practices and Recommendations.

Background: Musculoskeletal injuries, including lower extremity bone stress injuries (BSI) significantly impact initial entry training (IET) in the U.S. Army due to limited duty days, trainee attrition, early medical discharge, and related financial costs.

Cervical Cancer Screening.

Screening in women has decreased the incidence and mortality of cervical cancer. Precancerous cervical lesions (cervical intraepithelial neoplasias) and cervical carcinomas are strongly associated with sexually-transmitted high-risk human papillomavirus (HPV) infection, which causes more than 99% of cervical cancers. Screening methods include cytology (Papanicolaou test) and HPV testing, alone or in combination.

Risk of Obtaining Routine Cultures During Presumed Aseptic Orthopaedic Procedures.

Treating patients with antibiotics that are selected based on routine cultures obtained from presumed aseptic orthopaedic procedures may lead to an increased risk of antibiotic-related complications without reducing the rate of late deep infection. Routine cultures obtained from 60 of 169 procedures resulted in 23 (38.3%) positive and 37 (61.

Non-traditional risk factors for atherosclerotic disease: A review for emergency physicians.

Introduction: Acute coronary syndrome (ACS) is a life-threatening disease frequently managed in the Emergency Department (ED). Risk factors such as age, hypertension, diabetes mellitus, obesity, and smoking are classically associated with atherosclerosis and ACS.

Objective: This review evaluates non-traditional risk factors for atherosclerotic disease and seeks to inform physicians of their potential danger, particularly in vulnerable patient populations.

SEVERE IMMUNE-MEDIATED THROMBOCYTOPENIA AFTER INTRAVITREAL BEVACIZUMAB INJECTION.

Purpose: To report a case of severe immune-mediated thrombocytopenia after intravitreal bevacizumab administration.

Methods: A 77-year-old man with right-sided macular degeneration received intravitreal bevacizumab. After his third treatment dose, he was hospitalized for symptomatic thrombocytopenia (platelet count of 3 k/μL) and underwent testing to determine the etiology.

INTER-RATER RELIABILITY OF THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT (SFMA) BY SFMA CERTIFIED PHYSICAL THERAPISTS WITH SIMILAR CLINICAL AND RATING EXPERIENCE.

Background: The Selective Functional Movement Assessment (SFMA) assesses posture, muscle balance, and movement patterns in order to identify relevant musculoskeletal dysfunction in a clinical population.

Purpose: The purposes of this study were to: (1) determine if raters with similar clinical experience and rating experience exhibit adequate agreement of the scoring for the SFMA during clinical use; (2) determine the reliability of the categorical scoring of the SFMA in a clinical population; (3) determine the reliability of the criterion checklist scoring of the SFMA in a clinical population; (4) compare the reliability of real-time assessment to recorded assessment.

Design: Inter-rater reliability study.

Evaluation of a Novel Field Expedient Musculoskeletal Readiness Screening Tool in an Army Basic Training Population.

Background: Musculoskeletal injuries present a significant challenge to military readiness accounting for over 29% of ambulatory medical visits and 25 million limited duty days across the U.S. Army.

The implementation of prolonged exposure: Design of a multisite study evaluating the usefulness of workshop with and without consultation.

This randomized trial examines the dissemination and implementation of prolonged exposure (PE) therapy for posttraumatic stress symptoms in U.S. Army medical treatment facilities.

Acute Coronary Syndrome: Current Treatment.

Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non-ST elevation acute coronary syndrome.

A Case of Trichogerminoma With Pilomatrical Differentiation and a Unique Immunohistochemical Profile.

Trichogerminomas are rare adnexal neoplasms first described by Sau et al in 1992. Including the initial report, 20 cases have been reported, all with similar histological features, namely tumor nodules composed of basaloid cells that form densely packed, round nests or "cell balls" and which demonstrate variable degrees of pilosebaceous differentiation. In this study, the authors report a case of a trichogerminoma with pilomatrical differentiation and a unique immunohistochemical profile.

THE EFFECTIVENESS OF DRY NEEDLING AND STRETCHING VS. STRETCHING ALONE ON HAMSTRING FLEXIBILITY IN PATIENTS WITH KNEE PAIN: A RANDOMIZED CONTROLLED TRIAL.

Background: Recently, dry needling has emerged as a popular treatment for muscular pain and impairments. While there are numerous studies detailing the benefits of dry needling for pain, few studies exist examining the effects on soft tissue mobility.

Purpose: The purpose of this study was to determine if the addition of hamstring dry needling to a standard stretching program results in greater improvements in hamstring flexibility compared to sham dry needling and stretching in subjects with atraumatic knee pain.