Paroxysmal hemifacial pain: A report of two cases.

Paroxysmal hemifacial pain (PHFP) is the orofacial counterpart to paroxysmal hemicrania headaches. This paper reports the cases of two patients suffering from episodic attacks of severe unilateral facial pain. In both cases, pain attacks were absolutely responsive to therapeutic doses of indomethacin.

Resuscitative endovascular balloon occlusion of the aorta in combat casualties: The past, present, and future.

Background: Noncompressible torso hemorrhage is a leading cause of preventable death on the battlefield. Intra-aortic balloon occlusion was first used in combat in the 1950s, but military use was rare before Operation Iraqi Freedom and Operation Enduring Freedom. During these wars, the combination of an increasing number of deployed vascular surgeons and a significant rise in deaths from hemorrhage resulted in novel adaptations of resuscitative endovascular balloon occlusion of the aorta (REBOA) technology, increasing its potential application in combat.

Chronic incretin-based therapy in cystic fibrosis-related diabetes: A tale of 3 patients treated with sitagliptin for over 5 years.

Cystic fibrosis-related diabetes (CFRD) affects 40-50% of adult patients with cystic fibrosis. Insulin therapy is recommended but there are therapeutic challenges, particularly risk of hypoglycemia and aversion of some patients to injectables. An oral incretin-based therapy using a DPP-4i (dipeptidyl peptidase-4 inhibitor), may be a reasonable option, especially in the early stage of the disease.

Telomere Shortening and Accelerated Aging in US Military Veterans.

A growing body of literature on military personnel and veterans' health suggests that prior military service may be associated with exposures that increase the risk of cardiovascular disease (CVD), which may differ by race/ethnicity. This study examined the hypothesis that differential telomere shortening, a measure of cellular aging, by race/ethnicity may explain prior findings of differential CVD risk in racial/ethnic groups with military service. Data from the first two continuous waves of the National Health and Nutrition Examination Survey (NHANES), administered from 1999-2002 were analyzed.

Longitudinal mental health outcomes of combat-injured service members.

Background: The relationship between traumatic injury and subsequent mental health diagnoses is not well understood and may have significant implications for patient screening and clinical intervention. We sought to determine the adjusted association between traumatic injury and the subsequent development of post-traumatic stress disorder (PTSD), depression, and anxiety.

Methods: Using Department of Defense and Veterans Affairs datasets between February 2002 and June 2016, we conducted a retrospective cohort study of 7,787 combat-injured United States service members matched 1:1 to combat-deployed, uninjured service members.

Child-rearing During Postgraduate Medical Training and Its Relation to Stress and Burnout: Results From a Single-institution Multispecialty Survey.

Introduction: Child-rearing is difficult for medical trainees, but much of the available evidence is limited to individual specialties or lacks an analysis of well-being. In light of this, we sought to examine current perspectives across a wide range of medical specialties, determine associations with stress and burnout, and identify potential supportive solutions.

Methods: After Institutional Review Board approval, a voluntary and anonymous survey was sent to all residents and fellows at a large academic medical center with a U.

Exploratory Case Study of Barriers and Facilitators Associated With the Pilot Implementation of a New Electronic Healthcare Record in the Military.

Introduction: The Military Health System (MHS) overhauled its previous Electronic Health Records (EHRs) system. The MHS is in need of modernizing its healthcare system to improve patient safety and coordination of care between the MHS and Veterans Affairs. In 2015, the DoD awarded Cerner, Leidos, and Accenture a $4.

Social network analysis: Exploring connections to advance military nursing science.

Background: Military nurse scientists are embedded in service-affiliated branches (Army, Navy, Air Force) with different missions, but with the singular purpose of generating and disseminating research impacting the health and well-being of DoD beneficiaries.

Purpose: This project examines collaboration among TriService Nursing Research Program (TSNRP) members, seeking opportunities to strengthen, diversify, and expand research collaboration.

Method: Social network analysis (SNA) is the empirical inquiry of relations among social actors at different levels of analysis.

Idiopathic adult intestinal intussusception: a rare cause of an acute surgical abdomen.

Intussusception is uncommon among adults. The condition, which is defined as a telescoping of a proximal portion of the small or large bowel into the lumen of an adjacent segment of bowel, is most commonly seen in children. Among pediatric cases, the majority is benign and treated non-operatively.

Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review.

Background: Although combat stress and psychiatric casualties of war have consistently contributed to the need for deployed patient transport to higher echelons of care, little is known regarding specific evidence-based strategies for providing psychological support and optimal transport interventions for warriors.

Study Objective: The purpose of this scoping review is to map existing literature related to considerations for deployed mental health patient transport. The review's primary aims are to identify the existing scientific research evidence, determine research and training gaps, and recommend critical areas for future military research.

Anomalous Origin of the Circumflex or Left Anterior Descending Artery From the Pulmonary Artery.

Anomalous origin of the circumflex or left anterior descending artery from the pulmonary artery (ACxAPA and ALADAPA, respectively) are rare congenital coronary anomalies with clinical presentation varying from an asymptomatic murmur to sudden cardiac arrest. A systematic review was performed, and 46 cases of ACxAPA and 51 cases of ALADAPA were identified in 87 articles. Data were collected and analyzed from each case.

Development of a porcine model of emergency resternotomy at a low-volume cardiac surgery centre.

Emergency resternotomy in the intensive care unit (ICU) is a rarely performed, yet potentially life-saving intervention. Success relies on recognition of a deteriorating clinical condition, timely deployment of equipment/personnel and rapid execution. Given how infrequently it is performed, we sought to develop a large animal model of resternotomy to prepare ICU nurses and technicians at our low-volume cardiac surgery military centre.

The Evolving Role of the Orthopaedic Surgeon in Combat Zones and Austere Deployed Locations Since the 2012 Troop Drawdown.

The purpose of this study was to evaluate the operative experience of orthopaedic surgeons in the various deployment locations since 2012. We also evaluated the implications of humanitarian surgical care and the impact of deployment on an orthopaedic practice. An emailed survey was sent to orthopaedic surgeons deployed after 2012.

Acute Kidney Injury During Hospitalization Increases the Risk of VTE.

Background: Kidney disease has been linked to risk for hospitalization-related (HR) VTE, but the effect size and differences across types of kidney disease are described poorly.

Research Question: Can the risk for HR VTE among patients with acute kidney injury (AKI) and chronic kidney disease be quantified, and if so, how?

Study Design And Methods: We prospectively collected data on hospitalized adult patients and documented HR VTE events. We recorded creatinine clearance (CrCl) daily throughout hospitalization and modeled the effects that admission CrCl, peak CrCl, average CrCl, and AKI had on HR VTE.

A Survey of Energy Drink Consumption and Associated Adverse Effects in Air Force Personnel.

Introduction: Energy drinks are an increasingly utilized beverage and are gaining popularity in recent years. The U.S.

The Enduring Health Consequences of Combat Trauma: a Legacy of Chronic Disease.

Background: A better understanding of the long-term health effects of combat injury is important for the management of veterans' health in the Department of Defense (DoD) and Veterans Affairs (VA) health care systems and may have implications for primary care management of civilian trauma patients.

Objective: To determine the impact of traumatic injury on the subsequent development of hypertension (HTN), diabetes mellitus (DM), and coronary artery disease (CAD) after adjustment for sociodemographic, health behavior, and mental health factors.

Design: Retrospective cohort study of current and former US military personnel with data obtained from both the DoD and VA health care systems.

The Effects of Hyperbaric Oxygen on Rheumatoid Arthritis: A Pilot Study.

Background/objective: This case series pilot study assessed the effects of hyperbaric oxygen therapy (HBO2) for treating rheumatoid arthritis (RA).

Methods: Ten RA subjects received 30 HBO2 treatments over 6 to 10 weeks. Serial rheumatologic evaluations (ie, the Disease Activity Scale [DAS28], the Routine Assessment of Patient Index Data 3, and the Pain and Sleep Quality Questionnaire) were completed at baseline, throughout the course of the study, and at the 6-month follow-up.

Does the pediatric hemodynamic cliff exist in response to hemorrhagic shock?

Background: The paradigm that children maintain normal blood pressure during hemorrhagic shock until 30%-45% hemorrhage is widely accepted. There are minimal data supporting when decompensation occurs and how a child's vasculature compensates up to that point. We aimed to observe the arterial response to hemorrhage and when mean arterial pressure (MAP) decreased from baseline in pediatric swine.

High Versus Low Volume Fluid Resuscitation Strategies in a Porcine Model (Sus scrofa) of Combined Thermal and Traumatic Brain Injury.

Background: Combined burn and traumatic brain injury (TBI) treatment priorities may not align due to opposing fluid resuscitation paradigms used in treating burns and TBI. We developed a porcine model of combined thermal injury/TBI and compared an "aggressive" fluid resuscitation strategy using the Parkland formula and a "restrictive" resuscitation strategy using the modified Brooke formula.

Methods: Twenty-eight swine were deeply anesthetized and received a 40% total body surface area full-thickness burn injury and TBI.

De Garengeot hernia: a systematic review.

Background: A De Garengeot hernia is a femoral hernia that contains the appendix. This rare type of hernia was first described by René-Jacques Croissant De Garengeot in 1731. Numerous case reports have been published since then, yet collective analysis about the presentation, diagnosis, management, and outcomes of patients with this unique hernia is lacking.

Automated Partial Versus Complete Resuscitative Endovascular Balloon Occlusion of the Aorta for the Management of Hemorrhagic Shock in a Pig Model of Polytrauma: a Randomized Controlled Pilot Study.

Introduction: Endovascular variable aortic control (EVAC) is an automated partial resuscitative endovascular balloon occlusion of the aorta (REBOA) platform designed to mitigate the deleterious effects of complete REBOA. Long-term experiments are needed to assess potential benefits. The feasibility of a 24-hour experiment in a complex large animal trauma model remains unknown.