Recurrent Lumbar Disk Herniation and Revision Surgery Rates After Single-Level Lumbar Microdiscectomy in the Military Population.

Background: Lumbar microdiscectomy remains the most commonly performed surgical procedure for symptomatic lumbar disk herniation (LDH). Despite advances in surgical techniques, recurrent LDH (rLDH) ranges from 5% to 24%, representing the most common cause of surgical failure and revision surgery. Optimal treatment of reherniation remains controversial.

Unicortical Versus Bicortical Proximal Locking Screw for Prevention of Peri-Implant Fracture: A Biomechanical Analysis of an Osteoporotic Distal Radius Model.

Purpose: Osteoporotic patients are at risk of peri-implant fractures after distal radius fixation. A unicortical screw in the proximal hole of the plate can theoretically decrease stress riser formation by eliminating the hole in the far bone cortex. This construct has been proposed in orthopedic literature to prevent peri-implant fractures but has not been tested in an osteoporotic distal radius model.

Updates in Human Papillomavirus Vaccination to Improve Medical Readiness in Active Duty Service Members.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is associated with the development of genital warts, precancerous lesions, and cancers of the oropharynx, anus, penis, vulva, vagina, and cervix. HPV-associated diseases are preventable through vaccination. An Australian nationwide vaccination program will effectively eliminate cervical cancer as a public health concern by the year 2035.

The Effects of Experimental Sleep Extension in Middle-to-Older-Aged Healthy Sleepers.

 To determine the feasibility for middle-aged and older adults to extend their time in bed by 2 h per night for 3 consecutive weeks. Other aims were to examine the effects of sleep extension on mood, cognitive performance, and cardiovascular health.  Ten healthy middle-aged to older adults (9 women;  = 65.

Examining the Discrepancy between Subjective Cognitive Complaints and Processing Speed Performance in Military Personnel with Traumatic Brain Injury.

Objective: To examine correlates of the discrepancy between subjective cognitive complaints and processing speed performance in a sample of military personnel with and without traumatic brain injury (TBI).

Method: About 235 U.S.

Genotype-phenotype associations in individuals with Diamond Blackfan anaemia.

Introduction: Diamond Blackfan anaemia (DBA) is a rare disorder characterized by failure of red blood cell production, congenital abnormalities and cancer predisposition, primarily caused by pathogenic germline variants in genes encoding ribosomal proteins.

Methods: We conducted a genotype-phenotype and outcome study of 121 patients with DBA spanning the 20-year history of the National Cancer Institute's Inherited Bone Marrow Failure Syndromes study. Patient phenotypes were compared by large versus small ribosomal protein genes, across genes with >5 cases (, , and ) and by type of pathogenic variants (hypomorphic versus null, large deletions versus others).

Differential Infiltration of Key Immune T-Cell Populations Across Malignancies Varying by Immunogenic Potential and the Likelihood of Response to Immunotherapy.

Solid tumors vary by the immunogenic potential of the tumor microenvironment (TME) and the likelihood of response to immunotherapy. The emerging literature has identified key immune cell populations that significantly impact immune activation or suppression within the TME. This study investigated candidate T-cell populations and their differential infiltration within different tumor types as estimated from mRNA co-expression levels of the corresponding cellular markers.

The Efficacy of Botulinum Toxin Use in Service Members and Veterans with Migraine and Post-Traumatic Headache Disorders: A Scoping Review.

Objective: To delineate the trend of use of botulinum toxin, including onabotulinum toxinA (OTA), in active military personnel and veterans with the diagnoses of migraine and post-traumatic headache (PTH) and describe the efficacy of botulinum toxin administration.

Background: Service members and veterans represent a unique population in the medical management of headache disorders, particularly migraine. They exhibit higher susceptibility to pain of greater intensity and longer durations, possibly due to their history of exposure to combat, trauma, and the associated psychological stresses.

Mpox (Monkeypox) On Board a Naval Warship.

We report a case of mpox in an active duty male on board a naval warship, who presented with a chancre-like penile lesion and ulcerating lymphadenopathy in the setting of a nonreactive treponemal test. Despite empirical therapy for sexually transmitted infections, he developed a fever and a generalized pustular rash. The patient was placed in isolation, and contact tracing was performed.

Normative Ranges for Oculomotor and Reaction Time Tests in U.S. Military Service Members and Veterans.

Background:  Oculomotor and reaction time tests are frequently used assessments of vestibular symptoms, traumatic brain injury (TBI), or other neurological disorders in both clinical and research contexts. When interpreting these tests it is important to have a reference interval (RI) as a comparison for what constitutes a typical/expected response; however, the current body of research has only limited information regarding normative ranges calculated according to established standards or for a military-specific sample.

Purpose:  The purpose of the present study was to describe RIs for oculomotor and reaction time tests in a cohort of service members and veterans (SMVs) for use as comparators by clinicians and scientists.

Incidence rates of soft tissue sarcoma among U.S. military servicemen: Comparison with the rates in the general U.S. population.

Background: Soft tissue sarcoma (STS) is one of the most frequently diagnosed cancers among men younger than age 30 years and a leading cause of cancer death in men younger than age 40 years. The military may be more exposed to STS risk factors and have generally better health and health care access than the general population, which may relate to lower cancer risk and/or early detection. This study compared STS incidence between servicemen and men in the general U.

Difficult Encounters in Chronic Pain Patients: A Cohort Study.

Objective: To determine variables associated with difficult clinical encounters.

Patients And Methods: This was a cross-sectional study of 428 new patients evaluated from 2022 to 2023. Demographic, clinical, social (eg, missed appointments, prior felony conviction, prior pain physicians, medical assistance) and visit-related (eg, visit took longer than expected, difficulty communicating) information was recorded, supplemented by in-person history gathered by the trainee and attending whose demographic data were also recorded.

Navigating the Orthopaedic Maze as a New Patient: A National Mystery Caller Study on Medicaid Coverage and Access to Specialized Surgeons.

Introduction: Medicaid coverage is associated with longer appointment wait times, decreased access to care, and poorer health outcomes compared with private insurance across medical subspecialties. The purpose of this study was to evaluate new patient appointment wait times for subspecialty Orthopaedic care based on insurance type and to identify factors influencing these wait times.

Methods: Orthopaedic physicians were identified using the American Academy of Orthopaedic Surgeons patient-facing database in the fields of Adult Reconstruction, Foot and Ankle, Hand, Sports Medicine, Spine, Pediatric, and General Orthopaedic surgery.

Medical Resident Perceptions of Distress during Training.

Objectives: This study used a qualitative research approach to grounded theory to identify factors that contributed to resident distress during 2021-2022 in multiple different specialties and at different postgraduate years of residency. By better understanding these contributors to distress, the aim was to inform the design of optimal interventions to reduce burnout and other emotional distress.

Methods: The residents enrolled in this study completed a demographic survey and semistructured interview.

Beware the Manchineel: A Case of Irritant Contact Dermatitis.

The manchineel tree (Hippomane mancinella) grows along the sand-vegetation boundary of Caribbean beaches. The tree also can be found in Florida and the US Virgin Islands. All parts of the tree are toxic.