The incidence of eye injuries at three U.S. Army installations

Studies addressing the impact of eye injuries on U.S. Army readiness and the effectiveness of countermeasures are lacking. In 1989, the U.S. Army Environmental Hygiene Agency undertook a prospective, multicenter study of military units in the peacetime Army at selected installations to define the incidence of eye injuries, assess associated variables, and identify targets for intervention. During the first 5 months of 1989 at Fort Bragg, North Carolina, Fort Campbell, Kentucky, and Fort Lewis, Washington, health care providers saw 103 new eye injuries with an overall rate of 14.18 injuries per 1,000 personnel annually. Almost one-half of the injuries (48 cases, 46.60%) occurred during on-duty work and training. Most (93 cases, 90.29%) of the soldiers were not wearing eye protection when injured. This study identifies possible targets for intervention and provides a baseline against which the interventions of the last decade may be assessed for effectiveness.     

Rising hepatitis A immunity in U.S. military recruits

BACKGROUND: The U.S. military immunizes new recruits against hepatitis A. Since 2001, immunization with the hepatitis A vaccine has been recommended for civilian adolescents in higher risk areas. Recently, the Armed Forces Epidemiological Board recommended serologic screening where feasible to reduce redundant recruit immunizations. OBJECTIVES: The purpose of this study was to determine hepatitis A seroprevalence in recruit populations to inform screening policy. METHODS: Banked serum from a sample of military recruits (n = 2,592) in 2004 was tested for total antibody to hepatitis A (anti-hepatitis A virus (HAV)). RESULTS: The overall anti-HAV seroprevalence was 12.0% (95% confidence interval, 10.8%-13.3%). Adjusted to the age distribution of the 18- to 34-year-old population, the seroprevalence was 11.9% (10.5%-13.4%). The lowest seroprevalence was noted in the 1984 birth cohort, with significantly higher seroprevalence among younger recruits. CONCLUSIONS: Rising hepatitis A immunity among successive birth cohorts suggests increasing compliance with immunization recommendations. In anticipation of rising population immunity, universal screening of military recruits for anti-HAV is recommended.     

2021年度美军军事作业医学研究进展

该文梳理了美军2021年度军事作业医学领域的研究进展,涵盖美军作业效能维护的最新条令、指南和部队健康报告,极端自然环境和特殊作业环境损伤的发病机制研究进展及防护装备研发成果,以及女性军人健康维护和效能提升专职咨询机构70年发展历程回顾与最新政策制度等内容,旨在为我军同领域研究提供有益的借鉴和参考.     

U.S. Army noncombat munitions injuries

OBJECTIVE: The object of this study was to determine the types of noncombat injuries secondary to munitions sustained by U.S. Army soldiers. METHODS: A retrospective review of all noncombat munitions injuries reported to the U.S. Army Safety Center from August 1989 to September 1996 was conducted. RESULTS: There were 742 incidents reported, resulting in 894 injured soldiers. The most common types of injuries were thermal burns, puncture wounds, and lacerations. The extremities were the most common anatomical location injured. The most common activities associated with injuries were combat training exercises, munitions firing, and rendering munitions safe. CONCLUSION: This study demonstrates a distinctive injury pattern for each category of munitions. Military readiness will be improved if we train all personnel to be familiar with the injury patterns and the most common situations associated with injury. By informing unit commanders which activities are associated with increased risk of injury, they may better prepare preventive measures to decrease the number of noncombat injuries.     

美军新一轮卫生体制改革进展及启示

为了缓解医疗费用的不断增长,提高管理效率,美军于2013年10月正式开始实施新一轮卫生体制改革。这是美军卫生系统历史上规模最大的一次组织结构调整,其核心内容是成立全军统一的卫生管理机构———国防卫生局,并加快推进多军种联合的区域一体化医疗保障模式改革,预计于2015年底完成预期改革目标。该文从此次改革的背景入手,分析其改革前后卫生系统组织结构与管理机制的主要变化和改革原因,并提出对我军卫生体制改革的启示。     

Infection in war wounds: experience in recent military conflicts and future considerations

War wounds are characterized by devitalized tissue, the presence of debris, and contamination by bacteria--factors that contribute to the establishment of wound infection. A review of the literature regarding the incidence of wound infection in recent military conflicts strongly suggests that infection in open war wounds occurs with relative frequency despite strict adherence to the principles of surgical debridement and administration of "prophylactic" antibiotics. Further research leading to improved methods of preventing wound sepsis is warranted in order to reduce the incidence of wound infections in the future.     

Skiing injuries during initial military nordic ski training of a U.S. Marine Corps Battalion Landing Team

During 4 weeks of military nordic ski training with 638 men, 45 skiing injuries occurred with 359 days lost from training (5.63 injuries per 1,000 skier days). Knee injuries represented 38% of total injuries, with 58% of these being medial collateral ligament sprains. Knee injuries represented a greater fraction of total injuries in the novice skier cohort than in the experienced skier cohort. All injured subjects except one responded favorably to conservative therapy available at the training facility. Despite the special rigors of military nordic skiing, the incidence and anatomic distribution of injuries is similar to that reported with civilian skiing.     

Eye injuries in the U.S. Armed Forces

OBJECTIVE: To develop prevention and treatment modalities for eye injuries, ophthalmologists require epidemiological data on the various types of eye injuries. This study sought to define eye injury patterns in the U.S. armed forces. METHOD: Data on patterns of eye injury in the armed forces were obtained through voluntary reporting by U.S. military ophthalmologists throughout the world. The reporting format was standardized with the U.S. Eye Injury Registry initial and follow-up report forms. The data were analyzed for significant injury patterns. RESULTS: Data on 112 patients were submitted, representing a broad range of the military population. Data on a total of 96 patients with a 6-month follow-up were analyzed in this study. Immediately after injury, 43% of the patients were noted to have poor vision (worse than 20/200). After treatment, only 20% were noted to have poor vision. Patients lost an average of 21.6 days of work after a severe eye injury. CONCLUSION: An eye injury is a traumatic and potentially debilitating event. The loss of visual acuity can be drastic, resulting in an extensive recovery period.     

美军飞行疲劳管理规章制度

目的 综述美军飞行疲劳管理相关规章制度和措施,通过分析其经验与做法,阐述对我军飞行疲劳研究和规章制度建设启示. 资料来源与选择 美国陆、海、空三军飞行指令或条例以及国内外该领域相关文献. 资料引用 4份美国陆、海、空三军飞行指令或条例,2部专著,28篇文献. 资料综合 介绍了美国陆、海、空三军飞行指令或条例中有关飞行时限、值勤时间、休息与睡眠要求、空中疲劳对抗措施、兴奋及催眠药物使用等飞行疲劳管理措施和相关规章制度,分析了美军对飞行疲劳规章制度重要性和管理措施多样性的认识及对我军的启示,简要回顾了我军飞行疲劳相关研究工作. 结论 美军非常重视飞行疲劳管理规章制度建设,将其作为飞行条例条令的必要内容强制执行.各项管理规章制度职责明确、要求具体、操作性强.美军飞行疲劳对抗措施相关研究工作贴近实战、针对性强,为制定相关政策措施奠定了坚实基础.飞行疲劳已经成为威胁飞行安全的重要因素,我军应将飞行疲劳危险管理纳入相关规章制度.     

美军既往军事行动致伤因素分析研究

主要介绍美军利用伤情编码PC－code和巴雷尔伤情转换矩阵组成的标准化的伤员分类和编码体系,采集分析越南战争、索马里作战、伊拉克战争等伤员数据,得出武器致伤因素和战场环境因素对伤员伤类、损伤部位造成的影响,可以有效提高各类卫勤资源利用效率和卫勤保障针对性,对我军战时卫勤保障有一定启示借鉴作用。     

Temporal lobectomy for refractory epilepsy in the U.S. military

OBJECTIVES: To determine the characteristics, seizure outcomes, and quality-of-life outcomes for military beneficiaries undergoing partial temporal lobectomy for refractory epilepsy at the only U.S. military medical center with a comprehensive epilepsy surgery program. METHODS: The records of all 84 patients treated with partial temporal lobectomy between 1986 and 2000 at Walter Reed Army Medical Center were retrospectively reviewed. Outcome measures included seizure frequency according to the Engel classification system, driving, employment, anticonvulsant use, and military service. RESULTS: The study cohort consisted of 72 military dependents, 10 active duty military members, and 2 military retirees. Two years after surgery, 65 (92%) of 71 patients had seizure improvement (Engel classes I-III) and 46 (66%) of 71 had seizure remission (Engel class I). Driving and employment rates increased after surgery, whereas anticonvulsant use decreased. Five (50%) of 10 active duty patients achieved seizure remission postoperatively and continued to serve in the Armed Forces. Active duty patients had a later age of seizure onset, shorter duration of epilepsy, and greater proportion of lesional epilepsy, compared with nonactive duty patients. CONCLUSIONS: Epilepsy surgery outcomes in the U.S. military are similar to those reported from nonmilitary centers, with the majority of patients experiencing seizure remission and improvements in quality-of-life measures. Complete seizure remission after successful anterior temporal lobectomy enables some active duty military members to continue service in the U.S. Armed Forces.     

Predicting dental treatment workload of U.S. military personnel.

As the demographic composition of the U.S. armed forces shifts, so does dental treatment workload (DTW). To date, the effects of such shifts on DTW have been speculative. This study seeks to build regression models to predict the DTW of recruit and active duty military personnel as service demographic factors shift. The data come from a 1994-1995 random sample of 13,050 active duty and 2,711 recruit personnel. Dental treatment needs were charted for all participants. Patient demographic variables--age, sex, race, education, branch of service, and annual dental utilization (for all); home region and marital status (recruits only); and rank (active duty only)--were noted. Treatment needs were converted to composite time values. Respondent demographic factors were regressed on composite time values to determine which factors influence DTW using backward, stepwise, linear regression. Results show that DTW varies across demographic categories. The magnitude and direction of change in DTW as service demographic variables shift can be predicted with linear regression models.     

Unintended pregnancy and contraceptive use among women in the U.S. military: a systematic literature review

U.S. servicewomen's ability to plan pregnancies is of concern to the military in terms of troop readiness and cost and is an important public health issue. Contraception access and use are crucial, particularly given the high prevalence of sexual assault in the military and the benefits of menstrual suppression for deployment. We systematically searched for publications on contraception, unintended pregnancy, and abortion in the military. Pregnancy and unintended pregnancy rates are higher among servicewomen than the general U.S. population. Contraceptive use may be somewhat higher than the nonmilitary population, although use decreases during deployment. Reported use of hormonal methods for menstrual suppression is lower than interest. There are limited data on these topics; more large, representative studies and longitudinal data from all branches are needed, along with qualitative research to explore findings more deeply. Emergency contraception and abortion are particularly underresearched.     

2011年度美军卫生勤务进展概述

本文分析了2011年度美军卫勤发展的重要动态,概述了美军卫勤发展的总体态势,总结归纳了美军卫勤转型中的主要成就和经验.主要内容包括:卫勤组织管理、战时医疗保障、平时医疗保障、医学教育训练和军事医学科研.