Neuro-physiological and morphological manifestations of posttraumatic stress disorder (review of literature)

The article presents the review of neurophysiological and neuro-morphological researches of combat posttraumatic stress disorder. Also in the article presented data about the existence by the veterans, suffered by combat posttraumatic stress disorder, a regular dysfunction of hypothalamus-pituitary-paranephric system, approving by excessive allowance ruffling ofcortisol, tending the activation neuro-trasmitteric systems. These changes conjoin with predominance of sympaticotony and of increased psycho and physiological inflammability in response to cues, associated with real or imaginable danger. Methods of neurovisulisation show the existence of changes in visceral brain, prefrontal and sense-motorical zone of cerebrum, corresponded to stress signals. The article presents the discuss of cause-and-effects conditions between the morphological changes in central nervous system, influence of stress-factors and advance of disease.     

Combat stress disorder and the military physician. An approach to a category of post-traumatic stress disorder

The paper addresses the clinical entity of Combat Stress Reaction as it occurs in its immediate, undifferentiated form as well as its well-defined form - PTSD. Some aspects, such as the adaptive function of the syndrome and its relationship to physical injury, which may be of particular interest to the general military physician are touched upon.     

Pertussis in a military and military beneficiary population: case series and review of the literature

Three cases of pertussis (whooping cough) identified in a military emergency department are reported. Two of these cases involved infants with typical presentations. One of these infants was too young to have received immunizations, and the other child was only partially immunized. The third case involved an active duty soldier with a chronic cough. Pertussis has become increasingly important as a cause of chronic cough in adults. As a result of the infectivity of this organism, close-quarter situations, such as day care centers and military barracks, create the opportunity for substantial person-to-person transmission. Typical and atypical clinical presentations of pertussis are discussed, with an emphasis on currently available diagnostic modalities. The epidemiology and pathophysiology of this disease are also reviewed. The medical management of active duty soldiers and their dependents (both pediatric and adult) with this largely underappreciated infection and their close contacts is presented.     

Pharmacological prevention of combat-related PTSD: a literature review

Preventing posttraumatic stress disorder (PTSD) could have a significant positive impact on military readiness and quality of life. Few studies have examined whether pharmacological agents may prevent PTSD, and there has not been a systematic and critical review of these studies in order to guide future research efforts. We performed a literature review of articles examining the use of pharmacological agents for the prevention of PTSD. A total of 27 articles met inclusion criteria for the review and their results are summarized. The review points to corticosteroids and propranolol as the most promising agents for future research. Gamma-Amino butyric acid mimetic drugs received the least support. Complementary approaches using psychotherapy and pharmacological agents could also yield good results. Research aimed at determining the potential efficacy of these agents could start being carried out in the field with smaller numbers of personnel that has not been personally injured but have witnessed traumatic events. In addition, psychological interventions immediately after postdeployment could be used in large numbers of soldiers. Preliminary studies regarding the use of pharmacologic agents for the secondary prevention of PTSD are promising. However, much larger studies are needed before implementation in generalized practice.     

Awareness of posttraumatic stress disorder in veterans: a female spouse/intimate partner perspective

The purpose of this qualitative study was to identify perspectives of female spouses/intimate partners regarding posttraumatic stress disorder (PTSD) in returning Iraq and Afghanistan combat Veterans. Through the use of a self-administered questionnaire based on Flanagan's critical incident technique, reports were obtained from a purposive sample of 34 spouses/intimate partners of Veterans recruited through a social group for military spouses and a university in southeastern North Carolina. Two-thirds of the participants reported not having received formal education about PTSD. The main perceived barriers to PTSD treatment seeking were denial of symptoms, fear, and stigma about disclosing PTSD symptoms. Spouses/intimate partners observed Veterans for changes in behavior and routines, disturbed sleep patterns, and nightmares. In the event of PTSD treatment resistance, spouses/intimate partners reported they would suggest the need for treatment, issue an ultimatum, take action, or offer patience and support without taking any action.     

Protecting our militaries: a systematic literature review of military human immunodeficiency virus/acquired immunodeficiency syndrome prevention programs worldwide

OBJECTIVES: To systematically review published studies of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) prevention programs targeting the world's military populations. METHODS: We systematically searched eight electronic databases (publications from 1983 to February 2005) and hand-searched the bibliographies of HIV/AIDS prevention reviews to identify evaluative studies of HIV/AIDS prevention interventions for military personnel. RESULTS: Five hundred eighty-four abstracts were identified, of which eight met formal acceptance criteria. Four prevention interventions were identified, with each reporting a positive intervention effect on one or more of the following outcomes: increasing soldiers' knowledge of HIV/AIDS, willingness to engage in preventive behaviors, changing their attitudes toward greater compliance with prevention guidelines, and HIV/AIDS incidence and prevalence. CONCLUSIONS: Published interventions to reduce the risk of HIV/AIDS among military personnel are effective under certain conditions and with a limited number of populations. We discuss problems inherent in such research and make recommendations to improve the development, evaluation, and dissemination of findings of comprehensive HIV/AIDS prevention programs among military populations.     

Infection control in the dental laboratory: a review of the literature

The dental laboratory has been shown to be an area of potential disease transmission between patients and to laboratory personnel. This paper reviews pertinent literature on the subject and describes the "Barrier System," a proven infection control protocol to manage dental prostheses in the laboratory.     

Assessment of clinical depression comorbid with posttraumatic stress disorder

BACKGROUND/AIM: Comorbidity of the posttraumatic stress disorder (PTSD) and depression is often recognized in the clinical practice. The aim of the paper was to determine the severity of depression and the group of symptoms which are the most prominent in clinical depression comorbid with PTSD. METHODS: Totally 60 patients were assessed and divided into the experimental and control group using the Structured Clinical Interview for DSM-IV Axis I Disorders, Investigator Version (SCID-I, modified) (SCID for DSM-IV) and ICD-10 diagnostic criteria. The presence and the severity of the disorders were assessed by means of the following intruments: Clinician-Administrated PTSD Scale for DSM-IV (CAPS-DX), Montgomery-Asberg Depression Rating Scale (MADRS) and 17-item Hamilton Rating Scale for Depression (HAMD). The differences between groups were evaluated using Student t test and by means of the correlational analysis of the data with p < 0.05. RESULTS: The obtained results showed that depression which was comorbid with PTSD was of significant clinical severity with 31.20 score on HAMD and 30.43 score on MADRS in PTSD-D group. The group of the symptoms: lassitude, inability to feel, suicidal thoughts and inner tension contributed mostly to the global severity of the comorbid clinical depression on MADRS. The group of the symptoms: suicide and somatic symptoms, gastrointestinal, guilt, hypochondriasis, work and activity, anxiety psychic, agitation, and weight loss, genital symptoms and anxiety somatic contributed mostly to the global severity of comorbid clinical depression on HAMD. The average score was 16.03 and 16.97 on HAMD and MADRS, respectively in PTSD group. CONCLUSION: Depression which is comorbid with posttraumatic stress disorder represents significant clinical entity with domination of the different groups of symptoms between the groups PTSD and PTSD-D on HAMD. Identification of aforementioned severity of illness and delineated group of symptoms lead the clinician to establish the diagnosis of depression, reduce the risk of diagnostic ommition of the depression and enable the clinician to chose the optimal treatment method for the delineated disorders.     

The military medical management of missile injury to the spine: a review of the literature and proposal of guidelines

The management of missile injury to the spinal cord is controversial. The literature is reviewed and recommendations made about the management of these injuries. To surgeons in a country that is relatively safe such injuries are rare, this review provides useful information about this condition.     

军队疾病预防控制网站的设计与实现

目的：建立军队疾病预防控制网站,在全军范围内实现疾控信息发布、资源共享、业务交流,为广大官兵宣传疾病防控、健康维护的相关知识。方法以内容管理系统和元数据仓储平台为基础,采用B／S系统结构,利用JSP、MySQL等编程技术与工具完成系统开发。结果设计实现的军队疾病预防控制网已上线运行,构建了疾控资料库,实现了内容发布、全文检索、知识分类与聚合、在线咨询等一整套功能。结论网站对于展示军队疾控建设工作、宣传相关法规知识、解决广大官兵健康需求、提高基层部队防病能力,都起到了积极的作用。     

Exercise and primary dysmenorrhoea : a comprehensive and critical review of the literature

Primary dysmenorrhoea (PD) is chronic, cyclic, pelvic, spasmodic pain associated with menstruation in the absence of identifiable pathology and is typically known as menstrual cramps or period pain. PD is the most common gynaecological disorder in menstruating women. Despite treatments being available for PD, relatively few women consult a clinician about their symptoms, preferring not to use treatment, or to self-treat using non-pharmacological or over-the-counter interventions. The notion that exercise is effective in preventing and treating symptoms has prevailed for many years and led to the promotion of anecdotal belief that exercise is beneficial. Behavioural interventions such as exercise may not only reduce dysmenorrhoea, but also eliminate or reduce the need for medication to control menstrual cramps and other associated symptoms.With emphasis on data from experimental studies, this report seeks to review the available evidence regarding the role of exercise in the management of PD and menstruation-related symptomatology. Using key search terms, online bibliographical databases were searched from the beginning of each database to 1 April 2007. Despite the widespread belief that exercise can reduce PD, empirical support is limited. Evidence from observational studies was mixed. Several observational studies reported that physical activity/exercise was associated with reduced prevalence of dysmenorrhoea, although numerous other studies found no significant association between outcomes. Evidence from controlled trials suggests that exercise can reduce PD and associated symptoms, but these have been small and of low methodological quality. There are, however, several plausible mechanisms by which exercise might be effective in the management of PD. A large randomized controlled trial is required before women and clinicians are advised that exercise is likely to be effective in reducing PD and related menstrual symptoms.