Reaching the unreached with polio vaccine and other child survival interventions through partnership with military in Angola

BackgroundGrowing conflict and insecurity played a major role in precipitating polio outbreaks in the Horn of Africa and the Middle East. In Angola, the early post-conflict situation was characterized by the presence of many inaccessible zones and districts due to insecurity and poor infrastructure. Partnership with the Angolan Army health service (AAHS) was one of the innovative strategies that the Polio Eradication Initiative (PEI) introduced into the country to support the polio vaccination campaigns in insecure and hard to reach zones.MethodsBefore embarking on creating a partnership with Angolan military it was essential to make high-level advocacy with top military decision makers to engage the leadership in the process for better and sustainable support to the strategy. The principal supports provided by the AAHS were the administration of oral polio vaccine, vitamin A, deworming agents, social mobilization, monitoring campaign quality, and surveillance. Distribution of logistics using military vehicles and helicopters to hard to reach and insecure zones was also part of the support.ResultsUsing this partnership it was possible to reach a significant number of children in insecure and hard to reach areas with polio vaccine and other child survival interventions. The military partnership also contributed in increasing the demand and addressing rejection for the polio vaccine.ConclusionMilitary is a potentially productive force that can be used for any development activities in any country. The Angolan experience has demonstrated that it is possible to form a partnership with the military for basic health intervention activities with little training and investment.     

Free tissue transfer at an army medical center

Free tissue transfer has been demonstrated to be an effective modality of treating a variety of wounds and conditions in the civilian population. The use of these procedures has been underreported by American military surgeons. Military surgeons face unique hurdles that make the effective performance of these procedures difficult. We report our experience with free flap reconstruction at an American Army medical center. We performed 44 free flaps in 38 patients; although operative times and hospital length of stay were comparatively long, our success rates were excellent with only one partial flap loss. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.     

2 294名军人伤害住院情况分析

目的：对某区部队伤害住院患者进行流行病学特征分析，提出预防建议。方法：应用各医院上报军区统计中心的数据库资料进行分析。结果：意外损伤、军事训练伤、交通伤和烧烫伤是导致部队伤害住院的四大主要因素。伤害主要发生在18—23岁(占62．16％)之间，干部意外损伤、交通伤和锐器伤高于战士，军训伤则战士明显高于干部。结论：部队要重视和加强伤害的预防工作。     

Skin test suppression by antihistamines and the development of subsensitivity

The suppression of skin test reactivity by single doses of six antihistamines was measured before and after a period of daily antihistamine ingestion in 18 subjects. Single doses of hydroxyzine, 50 mg; chlorpheniramine, 16 mg; and promethazine, 50 mg; induced significant suppression of skin test reactivity at 2 hr, whereas the suppression produced by tripelennamine, 100 mg; diphenhydramine, 50 mg; and cyproheptadine, 16 mg; did not differ significantly from that produced by placebo. After 3 wk of treatment with hydroxyzine, 75 mg per day, the suppressive effect of hydroxyzine as well as the five clinically unrelated antihistamines was significantly reduced. Although the response to chlorpheniramine was also reduced after chronic treatment with chlorpheniramine, 24 mg per day, the difference was not statistically significant. We conclude that antihistamines in the doses used differ greatly in their suppressive effect on skin test reactivity. The antihistamine producing the most skin test suppression, hydroxyzine, when it was taken daily for 3 wk, caused the development of partial tolerance not only to its own effect but to those of clinically unrelated antihistamines.     

机动防疫队模块化保障信息管理系统的研制

目的 为规范、统一管理各军事行动防疫保障信息,提高工作效率,开发机动防疫队模块化保障信息管理系统.方法 采用问卷调查、查阅相关文献资料,整理归纳防疫保障信息管理需求,设计防疫保障模块和筛选防疫保障技术,并经专家咨询论证后确立,采用网络技术、数据库技术和相关的防疫技术,以B/S模式与C/S模式相结合的开发方式开发软件系统.结果 确立了组织部署、健康教育、饮水饮食、疾病监测、卫生设施、媒介控制、防疫保障技术咨询系统等功能模块;系统各模块的设计具有较强的科学性、安全性、可操作性、可扩展性和开放性,达到预期目标.结论 该系统的应用将规范、统一各军事行动防疫保障工作和极大地提高防疫信息管理的工作效率,具有良好的发展前景.     

某部队官兵血清阴性脊柱关节病发病规律调查

目的 调查血清阴性脊柱关节病(SpA)在不同地区不同兵种部队中的发病及流行特点。方法 采用COPCORD询问表,对内陆平原地区、南疆干旱地区、北疆寒冷高原地区及沿海潮湿地区,包括陆、海、空三军共21750人进行四级调查,初步诊断病例行X线及HLA-B27检测。结果 SpA患病率4.87‰,其中强直性脊柱炎(AS)患病率2.11‰,反应性关节炎(ReA)患病率0.276‰,未分化脊柱关节病(uSpA)患病率2.39‰,AS、uSpA在海军中患病率高于其他兵种。AS在高原寒冷地区及沿海潮湿地区的患病率高于干旱地区及内陆地区,uSpA在沿海潮湿地区的患病率高于干旱地区及内陆地区。结论 AS、uSpA在部队的患病率接近普通人群,在海军中患病率高于其他兵种,在高原寒冷及潮湿环境地区部队的患病率增高。     

Palliative dilation of esophageal carcinoma

The authors' experience with palliative dilation of 46 consecutive patients evaluated for squamous cell carcinoma of the esophagus was retrospectively reviewed. Thirty-nine of 46 patients (85%) underwent dilation in order to palliate symptoms, enable endoscopy and biopsy, or prepare for placement of an esophageal prosthesis. Thirty-two of the 46 patients (70%) were treated with radiation therapy and seven (15%) underwent placement of an esophageal prosthesis. Thirty-five of the 39 patients dilated (90%) noted improvement in swallowing, allowing resumption of a soft or regular diet. Complications were noted in three of the 39 patients dilated (8%). The authors conclude that peroral dilation is a safe, effective, and probably underutilized method of palliation in patients with squamous cell esophageal carcinoma.     

Circadian growth hormone and prolactin blood concentration during a self-limited viral infection and artificial hyperthermia in man

Growth hormone and prolactin blood concentrations were measured in five human volunteers over 28-hour periods including 24 hourly samples (0800 to 0800 hours) followed by an oral glucose tolerance test (0800 to 1100 hours) both preexposure and during the peak febrile phase of a self-limited viral infection, Sandfly fever. Several months after recovery, three of the subjects were studied for 24-hour periods while they sat in a tub of water at 41 degrees C for 2 hours from 1300 to 1500 hours. During all studies, mealtimes (0800 hours, 1130 hours, 1630 hours) and dark phase (2300 to 700 hours) were fixed. Growth-hormone concentrations were strikingly elevated throughout the 24-hour study done during the febrile period of Sandfly fever infection (P less than .01) except for the period of normal nocturnal release when they were not significantly different from the baseline study. No additional nocturnal surge was noted the already elevated growth-hormone values during the viral-induced fever. Growth-hormone values tended to decline slowly during the night but increased considerably during the glucose-tolerance test the following morning. These changes were similar to responses previously reported in patients with cases of malnutrition. A clear-cut increase in growth-hormone concentrations (P less than .001) was also seen during a brief 2-hour period of artificial hyperthermia, suggesting that elevated body temperature alone may explain part of the increase in growth-hormone values seen during the fever of infection. A nocturnal surge of growth hormone was still seen in the artificial hyperthermia study, albeit somewhat delayed.(ABSTRACT TRUNCATED AT 250 WORDS)