Military Medicine最新文献

{"title":"Genito-Urinary Trauma in the War Context: A Review of Two Decades of Experience From the French Armed Forces.","authors":"Yohann Vincent, Paul Chiron, Christopher Agüero, Pierre-Henrie Savoie, Arthur Peyrottes, Thibaut Long Depaquit","doi":"10.1093/milmed/usaf031","DOIUrl":"10.1093/milmed/usaf031","url":null,"abstract":"<p><strong>Background: </strong>In recent conflicts, injuries to urogenital organs ranged from 5 to 7.2% of all combat-related injuries. Open surgery remains the main approach in combat settings, and in the French military, urgent surgical procedures are mostly performed by general surgeons with no specialization in urological care. To explore the specific needs in advanced surgery courses, we aimed to describe the epidemiology and management of genito-urinary traumas in recent conflicts in French Medical Treatment Facilities (MTFs).</p><p><strong>Methods: </strong>Data were extracted from the OPEX® registry, which prospectively recorded surgical activity from 2001 to 2021. All patients treated in French Role 2 Enhanced or 3 MTFs requiring emergency surgery for urogenital injury were included. The mechanism of trauma, type of genito-urinary injury (GUI), and surgical management were reported.</p><p><strong>Results: </strong>After screening, a total of 4,603 patients were admitted for emergency or delayed emergency surgery. Among them, 31 (0.67%) patients had urogenital injuries requiring immediate management. Most injuries were combat-related (77.4%), caused by gunshots (45%) and explosions (29%). Ten patients (32%) were hemodynamically unstable at initial management. Bladder and testicular injuries were the most common (12 [39%] and 8 [25.8%], respectively). Kidney injuries were rare but led to organ extirpation in 60% of the cases. Associated digestive injuries occurred in 45.2% of the cases. All procedures used the open approach.</p><p><strong>Conclusion: </strong>This study is the first to examine genito-urinary traumas in overseas operations during French army deployments. The results highlight the relatively low incidence of urological trauma, with most injuries involving the bladder and testis. Our findings highlight the importance of equipping military surgeons with the skills necessary to manage complex cases.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e1529-e1533"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Spectrum Between Catatonia and Functional Neurologic Disorder Superimposed on Post-Infectious Encephalitis in a Marine Recruit.","authors":"Sydney Rogers, Jessica Lilley, Geoffrey Raynor, Sarah Hodges, Derek Larson","doi":"10.1093/milmed/usae382","DOIUrl":"10.1093/milmed/usae382","url":null,"abstract":"<p><p>Catatonia, a neuropsychiatric condition characterized by abnormal speech, volition, and movement, is primarily thought of as a symptom of a primary psychiatric pathology, but there are a variety of non-psychiatric medical conditions that must be considered. As a result of symptomatic complexity and the wide range of differential diagnoses, catatonia-like symptoms can cloud the clinical evaluation and complicate treatment regimens. Within the realm of catatonic-like diagnoses is functional neurological disorder because of its vast range of potential presentations. Functional neurologic disorder can be diagnosed by evidence of incompatibility between neurologic symptoms and recognized neurological or medical conditions. Clinical uncertainty is further intensified in the presence of co-morbid medical etiologies because of inability to neatly delegate symptoms to a specific diagnosis. The blurred spectrum between catatonia and functional neurologic disorder is highlighted in this patient's complex clinical presentation while being further obscured in the setting of a possible overlying encephalitis exacerbating the presentation. This case report presents a unique case of a Marine recruit whose inconsistent catatonic symptoms caused diagnostic uncertainty and were ultimately decided to have neurologic and psychiatric contributions, highlighting that diagnoses are not mutually exclusive and should be continually re-assessed as new data become available. This report also showcases the distinctiveness of U.S. Marine culture and possible physical manifestations because of imposed psychological stress.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e1751-e1754"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home Use Therapies for Pain, Disability, and Quality of Life in Military Service Members with a Musculoskeletal Injury: An Updated Systematic Review Meta-Analysis.","authors":"Laura A Talbot, Lin Wu, Vanessa J Ramirez, David F Bradley, Ross Scallan, Pilar Zuber, Christopher H Morrell, Kayla Enochs, Mathias Fagan, Jesse Hillner, E Jeffrey Metter","doi":"10.1093/milmed/usae541","DOIUrl":"10.1093/milmed/usae541","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Musculoskeletal (MSK) injury can negatively affect service members by compromising job performance and readiness. These injuries can impact the service member's physical health, functional abilities, and quality of life (QoL). Rehabilitation therapies for MSK injuries can reduce these impacts. One approach is home use rehabilitative therapy, usable during deployment and at home stations. The purpose of this updated systematic review with meta-analysis was to broaden our scope of pain/symptoms, disability, and QoL as outcome measures for nonpharmaceutical MSK therapies in a military population versus controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;An updated systematic literature search was conducted from inception to September 2022 using electronic databases. From 2790 retrievals, 22 reports were identified from 21 randomized or nonrandomized control trials. Interventions included exercise, electrotherapy, bracing, and other devices compared to a standard control treatment. Outcomes for MSK pain/symptoms, disability, and QoL were summarized as (1) standardized change from baseline for both intervention and control by time and (2) standardized mean differences (SMDs) in the time change between the intervention and control.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Relative to baseline, pain improved during treatment and follow-up (P &lt; .0001) with differences between intervention and control groups (P &lt; .0001) but no significant interactions between group and time (P = .11). Overall, interventions showed modest (0.33 SMD, 95% CI, 0.11 to 0.54) improvement relative to controls across body regions and time. On average, disability exhibited an SMD of 0.12 (95% CI, -0.20 to 0.44) across all measures with substantial heterogeneity (I2 = 0.93). Time (P = .02) but not intervention (P = .87) was a significant moderator with no clear pattern of change over time and no time by group interaction (P = .84). Quality of life had an overall modest effect with an SMD of 0.10 (95% CI, -0.04 to 0.24) with no evidence supporting a difference between the intervention and control groups (P = .10) and no significant interaction between time and group (P = .41). The QoL measures were primarily derived using the Short Form Health Survey (SF12/36), which provide a mental and physical component summary score. For the mental component, there was either no change or a small decline during the study (P(time) = .80), with a difference between the intervention and control (P = .04) but no interaction between groups over time (P = .40). For the physical component scale, there was improvement during the study (P = .01), with the intervention showing better improvement than the control (P = .005), with no interaction between the time and treatment/control group (P = .80). The report considers responses by region and individual treatments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This analysis demonstrated modest improvement in pain and physical well-being","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e1420-e1431"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Directed Skills Laboratories Increase Emergency Medicine Physician Confidence in High-Acuity, Low-Opportunity Procedures.","authors":"Sean M Stuart, Thomas Aubuchon","doi":"10.1093/milmed/usae533","DOIUrl":"10.1093/milmed/usae533","url":null,"abstract":"<p><strong>Introduction: </strong>The critical role of emergency physicians in military settings underscores the necessity for a broad and proficient skill set, especially in life-saving procedures such as thoracostomies, endotracheal intubations, and cricothyrotomies, to maintain combat readiness. The current peacetime phase, however, presents challenges in maintaining these skills because of decreased exposure to high-acuity medical scenarios. This decrease in exposure jeopardizes skills retention among military emergency medicine physicians, highlighted by studies showing a significant decline in performance over time because of reduced practice.</p><p><strong>Materials and methods: </strong>This study was carried out at the Naval Medical Readiness Training Center Portsmouth under IRB approval, employing a prospective, observational, mixed-methods design. Participants included board-certified emergency medicine physicians engaged in a self-directed, small-group skills lab focusing on central venous catheterization, thoracostomy, intraosseous access, endotracheal intubation, cricothyrotomy, and resuscitative thoracotomy. Pre- and post-lab surveys on a 5-point confidence scale assessed the impact of the lab, with data analyzed via the Wilcoxon signed-rank test to evaluate significant changes.</p><p><strong>Results: </strong>Fourteen physicians reported pre-lab confidence levels, showing high confidence in central venous catheter access, thoracostomy tube placement, intraosseous catheter placement, and endotracheal intubation. The interventions of cricothyrotomy, resuscitative thoracotomy, and suprapubic catheterization started with notably lower confidence levels. Statistically significant improvements in confidence were observed post-lab for cricothyrotomy, resuscitative thoracotomy, and suprapubic catheterization suggesting the lab's effectiveness in addressing less frequently practiced procedures.</p><p><strong>Conclusions: </strong>The Military Health System must find avenues to maintain the clinical skills of wartime procedures in the peacetime environment. Although there is no substitute for clinical encounters, alternative modalities are needed to augment skills retention in high-acuity, low-frequency procedures. Self-directed, small-group task trainers and cadaveric labs are a lower maintenance mechanism by which faculty can improve their confidence in certain procedural skills. Further studies should evaluate if this translates to changes in clinically oriented outcomes and how to optimize such training evolutions within the skills retention paradigm.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e1373-e1380"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned From the Frontline of GHE in the Indo-Pacific.","authors":"Matthew Holtkamp, John Finnigan","doi":"10.1093/milmed/usaf324","DOIUrl":"https://doi.org/10.1093/milmed/usaf324","url":null,"abstract":"<p><p>Medical readiness is critical to military success in the Indo-Pacific, where vast distances complicate evacuation and casualty care. The 5th Security Force Assistance Brigade has conducted over 70 medical assessments since April 2023, improving partner force interoperability from the point of injury through Role II care to enhance operational effectiveness.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening Military Medical Provider Readiness: A Comprehensive Examination of VHA-MHS Partnerships.","authors":"Shaun Brown","doi":"10.1093/milmed/usae372","DOIUrl":"10.1093/milmed/usae372","url":null,"abstract":"<p><p>Military medical readiness, particularly in surgical specialties, remains a significant concern within the Military Health System (MHS). While initiatives like the U.S. Army Military-Civilian Trauma Team (AMCT3) Program have addressed some readiness gaps, they primarily focus on trauma care, leaving other crucial medical specialties underserved. Leveraging partnerships between the Department of Veterans Affairs (VA) and the Defense Health Agency (DHA) emerges as a strategic approach to address these challenges comprehensively. Further collaboration between the VA and MHS is an opportunity to enhance military medical provider readiness, covering expanded medical specialties and health care personnel. By utilizing resource-sharing agreements (RSAs) and the Joint Incentive Fund (JIF), opportunities for increased collaboration and interoperability between the VA and MHS are explored. Challenges such as maintaining partnerships, addressing billing issues, and navigating local-level politics are identified, with proposed solutions, including establishing a centralized interagency office to monitor and manage specialty care partnerships. A comprehensive approach to enhancing military medical provider readiness through VA-MHS partnerships is crucial. By addressing readiness gaps and optimizing resource utilization, such collaboration would likely improve the overall readiness of the medical force, benefiting both military and veteran patient populations.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"187-191"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Emergency Rates at an Expeditionary Medical Facility Supporting Operation Inherent Resolve.","authors":"Michael W Struthers, Amar Kosaraju, Kraig S Vandewalle","doi":"10.1093/milmed/usae505","DOIUrl":"10.1093/milmed/usae505","url":null,"abstract":"<p><strong>Introduction: </strong>A core objective of U.S. medical services is to ensure the medical and dental readiness of military personnel. Oral diseases, resulting in pain, infection, or functional impairment, greatly affect the operational effectiveness of military personnel. This study aimed to compare the current causes of dental emergencies and the rates of dental disease nonbattle injuries in a deployed setting with those documented in previous research. Additionally, the study sought to determine if these rates have decreased because of preventive measures or potential improvements in overall oral health.</p><p><strong>Methods: </strong>Each soldier reporting to the health facility for dental care was screened by a dentist to determine the presence of a dental emergency. The reason for seeking care was classified into 1 of 7 categories and the rate of dental emergencies per 1,000 military members per calendar year was calculated.</p><p><strong>Results: </strong>The majority of emergencies (38.60%) were due to tooth fractures and/or caries. The second most common reason for visiting the dental clinic was pain from a tooth requiring endodontic therapy (16.81%). This was followed by musculoskeletal or nonendodontic tooth pain (16.10%), most often associated with stress. Periodontal issues accounted for 14.33% of emergencies. Teeth requiring extraction made up 7.16% of all emergencies, prosthodontic bonding complications accounted for 5.16%, and orthodontic bonding complications affected 1.84% of individuals. The dental disease nonbattle injuries rates determined from the current study were 154 emergencies per 1,000 personnel per year for Air Force members and 264 emergencies per 1,000 personnel per year for Army members, which align with previous research findings.</p><p><strong>Conclusions: </strong>The results of this study confirm that dental emergencies continue to be a threat to overall readiness in deployed environments. The primary etiologic factor in the current study was as a result of tooth fracture and/or caries.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e1564-e1569"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Tolerability of a Brief Cognitive-Behavioral Therapy for Chronic Pain Group for Veterans at Increased Risk for Suicide.","authors":"Amber Martinson, Erika M Roberge, Shan Wong, Rebecca Pruitt, John Perkins, Jamie Clinton-Lont","doi":"10.1093/milmed/usae548","DOIUrl":"10.1093/milmed/usae548","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is a significant risk factor for suicide, especially among Veterans. The aim of this study is to evaluate the safety (i.e., the occurrence of suicidal behavior after treatment) and tolerability (i.e., treatment completion) of a Brief Cognitive-Behavioral Therapy for Chronic Pain (Brief CBT-CP) group in primary care among a sample of Veterans with chronic noncancer pain deemed to be at an increased risk for suicide.</p><p><strong>Materials and methods: </strong>Chart review was used to assess suicide history and treatment completion among Veterans who participated in a Brief CBT-CP group within a Primary Care-Mental Health Integration Clinic at a Veteran Affairs Medical Center. Suicide risk was stratified into 3 categories: Minimal (no current suicidal ideation or history of suicidal behavior), Elevated (current suicidal ideation or history of suicidal behavior), and High Risk (current suicidal ideation and history of suicidal behavior). Safety was assessed as the absence of suicidal behavior during and after Brief CBT-CP sessions. Tolerability was defined as completion of at least 4/6 sessions.</p><p><strong>Results: </strong>Of the 261 Veterans who participated in a Brief CBT-CP group, 24.9% of Veterans were identified to be at Elevated Risk for suicide, and 1.5% of Veterans were identified to be at High Risk. Brief CBT-CP was identified as safe, as no deaths (by suicide or otherwise) or suicidal behaviors were observed while Veterans engaged in the treatment sessions. In fact, following completion of Brief CBT-CP, a 24.2% reduction in relative risk of suicidal behaviors was observed in the overall sample. Brief CBT-CP was also tolerable, with nearly 90% of Veterans completing at least 4 sessions (n = 229).</p><p><strong>Conclusions: </strong>Brief CBT-CP appears to be a safe and well-tolerated treatment for Veterans with chronic noncancer pain who are also at risk for suicide.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"1629-1636"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resonant Leadership in Army Nursing: A Concept Analysis.","authors":"Mollie F Christiansen, Nora Kakati, Sean M Reed","doi":"10.1093/milmed/usae556","DOIUrl":"10.1093/milmed/usae556","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Leadership development is of the utmost importance as the Army Medical Department prepares for future conflicts. All Army Medical Department leaders, including nurses, need to be prepared to lead in a high-tempo, complex environment. Nurse leader effectiveness is paramount to military readiness as well as for recruitment and retention within the Army Nurse Corps (ANC). Both Army talent management and Defense Health Agency documents recognize the importance of Emotional Intelligence principles for successful leadership. Resonant Leadership (RL) is informed by Emotional Intelligence principles and is well-studied within nursing literature. Additionally, the body of evidence examining RL demonstrates a positive impact on the nurse work environment. The purpose of this concept analysis is to define RL within the context of Army nursing, to clarify how this concept relates to Army leadership doctrine, and to propose innovative application(s) of RL within the ANC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Rodgers' evolutionary concept analysis method was used to define the attributes, antecedents, and consequences of RL. The concept elements were then cross-referenced with published Army leadership doctrine, applying RL to the context of Army nursing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The outcome of this analysis defines RL as a way of being, with attributes including strong, trusting relationships, the leader being in tune with followers, and mutual optimism. Antecedents of RL in Army nursing center on individual leader behavior and include emotional intelligence, technical/management skills and intellect, and acting on follower worries/concerns. Consequences of RL for Army nursing impact followers/staff and include improved job satisfaction, empowerment, and decreased burnout/emotional exhaustion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The defining characteristics of RL complement the competencies and attributes outlined in Army leadership doctrine. Additionally, the outcomes of RL positively influence the nursing work environment. There has been extensive research on the effect of RL within the civilian nursing workforce. However, to date, no studies have researched RL Army nursing. Leaders within the ANC can apply this analysis to their own leadership practice and integrate RL into leadership development education. Policy decisions within the ANC should promote RL to support positive nursing workforce outcomes including improved satisfaction and retention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Resonant Leadership bridges the gap between frontline nursing leadership development, the Army leadership model, and the DHA's Joint Professional Practice Model for nurses. By focusing on developing resonance, Army nurse leaders can simultaneously demonstrate many of the attributes and competencies the Army describes within its leadership doctrine. Although further research is needed to determine the prevalence of RL within Army nursing, RL has","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e1440-e1448"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Tuberculosis Cases in Military Personnel Versus Civilians: A Retrospective Descriptive Study.","authors":"Étienne Sence, Magali Billhot, Wanda Gaspard, Jean-Noel Lorenzi, Anne-Pierre Dubourdieu, Vincent Foissaud, Christine Bernard, Marc Aletti, Caroline Doutrelon","doi":"10.1093/milmed/usae503","DOIUrl":"10.1093/milmed/usae503","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) remains a leading cause of death from infectious diseases worldwide. Military personnel are particularly vulnerable to TB because of the factors like deployments to endemic regions and close-quarters living. This study aims to compare the characteristics and outcomes of symptomatic TB cases between military and civilian patients treated at 2 French military hospitals, with a specific focus on diagnostic delay.</p><p><strong>Materials and methods: </strong>This retrospective observational study included patients over 18 years old with culture-confirmed symptomatic TB treated between 2008 and 2021. Military patients (Group A) were compared to civilian patients (Group B), matched by age and sex. Data collected included demographic details, diagnostic delay, clinical presentations, and treatment outcomes. Statistical analyses were performed using chi-squared tests and Mann-Whitney tests, with significance set at P < .05.</p><p><strong>Results: </strong>A total of 17 military and 38 civilian patients were included in the study. The median diagnostic delay was shorter for military patients at 49 days, compared to 64 days for civilians, although this difference was not statistically significant (P = .42). In the military group, 59% had been deployed to TB endemic regions, with 35% showing symptoms during operational missions. Clinical presentations and microbiological findings were similar between the two groups. Notably, two military patients were infected with Mycobacterium canettii, likely linked to deployments in Djibouti, where this strain is endemic. The military population showed a significant burden of physical sequelae, with 25% experiencing lasting physical impairments post-treatment.</p><p><strong>Conclusion: </strong>Tuberculosis presentation and outcomes in military and civilian patients were generally comparable. Early diagnosis remains essential to minimize disease severity and operational impact, particularly in military settings.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e1693-e1697"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}