Military Medicine最新文献

{"title":"The Case for Dedicated Vaccine Communication Training: A Survey of Military Pediatricians.","authors":"Daley Auvil, Katherine Jones, Rebecca Ratusnik, Daniel J Adams","doi":"10.1093/milmed/usag473","DOIUrl":"https://doi.org/10.1093/milmed/usag473","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccine uncertainty is rising among families in the United States, even among military families. The ACGME mandates that pediatric residents be trained in effective communication strategies for patients and families hesitant about recommended vaccinations, yet few validated curriculum tools exist. We aimed to understand the current landscape of vaccine uncertainty experienced by military general pediatricians and see what communication strategies were routinely being implemented in clinical practice.</p><p><strong>Materials and methods: </strong>In March 2025, 45 graduates of a mid-sized military pediatrics residency program from the years 2016-2024 who were currently practicing general pediatricians were invited to participate in a survey on vaccine communication in clinical practice. The survey was a mix of quantitative questions asking for experienced trends in vaccine uncertainty as well as open-ended questions about communication strategies being implemented. Three clinical researchers performed a manual thematic analysis of free-text answers to understand and quantify common themes.</p><p><strong>Results: </strong>Thirty-seven general pediatricians (82%) responded, and 95% of those surveyed rated a curriculum during medical training on vaccine communication as \"very\" or \"extremely important.\" Only 19% of physicians were able to recall formal training in addressing vaccine hesitancy during medical school, and only 62% during residency. The 3 most commonly declined vaccines were COVID-19, influenza, and HPV. Pediatricians reported using communication strategies focused on knowledge-sharing (65%), partnership with families (62%), and normalizing vaccines (40%). Common barriers to vaccine acceptance were mistrust and disinterest, most commonly with unwillingness to engage in a conversation.</p><p><strong>Conclusions: </strong>Most practicing military pediatricians who graduated from our residency program report a rise in vaccine uncertainty in their practice and agree that a residency curriculum on vaccine communication is highly important. Such curricula should encourage evidence-based communication styles using vaccine normalization while de-emphasizing the urge to combat misinformation using knowledge-sharing and should specifically address the most commonly declined immunizations.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195113","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":"Commentary-The Development of the North Atlantic Treaty Organisation Standards on Military Healthcare Ethics From Concept to Publication.","authors":"Charlie Beardmore, Martin Bricknell, Alexander Faas","doi":"10.1093/milmed/usag480","DOIUrl":"https://doi.org/10.1093/milmed/usag480","url":null,"abstract":"<p><p>Military Healthcare Professionals face ethical dilemmas, which may cause them psychological suffering. Moral Injury may potentially be prevented through training in military healthcare ethics and practical simulations of clinical situations. Law, Ethics and Morality all influence the professional conduct of Military Healthcare Professionals. A widely accepted military healthcare ethics guidance Code may assist Military Healthcare Professionals discharge their duties. This commentary describes the development of such guidance. The North Atlantic Treaty Organisation Committee of the Chiefs of Military Medical Services tasked its Military Healthcare Working Group to produce such guidance, intended to promote consistency in applying ethical principles. It may also potentially mitigate against Moral Injury, although this has not been evaluated yet. A series of workshops created the document, published as Allied Medical Publication 8.19 (Military Healthcare Ethics), in July 2025. Military healthcare ethical issues include: \"dual loyalty\" (military healthcare professionals' responsibility to ensure patients receive appropriate care, whilst concurrently looking after the best interests of their parent organization), medical rules of eligibility, special populations, prisoners of war and detainees, conduct of military medical units/personnel, use of the Red Cross/Crescent/Crystal symbol, arming of medical units/personnel and absolute prohibitions. The workshops developed the King's Military Healthcare Ethics Analytical Framework to help analyze military healthcare ethical dilemmas. This is intended to add value and consistency to decision-making and to have wide utility across Military Healthcare Practitioners. This publication has the potential to support training, improve consistency in ethical decision-making, and potentially mitigate moral distress or Moral Injury if effectively implemented.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194782","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":"Comparative Analysis of Dental Emergency Visits and Dental Readiness Classifications on a Major U.S. Army Installation.","authors":"Eric Hu, Anna Yoo, James Giesen, Stephanie Helmus, Daniel DiPirro, Joseph Grant, John K Kreider","doi":"10.1093/milmed/usag467","DOIUrl":"https://doi.org/10.1093/milmed/usag467","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Optimal oral health is essential to service members' well-being, deployability, and operational performance. Dental emergencies (DEs) result in lost duty time and degrade combat effectiveness, particularly during large-scale combat operations (LSCO), when evacuation and definitive dental care may be limited. Dental Readiness Classifications (DRC) are used to determine service member deployability; however, their effectiveness in predicting and preventing DEs has not been well-characterized using contemporary data. This study evaluated the nature of DEs and its relationship with DRCs at a major U.S. military installation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This retrospective study reviewed de-identified Military Health System Genesis-Dentrix electronic dental records for active duty service members who presented for DE visits from January 1, 2025, to March 31, 2025. DE visits were identified using Current Dental Terminology codes W0199 (Dental emergency visit), and/or D9110 (Palliative emergency treatment for relief of dental pain). Each DE was categorized into major and sub-categories based on diagnosis at the DE visit. Data collected included association with prior diagnosis, planned treatment, or recent treatment; interval from the most recent comprehensive or periodic dental examination or associated dental visit; DRC status before and after the DE encounter; need for off-post referral through the Active Duty Dental Program (ADDP); and time required to resolve post-encounter DRC 3 conditions or return patients to DRC 1 or 2 status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 791 DE visits met inclusion criteria. The most common DE categories were oral surgery (31.9%), restorative non-caries (14.6%), and endodontics (12.5%). Third molar-related conditions comprised most oral surgery DEs, whereas defective restorations, fractured teeth, and molar pulpal diagnoses were leading contributors in other categories. Before the DE encounter, 90.8% of patients were classified as fully medically ready to deploy (DRC 1: 28.9%; DRC 2: 61.9%). Overall, 35.5% of DEs (DRC 1: 23.1%; DRC 2: 35.9%; DRC 3: 72.2%) were associated with a prior diagnosis, planned treatment, or recent treatment, and occurred a median 18.5 days after the associated appointment. Unassociated DEs occurred a median of 152 days after the patient's most recent annual dental examination. After the DE visit, the proportion of patients classified as DRC 3 increased from 9.1% to 22.8%. Post-encounter DRC 3 conditions required a median of 16.5 days to resolve or return to DRC 1 or 2 status. Off-post referral was required for 11.7% of DEs, most commonly for third molar extractions under intravenous sedation, molar endodontic treatment, and crowns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A high proportion of DEs occurred among service members classified as DRC 1 or 2 before the emergency encounter, indicating that current DRC definitions are unable to fully ","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194827","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":"Easing Licensure Barriers for Military Families.","authors":"Charles G Kels, Lori H Kels","doi":"10.1093/milmed/usag472","DOIUrl":"https://doi.org/10.1093/milmed/usag472","url":null,"abstract":"<p><p>The frequent moves necessitated by uniformed service pose employment and lifestyle challenges for military families. These economic pressures are exacerbated when military spouses require state-based licenses or certificates to practice their chosen profession. Although all states have taken some action to facilitate licensure transfers based on military moves, the imperatives of national security implicated by military recruiting and retention demand a more comprehensive solution to employment barriers facing military households. Recent legal developments at the federal level create opportunities for military families to seek both professional license portability and reimbursement for certain re-licensing expenses. This Commentary reviews the new mechanisms under federal law to improve employment opportunities for military families working in professional fields, with an emphasis on special considerations for practitioners of various healthcare disciplines.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183009","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":"Documented Fracture-Healing Outcomes After Operative and Nonoperative Management of Closed Mid-Diaphyseal Humerus Fractures in Active-Duty Service Members.","authors":"Matthew M McDonough, Elliott V Rebello, Reileigh S Fleeher, Cecelia O Brown, Thomas A Beltran, Christopher M Belyea","doi":"10.1093/milmed/usag471","DOIUrl":"https://doi.org/10.1093/milmed/usag471","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Closed diaphyseal humerus fracture treatment is nuanced with regard to the selection of surgical candidates. Fracture union is crucial, with historical data suggesting rivaling union rates between operative and nonoperative treatment; however, recent literature suggests increased union rates with operative treatment. Although nonoperative treatment of most fracture patterns is supported by the literature, there remains an argument for operative treatment for select patient populations, especially when considering union rates. Evidence regarding fracture-healing outcomes in young active-duty populations remains limited. We sought to characterize documented fracture-healing outcomes after operative and nonoperative management of closed diaphyseal humerus fractures in active-duty service members and to evaluate completeness of healing-status ascertainment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study queried the Medical Assessment and Readiness System (MARS), Womack Army Medical Center, Fort Bragg, NC, which contains information from the Military Health System (MHS) care system. This study defined a retrospective cohort of patients diagnosed with closed diaphyseal humerus fractures (OTA/AO 12A/B/C), using International Classification of Diseases (9th and 10th revision) codes, sustained from January 2011 to December 2022. Treatment type, including operative or nonoperative, was identified. We excluded patients with open humerus fractures; proximal humerus fractures; distal humerus fractures; and those treated with external fixation. The primary outcome measure was a diagnosis of union or malunion/nonunion. Unadjusted comparisons between groups were conducted using likelihood ratio chi-square tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study population comprised 402 patients with closed humeral diaphyseal fractures; 314 (78.1%) were managed nonoperatively and 88 (21.9%) operatively. Fracture-healing status could be classified in 216 patients (53.7%), whereas 186 (46.3%) lacked sufficient documentation to determine the primary outcome. Outcome ascertainment was more complete after operative than nonoperative management (61/88 [69.3%] vs. 155/314 [49.4%]; P = .001). Among those with documented healing status, union occurred in 149 of 155 nonoperatively managed fractures (96.1%; 95% CI, 91.8%-98.6%) and 59 of 61 operatively managed fractures (96.7%; 95% CI, 88.7%-99.6%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Among active-duty service members with documented healing status after closed diaphyseal humerus fracture, observed union rates were high after both nonoperative and operative management. However, treatment was nonrandom, important fracture-specific treatment-selection variables were unavailable, and healing status was determined from available clinical documentation, recorded radiographic interpretations, diagnosis codes, and revision procedures rather than standardized radiographic adjudication. These limitations, togeth","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168402","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":"Acute Onset Orolingual Choreoathetosis and Auditory Hallucinations in a Healthy Young Adult Following High Melatonin Dose.","authors":"Hunter L Bain, Alexandra M Yanez, Samuel I Bartlett","doi":"10.1093/milmed/usag468","DOIUrl":"https://doi.org/10.1093/milmed/usag468","url":null,"abstract":"<p><p>Melatonin is considered a safe OTC sleep aid with rarely reported adverse effects despite limited data. We present a case of acute orolingual choreoathetosis and auditory hallucinations following 132 mg ingestion of melatonin in an otherwise healthy, 22-year-old active-duty male in IBOLC training. The patient developed abrupt, predominantly orolingual choreoathetosis and mild auditory hallucinations, 1 hour after waking. Three days earlier, he began taking 24 mg of melatonin nightly for insomnia and ingested 132 mg the night before presentation. He denied alcohol, illicit drug, or other medication use. On ED arrival, he was hemodynamically stable with continuous orolingual choreoathetosis. Initial labs demonstrated mild acute kidney injury and transaminitis. Head CT was unremarkable. MRI head showed a nonspecific left frontal white matter hyperintensity. Lumbar puncture revealed normal protein and WBC, negative culture, and negative oligoclonal bands, though CSF processing difficulties prevented autoimmune panel completion. Neurologic symptoms resolved by the next morning without recurrence, and a subsequent EEG was unremarkable. This case documents a temporal association between high-dose melatonin exposure and acute neurologic symptoms but does not establish melatonin as the cause. The clinical presentation also occurred in the setting of substantial confounders, including sleep deprivation and heat exposure. This observation supports further investigation of uncommon neurologic presentations occurring after high-dose melatonin intake.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170792","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":"Maximizing Clinical Nurse Specialist Utilization in Future Conflicts Within the Navy and Marine Corps.","authors":"Benjamin E Makus, Tanna R Thomason, Sheree A Scott","doi":"10.1093/milmed/usag469","DOIUrl":"https://doi.org/10.1093/milmed/usag469","url":null,"abstract":"<p><p>The United States faces evolving strategic challenges that require military forces to adapt how they operate to achieve operational objectives. Emerging threats are reshaping the operational environment and require corresponding changes to health service support (HSS). Delayed casualty evacuation requiring prolonged care, high casualty volumes, and constrained medical logistics were identified as challenges in future conflict. Clinical nurse specialist (CNS) practice is examined in relation to these challenges to demonstrate the role's potential impact and support greater CNS utilization at the operational and tactical levels of medical care. Evidence from military treatment facilities, civilian health systems, and the COVID-19 response demonstrates how CNSs improve outcomes through rapid translation of evidence into practice, prevention of hospital-acquired complications, competency development, expansion of clinical capacity, resource conservation, and standardization of care. Greater integration of CNSs into operational and tactical medical forces could strengthen patient outcomes, clinician readiness, system efficiency, and the flexibility of HSS during future conflict.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168737","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":"Assessing the Impact of Increased Pull-Up Requirements on Upper Extremity Musculoskeletal Injuries Among Males in the U.S. Marine Corps: An Interrupted Time Series Analysis.","authors":"Bradley McNeal, Hava Marneweck, Amanda Banaag, Vivitha Mani, Mel Helgeson, Christian Coles, Tracey Perez Koehlmoos","doi":"10.1093/milmed/usag464","DOIUrl":"https://doi.org/10.1093/milmed/usag464","url":null,"abstract":"<p><strong>Introduction: </strong>In 2017, the United States Marine Corps (USMC) increased the pull-up requirements of the Physical Fitness Test (PFT) to improve combat readiness, raising concerns regarding potential increases in upper extremity (UE) musculoskeletal injuries (MSKIs). This study assesses the impact of this policy change on UE MSKI incidence among active-duty male Marines.</p><p><strong>Materials and methods: </strong>Linear regressions estimated with ordinary least squares were used to perform interrupted time series analyses of UE MSKI rates among male Marines from the Military Health System Data Repository between 2014 and 2023. Upper extremity MSKI rate trends were evaluated pre- (2014-2016) and post-intervention (2017-2023), stratified by age, race/ethnicity, body mass index (BMI), and rank. Newey-West SEs were used in linear regression analyses to adjust for violations from autocorrelation and heteroskedasticity.</p><p><strong>Results: </strong>The study population included 231,323 Marines in the pre-intervention period (2014-2016) and 313,537 in the post-intervention period (2017-2023). Cumulative UE MSKI proportions increased (9.0%-9.4%). Pre-policy, UE MSKI rates trended downward (b1 = -5.09, P < .001). Post-policy, this trend significantly reversed (b3 = 5.11, P < .001) but not immediately (b2 = -4.00, P = .431). Subgroup analysis revealed sustained increasing rates among Marines <20 years (b1 + b3 = 0.88, P < .001). Conversely, decreasing rates occurred in Marines with obesity (b1 + b3 = -1.09, P = .006), ages 40-49 (b1 + b3 = -1.21, P = .046), and senior enlisted (b1 + b3 = -1.10, P = .012). Warrant officers experienced a significant decrease in UE MSKI rates (b2 = -34.22, P = .007) as well as subsequent trend stabilization (b3 = 6.23, P < .001).</p><p><strong>Conclusions: </strong>The 2017 standards were temporally associated with a plateau in previously declining UE MSKI rates. While no immediate population-level spike occurred, the heterogeneity of subgroup responses highlights specific risks for younger personnel. Future policy modifications should balance fitness objectives with targeted injury prevention strategies to optimize readiness.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127870","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":"Seasickness or Postoperative Nausea and Vomiting? A Retrospective Review of Patients Receiving Anesthesia at Sea Onboard the USNS Comfort.","authors":"Mei S Goh, Shudee Wu, Joshua M Junge, Matthew R McGee","doi":"10.1093/milmed/usag463","DOIUrl":"https://doi.org/10.1093/milmed/usag463","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The USNS Comfort is a 1,000-bed hospital ship that provides full perioperative and surgical capabilities in a maritime environment. Patients may undergo surgery while the ship is pierside, anchored, or underway at sea. Postoperative nausea and vomiting (PONV) is a common anesthetic complication, but ship motion and sea state introduce an additional vestibular stimulus that is not captured by traditional PONV risk models. This study evaluated whether operating environment was associated with PONV after elective surgery aboard the USNS Comfort during a humanitarian mission.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This IRB-approved retrospective cohort study reviewed all patients who underwent elective surgery aboard the USNS Comfort between June 11 and August 9, 2025. Patient demographics, operative environment, procedure type, anesthetic technique, total room time, tobacco use, volatile anesthetic use, and intraoperative PONV prophylaxis were collected from perioperative records. Patients with documented PONV or postoperative rescue antiemetic use were compared with those without PONV. Continuous variables were analyzed with Mann-Whitney U or Kruskal-Wallis testing, and categorical variables were analyzed with Chi-square or Fisher's exact testing. Post hoc chi-square testing with Bonferroni correction and a sensitivity analysis limited to general anesthesia cases were performed. Limited logistic regression was performed on the operative environment, anesthetic method, and total room time to generate odds ratios and 95% confidence intervals for these variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 241 surgical patients, 22 developed PONV, for an overall incidence of 9.13%. PONV differed significantly by operating environment, increasing from 5.45% pierside to 15.38% while anchored and 20.83% while at sea (P value .011). When PONV rates were compared directly at each operating environment, PONV was also associated with general anesthesia (P value .022), volatile anesthetic use (P value .010), female sex (P value .050), longer room time (P value .001), and greater use of prophylactic antiemetics (P value .008), likely reflecting provider recognition of higher-risk patients. Baseline characteristics across operating environments were generally similar, though room times were longer while anchored and at sea (P value .021.) In the general anesthesia subgroup (118 patients), the association with operating environment persisted, with PONV rates of 26.09% anchored and 40.00% at sea when compared to 8.24% pierside (P value .003). Limited multivariable regression for all patients also demonstrated an association between a site of anchored (OR 3.34, 95% CI: 1.15-9.70) or at sea (OR 4.93, 95% CI: 1.34-18.14) compared to pierside.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;PONV after shipboard surgery varied significantly by operating environment, with the highest rates occurring when surgery was performed at sea. These findin","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127940","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":"Acute Calcific Tendonitis of the Longus Colli Muscle: A Case Series and Review of the Literature.","authors":"Joseph S Krivda, Taylor Lear, Kelsey Richard, Om Chitnis, Michael Pavio, Timothy C Blood","doi":"10.1093/milmed/usag457","DOIUrl":"https://doi.org/10.1093/milmed/usag457","url":null,"abstract":"<p><strong>Introduction: </strong>To review the presentation and treatment of acute calcific tendonitis of the longus colli muscle (ACTLC) at our institution and the existing literature to better define this disease process and facilitate its diagnosis and treatment, with special attention to the deployed military environment.</p><p><strong>Materials and methods: </strong>A retrospective chart review of 5 patients with ACTLC from 2 military treatment facilities was performed. Next, a literature review of reported cases of ACTLC was performed, and relevant findings for each case were recorded. This data was pooled and compared to that of our series.</p><p><strong>Results: </strong>Of the 5 patients in our series, 5/5 presented with neck pain and limited neck range of motion (ROM), 4/5 presented with odynophagia, and 1/5 was febrile. Flexible laryngoscopy showed posterior pharyngeal wall edema in 1/4. Leukocytosis was present in 1/5; CRP was elevated in 2/2, and ESR was elevated in 2/3. CT imaging showed prevertebral calcification in 5/5 and retropharyngeal effusion/edema in 4/5. Treatment consisted of different combinations of NSAIDs, corticosteroids, and antibiotics, and the average time to symptom resolution was 3.8 days (±2.4). The literature review yielded a total of 107 patients. The pooled data from historical cases closely mirrored that of our series.</p><p><strong>Conclusions: </strong>Acute calcific tendonitis of the longus colli muscle presents with acute neck pain, limited neck ROM, and odynophagia with retropharyngeal effusion/edema usually seen on CT; elevated inflammatory markers are also common. The characteristic imaging finding of prevertebral calcification can differentiate it from deep neck space infections and prevent unnecessary interventions, as ACTLC is self-limited and typically resolves with NSAIDs. Recognition and proper management of this condition is critical in a deployed setting to prevent unnecessary medical evacuation, allow efficient utilization of scarce resources, and prevent degradation of unit combat effectiveness.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127865","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}