Bmj Military Health最新文献

{"title":"Dispatches from the new Editor-in-Chief: a new dawn.","authors":"Jason E Smith","doi":"10.1136/military-2025-003025","DOIUrl":"10.1136/military-2025-003025","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"287"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561588","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":"Gross haematuria at sea: schistosomiasis in a US Military Servicemember.","authors":"Yuki Itani, E Jones, M Kachur, S Hughey, V Nella, J Miller","doi":"10.1136/military-2023-002631","DOIUrl":"10.1136/military-2023-002631","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"374-375"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068865","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":"Ethical issues in the application of genome-wide association studies to US military recruitment and personnel assignments.","authors":"Daniel J Hurst, L A Padilla","doi":"10.1136/military-2024-002715","DOIUrl":"10.1136/military-2024-002715","url":null,"abstract":"<p><p>Genome-wide association studies seek to associate an organism's genotypes with phenotypes. The goal of such research is to identify specific genetic variants that may be used to predict an individual's risk for a specific physical or mental disease. Recently, it has been recommended that policymakers in the USA should employ genomic surveillance so that it can be used for initial military personnel selection and personnel assignments. However, such a proposal highlights the necessity of subjecting such recommendations to rigorous ethical analysis, including concerns regarding recruitment, transparency and the return of genetic results.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"295-296"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263282","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":"Patterns of anatomical injury and anaesthesia procedures in wounded Ukrainian soldiers from Anti-Terrorist Operation/Operation Joint Forces: 2014-2021.","authors":"Iurii Kuchyn, D Sapunar, V Horoshko","doi":"10.1136/military-2023-002633","DOIUrl":"10.1136/military-2023-002633","url":null,"abstract":"<p><strong>Introduction: </strong>The study aims to analyse the causes and anatomical patterns of explosive and gunshot wounds in Ukrainian soldiers acquired during the Anti-Terrorist Operation/Operation Joint Forces. We also investigated how general and regional anaesthesia procedures affected post-operative pain in wounded soldiers.</p><p><strong>Methods: </strong>A retrospective observational study was done based on the medical records of Ukrainian soldiers wounded in the Anti-Terrorist Operation/Operation Joint Forces between 2014 and 2021. The collected data included the American Society of Anesthesiologists score, mechanism of injury, the pattern of anatomical injury, pain intensity and the choice of anaesthesia given. Pain intensity was diagnosed using a Numerical Rating Scale.</p><p><strong>Results: </strong>A total of 280 combat casualties with explosive (75.7%) and gunshot (24.3%) wound injuries were included in the study. Most of the wounded soldiers had one body region affected by injury (59.3%). In most of the cases, the affected body regions were lower (48.2%) and upper (33.8%) limbs. In 62.5% of patients, regional anaesthesia was used, while general anaesthesia was used in 37.5% of cases. The pain significantly decreased after initial treatment at the field medical unit regardless of the anaesthesia type or the number of affected body regions.</p><p><strong>Conclusion: </strong>Understanding the sources and anatomical patterns of war-related injuries in recent conflicts is an important element in reducing the mortality and suffering of wounded soldiers. The high percentage of injured extremities in our cohort emphasises the importance of regional anaesthesia in contemporary wars.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"344-349"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868407","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":"Frequency of deployed emergency donor panel use prior to implementation of the low titre group O whole blood program.","authors":"Catherine Y Lin, J D Hamm, A D Fisher, J A Rizzo, J B Corley, M D April, S G Schauer","doi":"10.1136/military-2023-002641","DOIUrl":"10.1136/military-2023-002641","url":null,"abstract":"<p><strong>Introduction: </strong>The US military has frequently used a 'walking blood bank', formally known as an 'emergency donor panel' (EDP) to obtain warm fresh whole blood (WFWB) which is then immediately transfused into the casualty. We describe the frequency of EDP activation by the US military.</p><p><strong>Methods: </strong>We analysed data from 2007 to 2015 within the Department of Defense Trauma Registry for US, Coalition and US contractor casualties that received at least 1 unit of blood product within the first 24 hours and described the frequency of WFWB use.</p><p><strong>Results: </strong>There were 3474 casualties that met inclusion, of which, 290 casualties (8%) required activation of the EDP. The highest proportion of EDP events was in 2014, whereas the highest number of EDP events was in 2011. Median injury severity scores were higher in the recipients, compared with non-EDP recipients (29 vs 20), as were proportions with serious injuries to the abdomen (43% vs 19%) and extremities (77% vs 65%). The median number of units of all blood products, except for packed red blood cells, was higher for WFWB recipients. Of the WFWB recipients, the median was 5 units (IQR 2-10) with a maximum documented 144 units. There were four documented cases of EDP recipients receiving >100 units of WFWB with only one surviving to hospital discharge. During the study period, there were a total of 3102 (3%) units of WFWB transfused among a total of 104 288 total units.</p><p><strong>Conclusions: </strong>We found nearly 1 in 11 casualties who received blood required activation of the EDP. Blood from the EDP accounted for 3% of all units transfused. These findings will enable future mission planning and medical training, especially for units with smaller, limited blood supplies. The lessons learned here can also enable mass casualty planning in civilian settings.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"339-343"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960303","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":"Military service and health-related quality of life among gay and bisexual prostate cancer survivors: Results from the <i>Restore-2</i> study.","authors":"Alex J Bates, D Mitteldorf, B R S Rosser, C W Wheldon, E J Polter, M W Ross, K M C Talley, R Haggart, M M Wright, W West, B R Konety","doi":"10.1136/military-2023-002649","DOIUrl":"10.1136/military-2023-002649","url":null,"abstract":"<p><strong>Introduction: </strong>There are notable disparities in health-related quality of life (HRQOL) between gay and bisexual men (GBM) and heterosexual patients with prostate cancer (PCa); however, the role of past military service is unclear. This study examines HRQOL differences in GBM PCa survivors based on reported military service history.</p><p><strong>Methods: </strong>We used data from the 24-month follow-up survey of the <i>Restore-2</i> study, a clinical trial which evaluated a rehabilitation programme for GBM PCa survivors. PCa HRQOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC-50) and the Functional Assessment of Cancer Treatment-Prostate (FACT-P). Mental health quality of life was assessed using the Brief Symptom Inventory-18 (BSI-18) scale, while sexual functioning was measured using the Sexual Minorities and Prostate Cancer Scale (SMACS). Multivariable linear regression was used to estimate unadjusted and adjusted mean differences in HRQOL between GBM with and without a reported history of military service.</p><p><strong>Results: </strong>In this cross-sectional study of 351 GBM PCa survivors, 47 (13.4%) reported a history of US military service. After adjusting for covariates, participants who reported a history of military service (compared with those with no military service) had clinically better scores on the FACT-P physical, social and emotional well-being domains, as well as higher total FACT-General, EPIC urinary bother and hormonal function scores. Additionally, men with a history of military service reported significantly fewer sexual problems, more sexual confidence and less urinary incontinence in sex.</p><p><strong>Conclusion: </strong>This exploratory study provides the first evidence that GBM PCa survivors with a military background may have clinically better outcomes than those without military service. Potential reasons may include the structured support and healthcare access associated with military service, fostering resilience and well-being. These findings underscore the need for further research to elucidate how military service influences PCa HRQOL.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"357-363"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of ear trauma within the Ukrainian military: organisational requirements and implementation of a three-stage regimen.","authors":"Roman Barylyak, D Horoliuk, I Chervan, P H Skarzynski","doi":"10.1136/military-2023-002624","DOIUrl":"10.1136/military-2023-002624","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"384"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869969","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":"Impact of COVID-19 on the veteran population: evidence from the Trends in Scottish Veterans Health study.","authors":"Beverly P Bergman, D F Mackay, J P Pell","doi":"10.1136/military-2024-002677","DOIUrl":"10.1136/military-2024-002677","url":null,"abstract":"<p><strong>Introduction: </strong>There have been few epidemiological studies on the impact of the SARS-CoV-2 (COVID-19) pandemic on the veteran population, other than on specific aspects such as mental health, and none in the UK. We used data from the Trends in Scottish Veterans Health cohort to explore the risk of hospitalisation and death associated with COVID-19 in veterans resident in Scotland in comparison with matched non-veterans.</p><p><strong>Methods: </strong>Retrospective cohort study of 71 000 veterans and a comparison group of 230 000 non-veterans matched for age, sex and geography, using Cox proportional hazard analysis to explore the risk of hospitalisation with COVID-19 and COVID-19-associated death overall and by birth cohort, sex and length of military service.</p><p><strong>Results: </strong>Between 1 January 2020 and 31 December 2021, 564 (0.79%) veterans had been hospitalised with COVID-19 compared with 1728 (0.75%) non-veterans. The Cox model showed no significant difference overall, HR 0.99, 95% CIs 0.90 to 1.11, p=0.800. Subgroup analysis showed increased risk in older, short-serving (<20 weeks) Early Service Leavers (ESL). There was no overall difference in COVID-19-associated deaths, HR 0.99, 95% CI 0.79 to 1.23, p=0.993, but subgroup analysis showed a non-significant reduced risk of death in veterans aged 61-70 years, and a 38% higher risk in veterans aged over 70 years which almost reached statistical significance, p=0.054. This was only partially explained by socioeconomic factors and common comorbidities, although we had no data on domestic circumstances or care home residence.</p><p><strong>Conclusions: </strong>Overall, military service was not a risk factor for either hospitalisation or death associated with COVID-19. Older ESLs were at increased risk compared with non-veterans, but military service is unlikely to have been causal. The risk of death was increased in the oldest veterans and further studies are needed to explain this once census data become available for linkage.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"327-332"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868299","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":"Evaluating health-related behaviours of armed forces personnel in Kuwait: a cross-sectional study.","authors":"Eiman Alkhezi","doi":"10.1136/military-2024-002668","DOIUrl":"10.1136/military-2024-002668","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence is lacking regarding the health-related behaviours of the military force in Kuwait. This study compared health-related behaviours of active-duty armed forces personnel according to their service branch and rank.</p><p><strong>Methods: </strong>In this cross-sectional descriptive study, an online questionnaire was developed to collect, via text messages, anonymised data from 392 armed forces personnel on their sociodemographics, health status, smoking, physical activity and desire for mental healthcare.</p><p><strong>Results: </strong>Most of the participants were non-officers (80.35%) from 'other' service branch (48.10%), had ≤10 years of military service (64.46%) and were Kuwaitis (79.97%) aged 18-39 years (77.62%) and rated their physical and mental health as 'good', with no chronic diseases (93.28%), although 53.13% were overweight and 8.55% were obese, and the prevalence of obesity increased with age. The survey revealed a high prevalence of physical inactivity (65.48%), which increased with age as well as a high prevalence of smoking (82.66%). Almost half of the respondents (46.21%) believed that seeking mental health help could probably damage their military career, this belief significantly increased with age.</p><p><strong>Conclusion: </strong>Although most of the Kuwaiti armed forces personnel reported having 'good' physical and mental health, with no chronic diseases, there was a high prevalence among them of overweight, smoking and low physical activity levels, with no difference between service branches or ranks. Moreover, the stigma of having mental health problems and the fear of the negative effects of seeking mental healthcare on a career were prevalent among the participants. These data are helpful in informing policy and development programmes that meet the needs of armed forces personnel.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"321-326"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285034","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":"French mobile neurosurgical unit: a retrospective analysis of 22 years of mission.","authors":"Rayan Fawaz, F L Maison, P Robert, M Fouet, J-M Delmas, R Dulou, N Desse, A Dagain","doi":"10.1136/military-2023-002601","DOIUrl":"10.1136/military-2023-002601","url":null,"abstract":"<p><strong>Introduction: </strong>The French mobile neurosurgical unit (MNSU) is used to provide specific support to remote military medicosurgical units deployed in foreign theatres. If a neurosurgical casualty is present, the Role 2 team may request the MNSU to be deployed directly from France. The deployed neurosurgeon can then perform surgery in Role 2 or decide to evacuate the casualty and perform surgery in Role 4 in France. We provide an epidemiological analysis of MNSU missions between 2001 and 2023 and investigate the value of the MNSU for the French Armed Forces.</p><p><strong>Methods: </strong>We conducted a retrospective case series that included patients managed by the MNSU from 1 January 2001 to 31 January 2023. We collected epidemiological data (eg, age, military or civilian status, delay between transmission and takeoff, origin of the injury and mission location), clinical records (aetiologies of the injury and disease), data on surgical intervention (operator nature and type of surgery) and data on postoperative outcomes recorded at the time of discharge from hospital.</p><p><strong>Results: </strong>51 patients were managed by the MNSU. 36 (70.5%) and 3 (5.8%) patients underwent surgery on Role 2 and Role 4, respectively. 39 (76.9%) interventions were due to traumatic injury, 4 (7.8%) due to hydrocephalus, 4 (7.8%) due to vascular causes, 3 (5.9%) due to tumour and 1 (2%) due to spine degeneration. In 30 (76.9%) of these cases, the first operator was a neurosurgeon from the MNSU, whereas in the remaining 9 (23.1%) cases, procedures were initially performed by a non-neurosurgeon.</p><p><strong>Conclusion: </strong>The MNSU contribution to D1 casualties' strategic evacuation (STRATEVAC) is important. The MNSU provides additional support for STRATEVAC during the reorganisation of French Armed Forces engaged in several fronts. With the return of high-intensity wars, the French MNSU must develop and adjust for the management of massive influxes of casualties.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"369-372"},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433135","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}