Medical journal (Fort Sam Houston, Tex.)最新文献

{"title":"Tooth Wear in Patients Undergoing Sleep Studies: A Blinded Observational Study.","authors":"Ryan Allred,&nbsp;David Shaha,&nbsp;Lowell Stanford,&nbsp;Thomas Beltran","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Obstructive sleep apnea (OSA) is a common health problem that remains an underdiagnosed issue. Screening tools and clinical markers are needed from a variety of providers to determine patients at risk for OSA. Tooth wear could be a good potential identifier of patients at risk of having OSA.</p><p><strong>Methods: </strong>This is an ambidirectional observational cohort. Participants were identified as retrospectively having undergone a sleep study and then tooth wear data was prospectively collected at patients' annual dental exam. The participants also completed an anonymous questionnaire to determine correlations with possible confounding factors.</p><p><strong>Results: </strong>A total of 107 individuals were included in the analyses. No significant differences in wear were found between participants with an Apnea-Hypopnea Index (AHI) less than 5 and those with AHI ≥ 5 for any of the teeth examined (all P > 0.05). Overall, both groups had median tooth wear scores of 2 (IQR 1). Similarly, no differences in tooth wear were found between participants based on their body mass index (BMI) classification or consumption data (all P > 0.05).</p><p><strong>Conclusion: </strong>Sleep is a complicated entity with many possible confounding factors. There is no correlation between AHI and tooth wear in the selected military cohort. Dentists should screen patients for possible medical and dental conditions whenever tooth wear is detected. Further research is needed to determine if tooth wear could be used as a potential identifier of patients at risk for OSA.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-10/11/12","pages":"3-8"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39574232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the History of Traumatic Brain Injury and Rates of Dental Treatment, Endodontic Therapy, and Caries Risk: A Records-Based Study.","authors":"Joseph Ferguson,&nbsp;Scott Mooney,&nbsp;Joseph Dutner,&nbsp;Stephanie Sidow,&nbsp;Matthew Phillips","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic Brain Injury (TBI) is a prevalent health issue in the US and even more prevalent amongst members of the armed forces. The purpose of this project was to evaluate the association between history of TBI and rates of dental treatment performed, endodontic therapy, and high caries risk.</p><p><strong>Methods: </strong>This was a retrospective medical and dental records study. The first 100 of a chosen dental hygienist's patients in 2016 who were seen for dental prophylaxis appointments were chosen as subjects. Armed Forces Health Longitudinal Technology Application (AHLTA) and Corporate Dental System (CDS) records were used to gather information on these subjects including rank, age, gender, duty status, tobacco use, history of TBI, total number of dental procedures, total Dental Weighted Value (DWV), number of endodontic procedures, endodontic DWV, high caries risk categorization, total days dental fitness class 1, and total days dental fitness class 3. From these subjects, a \"TBI group\" and a \"Non-TBI group\" were formed. T-Test analyses were performed to compare these groups to each other in categories of total number of dental procedures, total DWV, total days dental fitness class 1, and total days class 3. Relative risks ratio analysis was used to compare these groups in terms of high caries risk categorization.</p><p><strong>Results: </strong>Eight out of 100 subjects had a history of TBI. All TBI events were mild. Six subjects had 1 event, 1 had 2 events, and 1 had 4 events. The TBI group had a statistically higher mean number of dental procedures (P=0.00000025) and mean total DWV (P=0.0000062) compared to the non-TBI group. No subjects from the TBI group had an endodontic procedure. The TBI group had lower mean days in dental fitness class 1 and more mean days in dental fitness class 3, but the results were not statistically significant. The TBI group had lower high caries risk categorization rates than the non-TBI group, but the results were not statistically significant.</p><p><strong>Conclusions: </strong>Patients with a history of TBI had a significantly higher number of dental procedures performed and DWV generated compared to patients without a history of TBI.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-10/11/12","pages":"22-26"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39574180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sports Injuries among Deployed US Service Members between October 2001 and December 2018.","authors":"Marc A Schweizer,&nbsp;Jud Janak,&nbsp;Brock Graham,&nbsp;Jennifer M Gurney,&nbsp;Stacy A Shackelford","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Sports injuries are an important non-battle cause of attrition and morbidity among deployed US service members (SMs). Injuries secondary to sport may cause physical disability and prolonged periods of limited duty days. Our objective was to provide a descriptive analysis of sports injuries sustained by US SMs which may assist in the preventive strategies and thereby decrease their burden on the deployed force.</p><p><strong>Methods: </strong>Using the Department of Defense Trauma Registry's (DoDTR) data between October 2001 and December 2018, a retrospective cross-sectional analysis was conducted. We reported summary statistics of injury characteristics and care provided, stratified by geographic location.</p><p><strong>Results: </strong>We found 1,578 causalities with sport injuries (4.9% of DoDTR); 1,081 (68.5%) in Iraq and Syria and 497 (31.5%) in Afghanistan. Most casualties had mild injuries (injury severity score: 1-9; n=1,514; 95.9%) and most sustained injuries in the lower extremities (n=741; 47%) followed by upper extremities (n=430; 27.2%). Most injuries were caused by a striking force (n=827; 52.4%) followed by overexertion (n=444; 28.2%), and 512 casualties (32.4%) had a fall incident. About 833 casualties (52.8%) received at least one surgery, and 931 casualties (59%) were hospitalized for two days or more. One casualty died of wound (0.1%).</p><p><strong>Conclusions: </strong>Sports injuries continue to be an important source of morbidity and attrition and require disproportional medical attention, relative to their mild severity, representing a significant burden to the deployed health care system and impact combat readiness. Further research addressing the prevention of sports injury among deployed US SMs is needed.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-07/08/09","pages":"50-56"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound at the Role 1: An Analysis of After-Action Reviews from the Prehospital Trauma Registry.","authors":"Melissa A Myers,&nbsp;Eric J Chin,&nbsp;Amie R Billstrom,&nbsp;Jared L Cohen,&nbsp;Kerri A Van Arnem,&nbsp;Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound is a portable and adaptable imaging modality used widely in the care of trauma patients. The initial exam, known as the \"Focused Assessment in Trauma (FAST) exam focused on the evaluation for hemoperitoneum and hemopericardium. In recent years, the exam has expanded to include evaluate for thoracic pathology, including pneumothorax, and is now known as the \"Extended Focused Assessment in Trauma\" (E-FAST) exam.</p><p><strong>Methods: </strong>We reviewed after-action reviews (AAR) from the Joint Trauma System Prehospital Trauma Registry from 2013-2014 in which the use of an ultrasound exam was noted. Given the largely unstructured nature of the AARs, we selected relevant information from the free text available.</p><p><strong>Results: </strong>Our initial dataset contained 705 casualties, of which we identified 45 cases containing the key words with AAR data for review: 39 cases involved the use of the FAST exam, three explicitly described the use of pulmonary ultrasound and they were categorized as E-FAST exams, two cases described the use of point of care echo to evaluate for cardiac standstill, and two cases described the use of ultrasound to evaluate for vascular injury. Of those with vital signs documented, 25% (11) reported at least one episode of tachycardia (≥120/min) and 16% (7) with at least one episode of systolic hypotension (less than 90mmHg). Of the 45 cases reviewed, six were recorded as equivocal, which we interpreted to indicate more training in either performance or interpretation of the exam was needed.</p><p><strong>Conclusions: </strong>Our findings suggest that training in both the FAST exam and E-FAST has the potential to improve patient care for military trauma patients. A performance improvement system would enable real-time confirmation of findings and feedback for training and quality improvement.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-07/08/09","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis of the Shock Index and Pulse Pressure as a Predictor for Massive Transfusion and Death in US and Coalition Iraq and Afghanistan.","authors":"David A Sorensen,&nbsp;Michael D April,&nbsp;Andrew D Fisher,&nbsp;Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Among combat casualties with survivable injuries, the most common cause of mortality is massive hemorrhage. The objective of this study was to identify the accuracy of shock index (SI) and pulse pressure (PP) for predicting receipt of massive transfusion and death on the battlefield. The study searched the Department of Defense Trauma Registry from January 2007 to August 2016 using a series of procedural codes to identify casualties which has been previously described. This is a secondary analysis of casualties analyzing SI. This study analyzed using receiver operating characteristic (ROC) and regression analyses. Within that dataset, there were 15,540 that were US Forces (75.1%), Coalition Forces (14.5%) or contractors (10.3%)-of which, 1,261 (7.9%) underwent massive transfusion. On ROC analyses for SI, this study found an overall optimal threshold at 0.91 with an area under the curve (AUC) of 0.89 with a sensitivity of 0.81 and specificity of 0.87 for predicting massive transfusion. The study found an optimal threshold of 0.91 with an AUC of 0.76 with a sensitivity of 0.67 and specificity of 0.82 for predicting death. On ROC analyses for PP, the study found an overall optimal threshold at 48 with an AUC of 0.71 with a sensitivity of 0.56 and specificity of 0.76 for predicting massive transfusion. The study found an optimal threshold of 44 with an AUC of 0.75 with a sensitivity of 0.60 and specificity of 0.82 for predicting death. SI and PP may accurately predict receipt of massive transfusion and of mortality in a combat casualty population.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-07/08/09","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Combat-Relevant Endpoints for Early Trauma Resuscitation Research in a Resource-Constrained Civilian Setting.","authors":"Nee-Kofi Mould-Millman,&nbsp;Lina Mata,&nbsp;Steven G Schauer,&nbsp;Julia Dixon,&nbsp;Sean Keenan,&nbsp;John B Holcomb,&nbsp;Joshua M Tobin,&nbsp;E Moore,&nbsp;Shaheem de Vries,&nbsp;Alexander Bedard,&nbsp;Vikhyat S Bebarta,&nbsp;Adit A Ginde","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Studies assessing early trauma resuscitation have used long-term endpoints, such as 28- or 30-day mortality or Glasgow Outcomes Scores at 6-months. These endpoints are convenient but may not accurately reflect the effect of early resuscitation. We sought expert opinion and consensus on endpoints and definitions of variables needed to conduct a Department of Defense- (DoD) funded study to epidemiologically assess combat-relevant mortality and morbidity due to timeliness of resuscitation among critically injured civilians internationally.</p><p><strong>Methods: </strong>We conducted an online modified Delphi process with an international panel of civilian and US military experts. In several iterative rounds, experts reviewed background information, appraised relevant scientific evidence, provided comments, and rendered a vote on each variable. A-priori, we set consensus at ≥80% concordant votes.</p><p><strong>Results: </strong>Twenty panelists participated with a 100% response rate. Eight items were presented, with the following outputs for the epidemiologic study: Assess mortality within 7-days of injury; assess multi-organ failure using SOFA scores measured early (at day 3) and late (at day 7); assess traumatic brain injury mortality early (≤7-days) and late (28-days); hybrid (anatomic and physiologic) injury severity scoring is optimal; capture comorbidities per the US National Trauma Data Standard list with specific additions; assign resuscitative interventions to one of five standardized phases of trauma care; and, use a novel trauma death categorization system.</p><p><strong>Conclusions: </strong>A modified Delphi process yielded expert-ratified definitions and endpoints of variables necessary to conduct a combat-relevant epidemiologic study assessing outcomes due to early trauma resuscitation. Outputs may also benefit other groups conducting trauma resuscitation research.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"PB 8-21-07/08/09 PB 8-21-07-08-09","pages":"3-14"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Sensitivity of a Low Frequency Versus a High Frequency Probe in the Detection of Pneumothorax in a Swine Model.","authors":"Melissa Myers,&nbsp;Amie Billstrom,&nbsp;Jared Cohen,&nbsp;Ryan Curtis","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Correct diagnosis of pneumothorax in trauma patients is essential. Under-diagnosis can lead to development of life-threatening tension pneumothorax, but overdiagnosis leads to placement of unnecessary chest tubes with potential related morbidity and pain. It is unclear from previous work if there is a benefit to switching from the phased array (low frequency) probe to the linear (high frequency) probe. Is the improvement in image quality worth the time lost changing probes?</p><p><strong>Methods: </strong>We compared the sensitivity and specificity of a low frequency and high frequency ultrasound probe for the detection of pneumothorax. Images were obtained using swine models and were interpreted by Emergency Medicine residents, attendings, and physician assistants.</p><p><strong>Results: </strong>We found a specificity of 89% and sensitivity of 99% for the low frequency probe and specificity of 96% and sensitivity of 99% for the high frequency probe. There was a statistically different specificity between the two probes, suggesting that the linear probe may be the superior probe for confirming the presence of pneumothorax.</p><p><strong>Conclusion: </strong>We conclude switching to the linear probe for the thoracic portion of the Extended-Focused Assessment in Trauma will lead to more accurate diagnosis of pneumothorax and decreased false-positive exams.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-07/08/09","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Decision Support for Prehospital Combat Casualty Care: The Airway Clearance Model.","authors":"Katherine Raczek,&nbsp;David Restrepo,&nbsp;R Lyle Hood,&nbsp;Robert A De Lorenzo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Airway management is a foremost priority for combat medics treating battlefield casualties, as a compromised airway is the second leading cause of potentially survivable death on the battlefield, accounting for 1 in 10 preventable combat deaths. Effective suction is a critical component of airway clearance. However, currently available commercial devices are too heavy and bulky for combat medics to carry, and/or lack sufficient power to be useful. Clinical decision support systems (DSS) can close the gap between existing commercial devices and their clinical use and enhance combat medic clinical performance by providing the right \"tooth-to-tail\" tools to accomplish the task of clearing the airway. Our DSS approach will provide a focused, real-time set of guidelines and recommendations that are tailored to the combat medic. Our proposal will create a knowledge-based algorithm and clinical guideline regarding the use of suction, delivering to the combat medic the \"right information, to the right person, in the right format, through the right channel at the right time.\"</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-07/08/09","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Versus Old, The i-View Video Laryngoscope Versus the GlideScope: A Prospective, Randomized, Crossover Trial.","authors":"David H Taylor,&nbsp;Eric M Wagner,&nbsp;Jerry S Hu,&nbsp;Michael R Tobin,&nbsp;Aaron J Cronin,&nbsp;Kyle S Couperus,&nbsp;Michael D April,&nbsp;Steven G Schauer,&nbsp;Jason F Naylor","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A novel video laryngoscope device, the i-view, may extend intubation capability to the lowest echelons of deployed military medicine. The i-view is a one-time use, disposable laryngoscope. We compared time to completion of endotracheal intubation (ETI) between the i-view and GlideScope among military emergency medicine providers in a simulation setting.</p><p><strong>Methods: </strong>We conducted a prospective, randomized, crossover trial. We randomized participants to i-view or GlideScope first before they performed 2 ETI-1 with each device. The primary outcome was time to completion of ETI. Secondary outcomes included first-pass success, optimal glottic view, and end-user appraisal. We used a Laerdal Airway Management Trainer for all intubations.</p><p><strong>Results: </strong>Thirty-three emergency medicine providers participated. ETI time was less with GlideScope than i-view (22.2 +/- 9.0 seconds versus 30.2 +/- 24.0 seconds; p=0.048). Optimal glottic views, using the Cormack-Lehan scale, also favored the GlideScope (2 [1,2] versus 2[2,2]; p=0.044). There was no difference in first-pass success rates (100% versus 100%). More participants preferred the GlideScope (24 versus 9; p=0.165); however, participants agreed that the i-view would be easier to use than the GlideScope in an austere environment (4[4,5]).</p><p><strong>Conclusions: </strong>We found the GlideScope outperformed the i-view with respect to procedural completion time. Participants preferred the GlideScope over i-view, but indicated the i-view would be easier to use than the GlideScope in an austere setting. Our findings suggest the i-view may be a suitable alternative to GlideScope for US military providers, especially for those in the prehospital setting.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-07/08/09","pages":"81-89"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39360468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Military Emergency Medicine Scholarly Activity.","authors":"Zachary Sletten,&nbsp;Norah Shemery,&nbsp;James K Aden,&nbsp;Michael Morris,&nbsp;Brit Long,&nbsp;Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Emergency medicine is recognized as a critical wartime specialty within the US military. Military emergency medicine contributes to medical literature in unique ways not seen with our civilian counterparts. The impact of this contribution, especially regarding innovations in military medicine, has not been previously examined. This study evaluates the numbers of citations for emergency medicine manuscripts published by members of the US military.</p><p><strong>Methods: </strong>Utilizing the Scopus database, we identified published manuscripts from 2000 to 2020 with an emergency medicine author affiliated with a US military treatment facility. We sorted manuscripts on the number of citations in Scopus and categorized each paper as to whether it addressed military unique topics.</p><p><strong>Results: </strong>We identified 1,718 manuscripts through Scopus, and based on a 10-citation minimum, we further analyzed 508 manuscripts. After verification of military affiliation, we included 421 manuscripts. The mean number of citations per manuscript was 31.7 ± 40.5; the Mean Cite Score was 4.75 ± 6.17 with a Field Weighted Citation Index (FWCI) of 2.96 ± 6.25. Citation count of publications has been steadily increasing in recent years with significantly more citations for military relevant publications when compared to non-military relevant publications.</p><p><strong>Conclusions: </strong>These findings highlight the importance of military emergency medicine scholarly activity which has a history of contributions that address specific medical needs of the warfighter and advance the specialty. Military emergency medicine papers have seen rising numbers of citations in the medical literature, particularly those related to military relevant topics emphasizing combat casualty care and military readiness.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":" PB 8-21-07/08/09","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}