Abstract：
OBJECTIVE:To determine the clinical outcomes of an aggressive combined cooling technique for exertional heatstroke in Thailand. METHODS:We analyzed patients who were diagnosed with exertional heatstroke between 1995 and 2007. Outcomes were assessed both in hospital and at 3 months follow-up. RESULTS:Twenty-eight cases of exertional heatstroke presented to Phramongkutklao Army Hospital over 12 years. All patients developed multiorgan dysfunction and encephalopathy. Twenty-four cases had acute renal failure, 7 of whom required dialysis. Disseminated intravascular coagulation (DIC) was detected in 9 patients (32.1%). In-hospital mortality was 7.1%. Most survivors recovered with nearly normal organ function. However, 9 exhibited prolonged neurologic dysfunction and 2 had chronic renal dysfunction requiring hemodialysis. At 3-month follow-up, neurologic and renal dysfunction in those patients persisted. Higher serum prothrombin time and DIC correlated to fatality. The patients whose core body temperature achieved 38 degrees C within 3 hours revealed a significantly lower DIC and twice as low in the frequency of poor outcome than the patients cooled longer than 3 hours to reduce core body temperature to 38 degrees C. CONCLUSIONS:Despite early recognition and aggressive combined cooling, exertional heatstroke remains associated with multiorgan dysfunction. However, our 7.1% in-hospital mortality rate was low compared to previous studies. Early diagnosis and prompt treatment are critical.
journal_name
Mil Medjournal_title
Military medicineauthors
Sithinamsuwan P,Piyavechviratana K,Kitthaweesin T,Chusri W,Orrawanhanothai P,Wongsa A,Wattanathum A,Chinvarun Y,Nidhinandana S,Satirapoj B,Supasyndh O,Sriswasdi C,Prayoonwiwat W,Phramongkutklao Army Hospital Exertional Heatstrodoi
10.7205/milmed-d-02-5908subject
Has Abstractpub_date
2009-05-01 00:00:00pages
496-502issue
5eissn
0026-4075issn
1930-613Xjournal_volume
174pub_type
杂志文章abstract：:In 1991-1992, a pelvic stress fracture incidence of 11.2% was recorded in a cohort of 143 female Australian Army recruits. An incidence of 0.1% was recorded in a cohort of male recruits trained in the 1992-1993 year using a nearly identical program. A number of preventive strategies were instituted in an attempt to re...
journal_title：Military medicine
pub_type： 临床试验,杂志文章
doi：
更新日期：1999-05-01 00:00:00
abstract：:The Army experience with discharges against medical advice (AMA) from 1971 to 1988 is analyzed. AMA discharges have declined in a statistically significant manner in both medical centers and community hospitals. Discharges have decreased among men but increased among women. AMA discharges have decreased for both black...
journal_title：Military medicine
pub_type： 杂志文章,评审
doi：
更新日期：1993-02-01 00:00:00
abstract：INTRODUCTION:Obtaining vascular access is of paramount importance in trauma care. When peripheral venous access is indicated but cannot be obtained, the intraosseous route represents an alternative. The Bone Injection Gun (BIG) is the device used for intraosseous access by the Israeli Defense Force (IDF). The purpose o...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-14-00013
更新日期：2014-11-01 00:00:00
abstract：INTRODUCTION:Today, the prevalence of overweight and obesity is, respectively, 49% and 17% among French adults. This research investigates their existence in the French Armed Forces, in terms of the impact on military operative response and military readiness. As no previous studies have evaluated the weight status of ...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usaa369
更新日期：2020-12-17 00:00:00
abstract：:Camp Bullis, Texas, is an active training facility for the U.S. Army and Air Force with a storied history dating back to the late 19th century. In the early 1940s, an epidemic of a seasonal tick-borne rickettsial-like illness occurred at Camp Bullis; the last case was reported in 1947. To date, the etiology of this di...
journal_title：Military medicine
pub_type： 历史文章,杂志文章
doi：10.7205/milmed.169.11.863
更新日期：2004-11-01 00:00:00
abstract：:With the increasing frequency of mass disasters, identification of an isolated upper extremity and determination of the stature of the person it belonged to have created problems for investigation of the identity of some victims. Despite a need for such a study, there is a lack of systematic studies to identify fragme...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.171.4.288
更新日期：2006-04-01 00:00:00
abstract：:The elderly military beneficiary is a valued, high-risk, high-cost, and complex individual with unique medical needs. Attention to common geriatric syndromes (such as incontinence) and quality end-of-life care is critical in this population. Care of older adults is part of every adult medical and surgical specialty an...
journal_title：Military medicine
pub_type： 杂志文章,评审
doi：10.7205/milmed-d-09-00067
更新日期：2010-02-01 00:00:00
abstract：INTRODUCTION:Despite greater than 60,000 nonfatal firearm injuries per year in the United States, retained shrapnel is a relatively rare cause of systemic lead toxicity with less than 100 cases reported in the medical literature since 1867. While intra-articular retained shrapnel as a cause of lead toxicity is well-des...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-16-00231
更新日期：2017-03-01 00:00:00
abstract：OBJECTIVE:The goal was to describe the association between post-traumatic stress disorder (PTSD) and in-service sexual harassment in a nationally representative sample of Department of Veterans Affairs PTSD disability applicants. METHOD:The study was a cross-sectional survey. RESULTS:Of 4,918 eligible veterans, 3,337...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.171.2.166
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:Fluid intake during military training is prescribed based on the interactions among work rates, environmental conditions, and uniform configurations. The efficacy of this guidance has not been empirically assessed in over a decade. To determine the acceptability of the fluid intake guidance, sweat losses wer...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usy066
更新日期：2018-09-01 00:00:00
abstract：INTRODUCTION:Military helicopters are increasingly agile and capable of producing significant G forces experienced in the longitudinal (z) axis of the body in a head-to-foot direction (+Gz). Dehydration and fatigue can adversely affect a pilot's +Gz tolerance, leading to +Gz-induced symptomatology occurring at lower +G...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-16-00073
更新日期：2016-11-01 00:00:00
abstract：:Aeromedical (AM) evacuation of trauma victims from action is an integral part of trauma care. The Israeli Air Force Rescue and Evacuation Unit is responsible for nearly all AM evacuations in Israel. We present three recent cases, within 1 year of operation, of engagement process failure during evacuations performed by...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.173.10.1004
更新日期：2008-10-01 00:00:00
abstract：:Telemedicine, an emerging technology which seeks to use advanced telecommunications equipment to enhance medical care, is progressing rapidly in the Department of Defense health care delivery system. This paper recommends that a cautious, preventive law approach be simultaneously initiated to ensure that the technolog...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1996-05-01 00:00:00
abstract：:Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do "people work" of some kind. Health care providers, including dentists, are at high risk for burnout because their occupations often require intense interactions between themselv...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1991-03-01 00:00:00
abstract：:Fixed wing aircraft are the primary means of deployment for designated U.S. contingency forces. The majority of logistical constraints medical units encounter during deployment (in support of contingency forces) are a direct result of limited airframes dedicated to their movement into an area of operations. The compet...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：OBJECTIVES:Military medical subspecialists consult with referring physicians, direct patient care and education, support isolated subspecialists, and maintain cohesive readiness plans. The World Wide Web appears promising in fulfilling these roles. METHODS:A website providing directed resources, the Walter Reed Army M...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
abstract：INTRODUCTION:To evaluate the long-term refractive results of laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) performed by the military in a veteran population. MATERIALS AND METHODS:Three Department of Veterans Affairs (VA) hospital sites (Puget Sound, Buffalo, and Washington D.C.) obtained ...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usz096
更新日期：2019-12-01 00:00:00
abstract：OBJECTIVE:Postexposure prophylaxis (PEP) is an important strategy to prevent human immunodeficiency virus acquisition after occupational and nonoccupational exposures. Since exposures to blood and other body fluids commonly occur in a combat setting, it is important to evaluate PEP utilization in the deployed environme...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed-d-12-00341
更新日期：2012-12-01 00:00:00
abstract：:During Operation Desert Shield/Storm, it was necessary to activate and deploy a large number of U.S. Army Reserve and National Guard medical units to augment the active Army health care treatment capability. In addition, a significant number of active Army physicians, nurses, dentists, and other health care providers ...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：INTRODUCTION:Respiratory tract infections (RTI), such as those caused by influenza viruses and, more recently, the severe acute respiratory syndrome coronavirus-2, pose a significant burden to military health care systems and force readiness. The gut microbiota influences immune function, is malleable, and may provide ...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usaa261
更新日期：2020-11-02 00:00:00
abstract：:This quality improvement project implemented and evaluated an evidence-based practice (EBP) program at two Army outpatient health care facilities. The EBP program consisted of five implementation strategies that aimed to inculcate EBP into organizational culture as well as nursing practice and culture. A conceptual mo...
journal_title：Military medicine
pub_type： 临床试验,杂志文章
doi：10.7205/MILMED-D-13-00191
更新日期：2013-09-01 00:00:00
abstract：INTRODUCTION:While previous studies have examined the stress of the military training environment, studies have not systematically examined the stress associated with attending the Defense Language Institute Foreign Language Center (DLIFLC). Service members assigned to DLIFLC endure intense academic pressure to succeed...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usy359
更新日期：2019-07-01 00:00:00
abstract：:An outbreak of rubella occurred among visiting German troops involved in a combined military exercise at Fort Bragg, North Carolina, in April 1995. Public health and military operational concerns centered on the significant contact the German soldiers had had with host battalion dependents and the impact of the outbre...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1999-09-01 00:00:00
abstract：INTRODUCTION:Emergency department (ED) utilization represents an expensive and growing means of accessing care for a variety of conditions. Prior studies have characterized ED utilization in the general population. We aim to identify the clinical conditions that drive ED utilization in a universally insured population ...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usaa547
更新日期：2020-12-17 00:00:00
abstract：:Mindfulness meditation training has been shown to reduce stress and improve short-term memory for military personnel. However, no studies have investigated the effects of in-person and virtual world (VW) mindfulness training on Post-Traumatic Stress Disorder (PTSD) or Attention Deficit Hyperactivity Disorder (ADHD) sy...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usx227
更新日期：2018-03-01 00:00:00
abstract：:Correspondence of three core Trauma Symptom Inventory (TSI) posttraumatic stress disorder (PTSD) scales (Intrusive Experiences, Defensive Avoidance, and Anxious Arousal) and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-IV) PTSD module were examined among 72 veterans with traumatic brain injury (...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed-d-00-9509
更新日期：2009-10-01 00:00:00
abstract：:The Department of Defense (DoD) requires service members to complete regular health assessments for identification of deployment-related physical/behavioral issues and environmental/occupational exposures. Compliance among active duty Department of the Navy personnel varies; however, and the impact of incomplete asses...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-15-00019
更新日期：2016-02-01 00:00:00
abstract：INTRODUCTION:The U.S. Air Force utilizes specialized Critical Care Air Transport Teams (CCATT) for transporting "stabilized" patients. Given the drawdown of military forces from various areas of operation, recent CCATT operations have increasingly involved the evacuation of unstable and incompletely resuscitated patien...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usy371
更新日期：2019-05-01 00:00:00
abstract：BACKGROUND:Transfusion of freshly collected blood products (FCBP) is sometimes necessary to save service member (SM) lives in austere deployed environments. Recipients of FCBPs are administratively tracked and offered serial serologic testing via the Armed Services Blood Program "Blood Look Back" (BLB) program to assur...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-15-00512
更新日期：2016-09-01 00:00:00
abstract：:Questionnaires were sent to directors of the 118 oral and maxillofacial surgery training programs in the United States and its territories to survey current trends and recent experience with maxillo-mandibular fixation (MMF). Eighty-eight percent of the respondents indicated that it was customary to keep wire cutters ...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1997-05-01 00:00:00
