Abstract:
PURPOSE:Alpha-blockers and calcium channel blockers have shown promise for medical expulsion therapy (MET) of distal ureteral calculi < 1 cm in size. Although MET has been discussed in urology for some time, little has been written about MET in the emergency medicine and primary care literature. We sought to evaluate current practice patterns of MET among urologists, emergency medicine physicians, other primary care providers, and frontline military care providers. METHODS:Web-based, self-developed survey to assess the current practice patterns of providers for the initial management of uncomplicated ureteral calculi, and specifically, their frequency of using MET. Cross-tabulation strategies utilizing compiled survey results were used to assess survey outcomes and determine prevalence values for understanding, familiarity, and therapeutic interventions for nephrolithiasis. RESULTS:Of 293 medical professionals, 114 (39%) were urologists, 55 (48%) of which were fellowship trained in endourology. Fifty-six (19%) were emergency medicine physicians, 22 (8%) were family practitioners, and 19 (7%) were internists and other primary care physicians. Other physician subspecialists and medical paraprofessionals comprised the remaining 34%. Overall 27% of respondents were unfamiliar with MET for expulsion of uncomplicated ureteral stones, including 13% of staff physicians, 21% of emergency medicine doctors, 56% of family practitioners, 40% of internists, and 43% of other primary care providers. The overall prevalence of use of MET was 45%. All urologists were familiar with MET, but 31% rarely, never, or only sometimes used this therapy. Specifically, urologists, emergency physicians, family practitioners, internists, and other providers, usually or always used MET 69%, 55%, 16%, 16%, and 27%, of the time, respectively. In academic institutions, 71.6% use MET usually or almost always compared to 36% in military healthcare settings and 47% in other practice settings. Tamsulosin is the most widely used medication for MET, accounting for 57% of MET use. Factors identified that inhibit more widespread use of MET include, physician unfamiliarity with MET (72%), the belief that MET is not effective (10%), patient unwillingness to undergo MET (5%), and medications not covered by insurance plans (4%). CONCLUSION:While MET has been established as a reasonable adjunct for management of uncomplicated ureteral stones, it may be underutilized due to physician unfamiliarity with this type of treatment and perceived ineffectiveness. This therapy may be of particular benefit to forward deployed forces. Education programs and practice-specific guidelines to target this audience may help to improve the dispersion of MET into the medical community.
journal_name
Mil Medjournal_title
Military medicineauthors
Stroup SP,Garvin AN,Irby J,Stroup KK,L'Esperance JO,Auge BKdoi
10.7205/milmed-d-10-00100subject
Has Abstractpub_date
2010-11-01 00:00:00pages
883-9issue
11eissn
0026-4075issn
1930-613Xjournal_volume
175pub_type
杂志文章abstract::The diagnosis and management of concussion can be difficult in a combat environment, especially in the absence of loss of consciousness or post-traumatic amnesia. As no validated test exists to diagnose or grade neurocognitive impairment from a concussion, the military currently employs the Military Acute Concussion E...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-09-00258
更新日期:2010-07-01 00:00:00
abstract::Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most prevalent human enzyme deficiency, affecting an estimated 400 million people worldwide. G6PD deficiency increases erythrocyte vulnerability to oxidative stress and may precipitate episodes of hemolysis when individuals are exposed to triggering agents. Al...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-00-7608
更新日期:2009-05-01 00:00:00
abstract::To-date, there has been no international review of mental health resilience training during Basic Training nor an assessment of what service members perceive as useful from their perspective. In response to this knowledge gap, the North Atlantic Treaty Organization (NATO) Human Factors & Medicine Research & Technology...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-12-00549
更新日期:2013-07-01 00:00:00
abstract::Sudden cardiac death in seemingly healthy young people during exertion has led to preparticipation assessment of athletes. Typically, cardiac evaluation is limited to auscultation by a primary care provider. Screening electrocardiography is controversial. The value of limited echocardiography is unknown. High school a...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Deployed service members exposed to burn pit smoke can experience a multitude of symptoms. Respiratory symptoms after burn pit smoke exposure are well recognized, but neurologic symptoms are less well recognized. There are reports of migraines triggered by odors but no specific reports of new onset migraines...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-16-00200
更新日期:2017-05-01 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:OBJECTIVE:A cavum septum pellucidum is an anatomical variant that is usually considered an incidental finding of little clinical significance. This is a fluid-containing structure between the lateral ventricles whose walls exhibit lateral bowing and are 10-mm apart or greater. It has been hypothesized that enlarged cys...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-11-00009
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Nutritional information seldom reaches individuals with the most unhealthful dietary habits. OBJECTIVE:To explore whether an intervention focusing on a combination of nutritional information and increased availability of vegetables, fruits, and semi whole grain bread was effective to raise the intake, and k...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-14-00046
更新日期:2014-09-01 00:00:00
abstract::Military commanders frequently mention that communicating difficult or taboo information is especially challenging. In the context of gender-integrated ground combat service there may be additional communication challenges for military commanders who may be unaccustomed to leading both men and women. Often, military c...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-15-00201
更新日期:2016-01-01 00:00:00
abstract::The objective of this study was to compare military suicide rates with civilian suicide rates, adjusting for age and sex differences that exist between the two populations. The number of active component (AC) service members whose manner of death was certified as suicide was determined for specific age and sex groups ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usx209
更新日期:2018-03-01 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::Post-residency fellowship education has traditionally been a transitionary phase toward a possible career involving medical research and teaching. The increasing sophistication required for performing medical research, the emphasis on molecular medicine, significant overcrowding in specialty disciplines, high student ...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract::In the easily surveyable and rather homogeneous military population of the Norwegian Armed Forces, a group of 112 male suicide-attempting conscripts was studied retrospectively. Compared to a normal conscript population, suicide attempters more often had troublesome backgrounds, had experienced psychiatric problems an...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1990-12-01 00:00:00
abstract::The U.S. military health care system forms a vast network across thousands of miles to serve patients in the Pacific theater. The medical treatment facilities in the Pacific, however, act independently and do not effectively track patients in the air evacuation system. The patients and the tracking systems are so disc...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:The objective of this project was to evaluate the use of preprocedural mouth rinses in Army dental clinics. MATERIALS AND METHODS:Three hundred six-question surveys were distributed to 10 Army dental organizations throughout the United States and Germany during the period from March 2001 to March 2002. Two h...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.169.8.600
更新日期:2004-08-01 00:00:00
abstract::Cluster headaches (CHs) are one of the most debilitating of all the identified headache syndromes. Their pathogenesis is poorly understood, which has made their treatment challenging. Various medicines and modalities have been put forth in an effort to minimize the symptoms, but none have proven to be consistently rel...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-14-00713
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The objective of this study is to directly compare different types of cervical artificial disc implants using an in vivo model capable of simulating the axial load on a neck that is similar to the human neck. METHODS:Cervical arthroplasty was performed at C3-4 in 14 healthy female adult Alpine goats. The goats...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy395
更新日期:2019-03-01 00:00:00
abstract::A unique chronic obstructive pulmonary disease (COPD), provisionally called "mustard lung", which occurs as a late complication of sulfur mustard (SM) exposure among SM-exposed Iranians, is presently poorly characterized. This investigation evaluates p53 immunoreactivity in bronchial epithelium of individuals with his...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.172.1.70
更新日期:2007-01-01 00:00:00
abstract::We describe a patient originally diagnosed with clinically definite multiple sclerosis whose actual diagnosis of conversion disorder was revealed when his examination was found to be fictitious, his radiological, electrophysiological, and biochemical tests were determined to be normal, and his symptoms were reversed t...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract::Operations Just Cause and Desert Storm were of relatively brief duration; however, severe wounds were produced that required complex reconstructive procedures. This paper describes the type of wounds managed in theater and subsequently at three U.S. military medical centers. Specific reconstructive techniques included...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::Twenty-four pilots (age 20-32 years) were monitored with a Holter monitor during 26 hours including a high-Gz flight in order to evaluate heart rate (HR) and cardiac rhythm. Flight experience did not predict the mean in-flight HR (range 69-121 beats/minute), which decreased with increasing age and correlated to the ma...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract::The medical services of the German contingent of the Stabilization Forces in Bosnia maintain a high-standard-preventive health care system. Because knowledge about German food and water surveillance laboratories is not widespread, these and the methods used for sample examinations as well as their analytical capacitie...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract:PURPOSE:Determine the short-term effects of creatine supplementation on performance of military tasks, thermoregulation, and health risks. METHODS:Male military personnel were randomly assigned to a creatine (CR; N = 8) or a placebo (CON; N = 8) supplementation group. Testing was conducted at baseline, after a 6-day l...
journal_title:Military medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2001-11-01 00:00:00
abstract::Recently, fat distribution has become of clinical interest in assessing one's risk for coronary heart disease (CHD). Investigations have shown stronger relationships between abdominal, or central adiposity, and various well known risk factors for CHD, than peripheral and/or total adiposity. The simple waist-to-hip rat...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-04-01 00:00:00
abstract::Squamous cell carcinoma of the uterine cervix typically has a curable precancerous phase of 5 to 10 years, during which the Papanicolaou (Pap) test can often detect characteristic cytologic features. The records of 126,024 Pap tests from January 1994 through June 1999 were reviewed. The distribution of cervical dyspla...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::U.S. military researchers have made major contributions to the discovery, diagnosis, treatment, and prevention of a number of parasitic diseases. We review the paramount U.S. military contributions to the understanding of leishmaniasis, filariasis, schistosomiasis, trypanosomiasis, gastrointestinal parasites, intestin...
journal_title:Military medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7205/milmed.170.4s.17
更新日期:2005-04-01 00:00:00
abstract::The use of traction to transport patients with femur fractures is well accepted. This paper describes step-by-step the construction of a traction device suitable for use on military aircraft. This "Landstuhl frame" is easily constructed using materials readily available. It is quick and effective for the transportatio...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract:INTRODUCTION:Extremity war-wounds present an elevated risk of infection and compromise reconstructive procedures. In a French military hospital, a multi-disciplinary meeting (MDM) was created to standardize the care given to soldiers with osteoarticular infection. The aim of this study was to evaluate the usefulness of...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy369
更新日期:2019-05-01 00:00:00
abstract::Military personnel deployed to Iraq and Afghanistan often develop mental health difficulties, which may manifest as problematic driving behavior. Veterans may be more likely to engage in risky driving and to subsequently be involved in motor vehicle accidents and fatalities. This article reviews literature on driving ...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-13-00327
更新日期:2014-06-01 00:00:00
abstract::Academic medical centers (AMCs) have traditionally symbolized technological advancements and specialization in patient care. AMCs are defined as institutions that include at a minimum a hospital and associated clinics and a medical education role. Today, these institutions face a transition to managed care and radical...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00