Abstract:
BACKGROUND:Malaria prevention and treatment are big challenges for the French forces deployed in sub-Saharan Africa. Since December 2013, 1,800 French soldiers have been deployed at any one time in the Central African Republic in the framework of "Operation Sangaris" and European Union Force (EUFOR). Over the 2014-2015 period, about 500 cases of malaria were notified in these troops during the operation or after their return (annual incidence: 13.4 p.100 person-year). The recommendation to use dihydroartemisinin-piperaquine (DHA-PQ) as the first-line treatment for French soldiers suffering from uncomplicated Plasmodium falciparum malaria in endemic areas is not always followed in practice in the field by French military general practitioners (GPs). METHODS:We conduced a retrospective Knowledge-Attitude-Practice study by self-administered questionnaire, to all military French doctors who were in mission in Central African Republic from January 2014 to July 2015 to try to understand what were the reasons for the GP not to prescribe DHA-PQ on the field. FINDINGS:Thirty-six GPs (53%) answered to the questionnaire. Eighty-three percent of them knew about the recommendation to use DHA-PQ for un uncomplicated Pf malaria. Fifty-eight percent had a favorable attitude toward DHA-PQ. The factors associated with the prescription of another drug (Atovaquone-proguanil) were: the habit (odds ratio [OR] 0.1, confidence interval (CI) 0-0.6], the fact that Atovaquone-proguanil is more practical to use [OR 0.01, CI 0-0.1]. In practice, only 37.5% prescribed DHA-PQ the most of the time during their mission. Factors associated with a non-favorable attitude toward DHA-PQ were: the necessity to calculate a QTc interval during the treatment [OR 0.2, confidence interval 0-0.9], and the fact that DHA-PQ must be taken on an empty stomach [OR 0.3, CI 0.1-0.8]. GP who received a formation before their mission about malaria and treatment had a favorable attitude toward DHA-PQ. DISCUSSION:There is very satisfactory knowledge by the military GPs stationed in the Central African Republic on both the recommendations and prescription of antimalarial drugs. The present study highlights some difficulties in implementing the recommendations in an operational context, notably factors limiting the prescription of DHA-PQ during military deployment (need for ECG monitoring, empty stomach, and lack of habit). Proposals can be made to improve the efficacy, tolerance, and practicability of malaria treatment in the field. The main focus should be a more flexible application of the French DHA-PQ risk management plan in the field, specific training and communication about DHA-PQ use, the generalization of ECG printing equipment in the field, and the switch from DHA-PQ to an alternative artemisinin-based combination therapy during deployments in malaria-endemic areas.
journal_name
Mil Medjournal_title
Military medicineauthors
Perisse A,Velut G,Javelle E,Loarer G,Michel R,Simon Fdoi
10.1093/milmed/usx117subject
Has Abstractpub_date
2018-09-01 00:00:00pages
e638-e643issue
9-10eissn
0026-4075issn
1930-613Xpii
4841670journal_volume
183pub_type
杂志文章abstract::The usability of a rapid point-of-care ABO-Rh blood typing kit was determined by comparing the performance of individuals with extensive medical training/experience to those with a lesser extent. Subjects were asked to use the blood typing kit with their own blood. These outcomes were compared to that listed in the su...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-12-00500
更新日期:2013-05-01 00:00:00
abstract::In a community sample of 573 New Zealand Vietnam War veterans, 20% were identified as posttraumatic stress disorder (PTSD) cases. The association between PTSD diagnoses and a range of military experience variables and current demographic variables was examined. Significant differences were reported between cases and n...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::Combat trauma differs from its peacetime counterpart by involving a different spectrum of injuries, occurring in austere environments, dealing with mass casualties, and embodying inherent treatment delays. Thus, civilian trauma practices may be inappropriate in certain combat settings. A review of historical as well a...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1999-04-01 00:00:00
abstract::We present the case of a young woman presenting to a military field hospital in Afghanistan with a non-ST-elevation myocardial infarction (NSTEMI) associated with the diet drug sibutramine. We also provide a brief literature review on the association between sibutramine and myocardial infarction. ...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/milmed-d-10-00011
更新日期:2010-08-01 00:00:00
abstract::The combined effects of injury from exposure to ionizing radiation and the potential biological warfare agent Venezuelan equine encephalitis (VEE) virus remain largely unknown. To study these effects, 4- to 5-week-old B6D2F1/J female mice were given a sublethal whole-body 7 Gy dose of 60Co gamma-photon radiation follo...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2001-12-01 00:00:00
abstract::The U.S. military was actively involved in humanitarian aid throughout the world for much of the 20th century and is likely to continue in this role well into the 21st century. During the recent Western Pacific Deployment, we were called on to provide assistance to the local population in East Timor in what is called ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.171.1.29
更新日期:2006-01-01 00:00:00
abstract::The U.S. military may consider exploring the inclusion of the long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in the diets of active duty military personnel. To be successful, certain challenges must be overcome including determining appropriate dosage, ensuring cost efficie...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-14-00148
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVES:To evaluate a managed care demonstration project in CHAMPUS (Civilian Health and Medical Program of the Uniformed Services), the insurance program covering physical and mental health care services for the dependents of active duty military personnel, military retirees, and the retirees' dependents. The demon...
journal_title:Military medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract::Rationale for the decision to transport and assessment of available resources are integral components of the decision for aeromedical evacuation of critically ill patients. We present the case of a 20-year-old man who sustained significant trauma after his vehicle struck a land mine. This case reviews and emphasizes t...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.171.7.586
更新日期:2006-07-01 00:00:00
abstract::From August 1, 1991, to May 30, 1992, 148 severely wounded military and civilian casualties with the injury severity score of 3 to 5 were treated in the intensive care unit of the Zadar General Hospital. There were 138 male and 10 female patients; their mean age was 32 years. There were 64 wounded civilians and 84 wou...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::The clinical entity of chronic low back pain is not well understood at present. Disparate spinal conditions can result in symptoms of low back pain, and various treatment options have been proposed in the literature including surgical intervention and prolonged nonoperative therapy. Low back pain, as well as lumbar de...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/milmed-d-10-00397
更新日期:2011-05-01 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:OBJECTIVE:To assess whether race is a significant factor in the ability of prostate-specific antigen velocity (PSAV) for predicting high-grade prostate cancer (HGPC). METHODS:Records of men who underwent prostate biopsy between January 2003 and December 2007 were retrospectively reviewed to collect demographic data, s...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-13-00332
更新日期:2014-03-01 00:00:00
abstract::This study surveyed 2,287 U.S. Navy health care providers (HCPs) regarding patient-care practices and attitudes related to tobacco use. Almost 80% of HCPs reported that they usually asked new patients about tobacco use. Of 11 recommended practices, two-thirds to three-quarters of HCPs engaged in only 4 behaviors with ...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract:INTRODUCTION:Deployment-related mild traumatic brain injury (mTBI) affects a significant proportion of those who served in Post-9/11 combat operations. The prevalence of head injuries, including those that lead to mTBI, is often reported quantitatively. However, service member (SM) and Veteran firsthand accounts of the...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa308
更新日期:2021-01-25 00:00:00
abstract::A complete dental examination is the basis for identifying the dental readiness of Air Force Reserve Command members. Historically, these were done on an infrequent basis. Recently, an annual dental examination has been mandated for all military members. Current dental personnel manning and resources are not sufficien...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.170.1.26
更新日期:2005-01-01 00:00:00
abstract::Mass casualties during war, civil unrest, or natural disasters can generate chaos and disarray in the emergency room setting. The influx of numerous casualties in a short period of time can paralyze the medical facility and cause irreparable damage to the injured. Maintaining calm and order is very essential for triag...
journal_title:Military medicine
pub_type:
doi:
更新日期:2001-12-01 00:00:00
abstract::Primary care providers are often the initial evaluators of soldiers presenting with acute eye complaints. It is crucial for these providers to master performing the basic eye examination with a systematic approach. Obtaining a thorough history is an important first step to the eye examination, but providers need to be...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-15-00161
更新日期:2016-02-01 00:00:00
abstract::Carotid atherosclerosis affects thousands of individuals each year. A history of transient ischemic attacks should alert the clinician to the possibility of carotid artery disease. Carotid endarterectomy is of proven benefit in both symptomatic and asymptomatic individuals, with angiographically confirmed carotid sten...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:INTRODUCTION:This article presents an emerging capability to project damage control procedures far forward for situations where evacuation to a formal surgical team is delayed. Specifically, we demonstrate the plausibility of using a wearable augmented reality (AR) telestration device to guide a nonsurgeon through a da...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz298
更新日期:2020-01-07 00:00:00
abstract::Arterial thromboembolic events are not common after chemotherapy. We present a case of a cerebrovascular accident, which developed after chemotherapy in a patient with a germ cell tumor. A 34-year-old man with a testicular germ cell tumor who did not have any comorbid disease was admitted to hospital. After a radical ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-01-3508
更新日期:2009-03-01 00:00:00
abstract::Recently, observational studies analyzing prehospital blood product transfusions (PHT) for trauma have become more widespread in both military and civilian communities. Due to these studies' non-random treatment assignment, propensity score (PS) methodologies are often used to determine an intervention's effectiveness...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.1093/milmed/usx137
更新日期:2018-03-01 00:00:00
abstract:INTRODUCTION:Obstetric fistulae are a leading scourge for women in developing countries resulting, in severe individual suffering and devastating socio-economic repercussions for her family and community. The underlying causes of obstetric fistula stem from multiple factors to include poor nutrition, early marriage, in...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz172
更新日期:2020-02-12 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::Self-directed violence (SDV), which includes suicidal ideation with and without intent, suicidal preparatory behaviors and attempts with and without harm, non-suicidal self-directed violence, and completed suicide, has been a rising concern in the military. Military shipboard personnel may represent a unique subset of...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-15-00257
更新日期:2016-04-01 00:00:00
abstract::A 36-year-old man with chronic severe exertional myalgias had a normal serum lactate elevation and diminished serum ammonia elevation on an ischemic forearm exercise test (IFET). The IFET is commonly performed in the evaluation of patients with complaints of exertional myalgias, cramps, and rhabdomyolysis. The finding...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::Patients are referred to the endodontist to have root canal therapy performed to treat pulpal and periradicular diseases. Routinely, the only radiograph to accompany the patient is the periapical radiograph. This radiograph is inadequate in the detection of asymptomatic pathosis that may be present in other areas of t...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:INTRODUCTION:Department of Defense (DoD) has identified problem-solving training (PST) as a promising prevention/early intervention for mental health disorders. PST is a four-session group intervention that emphasizes building problem-solving and coping skills to mitigate emotional dysregulation and the adverse effects...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy229
更新日期:2019-05-01 00:00:00
abstract::This study profiles tobacco use by 2,241 dependent teenagers in grades 6-12 at two Army posts. Data were collected in February 1989 by self-administered questionnaires. Results show 40.9% of dependent teenagers have tried smoking and 16.4% have tried smokeless tobacco. Most youths who tried tobacco did so experimental...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::Post-traumatic stress disorder (PTSD) is associated with poor health but there is a gap between need and receipt of care. It is useful to understand where to optimally locate in-person care and where video-based PTSD care would be most useful to minimize access to care barriers, care outside the Veterans Affairs syste...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-13-00177
更新日期:2014-02-01 00:00:00