Race- and Rank-Specific Infant Mortality in a US Military Population

Abstract Background Plasmodium vivax malaria requires a 2-week course of primaquine (PQ) for radical cure. Evidence suggests that the hepatic isoenzyme cytochrome P450 2D6 (CYP2D6) is the key enzyme required to convert PQ into its active metabolite. Methods CYP2D6 genotypes and phenotypes of 550 service personnel were determined, and the pharmacokinetics (PK) of a 30-mg oral dose of PQ was measured in 45 volunteers. Blood and urine samples were collected, with PQ and metabolites were measured using ultraperformance liquid chromatography with mass spectrometry. Results Seventy-six CYP2D6 genotypes were characterized for 530 service personnel. Of the 515 personnel for whom a single phenotype was predicted, 58% had a normal metabolizer (NM) phenotype, 35% had an intermediate metabolizer (IM) phenotype, 5% had a poor metabolizer (PM) phenotype, and 2% had an ultrametabolizer phenotype. The median PQ area under the concentration time curve from 0 to ∞ was lower for the NM phenotype as compared to the IM or PM phenotypes. The novel 5,6-ortho-quinone was detected in urine but not plasma from all personnel with the NM phenotype. Conclusion The plasma PK profile suggests PQ metabolism is decreased in personnel with the IM or PM phenotypes as compared to those with the NM phenotype. The finding of 5,6-ortho-quinone, the stable surrogate for the unstable 5-hydroxyprimaquine metabolite, almost exclusively in personnel with the NM phenotype, compared with sporadic or no production in those with the IM or PM phenotypes, provides further evidence for the role of CYP2D6 in radical cure. Clinical Trials Registration NCT02960568.

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Suicide Incidence and Risk Factors in an Active Duty US Military Population

American Journal of Public Health ◽

10.2105/ajph.2011.300484 ◽

2012 ◽

Vol 102 (S1) ◽

pp. S138-S146 ◽

Cited By ~ 75

Author(s):

Jeffrey Hyman ◽

Robert Ireland ◽

Lucinda Frost ◽

Linda Cottrell

Keyword(s):

Risk Factors ◽

Active Duty ◽

Military Population ◽

Us Military

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Incidence of Carpal Tunnel Syndrome in the US Military Population

Hand ◽

10.1007/s11552-009-9166-y ◽

2009 ◽

Vol 4 (3) ◽

pp. 289-293 ◽

Cited By ~ 18

Author(s):

Jennifer Moriatis Wolf ◽

Sally Mountcastle ◽

Brett D. Owens

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

International Classification Of Diseases ◽

Common Disease ◽

Military Population ◽

Us Military ◽

The Us ◽

Classification Of Diseases ◽

Tunnel Syndrome ◽

General Populations

Carpal tunnel syndrome (CTS) is a common disease. Its epidemiology has been evaluated previously, mostly in regional populations or in working groups, with an incidence between 1.5 and 3.5 per 1,000 person-years. We studied this diagnosis in the US military population, with the hypothesis that this young population would have a lower incidence of CTS than previously reported in general populations. The Defense Medical Epidemiology Database notes all medical encounters for all US military personnel and maintains the number of all personnel on active duty each year. We queried the database using the International Classification of Diseases, ninth revision, code 354.0 (CTS) and analyzed the personnel presenting for initial visits for the years 1998–2006. Multivariate Poisson analysis was performed, controlling for rank, gender, age, and race. The raw incidence of CTS in the US military was 3.98 per 1,000 person-years, in a population of 12,298,088 person-years. Females had a significantly higher incidence of CTS than males, with an adjusted incidence rate ratio of 3.29. CTS incidence increased by age, with the age group ≥40 years having a significantly higher incidence. Additionally, military rank was found to be an independent risk factor for CTS, with rates higher in senior officer and enlisted groups. This suggests that occupational requirements have an effect on CTS within the military. We showed a comparable incidence of CTS between the US military and general population, with a significantly higher female cohort with a diagnosis of CTS. Increased age and advanced rank were risk factors for CTS.

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