scholarly journals Viral Hepatitis C-Related Care in Active Duty and Reserve Service Members: A Retrospective Review

2021 ◽  
Author(s):  
Allison M Bush ◽  
Cara Deegan ◽  
Todd Gleeson
Keyword(s):  
Hepatitis C ◽  
Retrospective Review ◽  
Military Service ◽  
Antiviral Agents ◽  
Retrospective Chart Review ◽  
Active Duty ◽  
Virologic Response ◽  
Service Members ◽  
Military Population ◽  
Viral Hepatitis C

ABSTRACT Introduction Hepatitis C Virus (HCV) infection is a leading cause of chronic liver disease and hepatocellular carcinoma, and universal screening of all adults is recommended. Treatment with new direct antiviral agents are well tolerated and highly effective and decrease morbidity and mortality from HCV. The timely treatment of active-duty Service members (SMs) is essential to prevent complications of HCV and to ensure medical readiness and safety of the Department of Defense blood supply. We performed a retrospective review of the quality of care of Navy Active Duty (AD) and reserve SMs diagnosed with HCV to assess rates of successful treatment and compliance with national guideline recommendations and identify potential challenges to receiving curative HCV therapy. Materials and Methods A retrospective chart review was completed on the health records of 54 AD and reserve US Navy SMs diagnosed with HCV. The records were reviewed for timeliness of subspecialty evaluation, achievement of sustained virologic response (SVR), and documentation of the completion of HCV-associated recommendations from national organizations and guidelines. Challenges and barriers to care were identified. Results Ninety-eight percent of AD and reserve Navy SMs diagnosed with HCV were prescribed treatment, 81% achieved an SVR after completing initial treatment, which reached 92% after initial nonresponders underwent a second round of treatment. Fifty percent of SMs experienced a delay in care due mostly to military-related obligations and patient noncompliance or both. There was a small number of delays in care as a result of prolonged notification of results and referral time. Conclusion As HCV screening recommendations expand to include all adults, more HCV infections will be identified in both the active and reserve components. Modern HCV therapies are both relatively short in duration as well as curative, allowing for the restoration of medical readiness and military service retention. Despite these advantages, we identified challenges of effecting HCV cures in a mobile military population. We recommend centralized compliance monitoring of not only HCV force screening but also HCV treatment to ensure maximized military medical readiness.

Health and Service-related Impact of Sexual and Stalking Victimization During United States Military Service on LGBT Service Members

2020 ◽  
pp. 088626052097031
Author(s):  
Cary Leonard Klemmer ◽  
Ashley C. Schuyler ◽  
Mary Rose Mamey ◽  
Sheree M. Schrager ◽  
Carl Andrew Castro ◽  
...  
Keyword(s):  
United States ◽  
Military Service ◽  
The United States ◽  
Active Duty ◽  
Service Members ◽  
United States Military ◽  
Service Outcomes ◽  
Study Participants ◽  
The Military ◽  
Stalking Victimization

Prior research among military personnel has indicated that sexual harassment, stalking, and sexual assault during military service are related to negative health sequelae. However, research specific to LGBT U.S. service members is limited. The current study aimed to explore the health, service utilization, and service-related impact of stalking and sexual victimization experiences in a sample of active-duty LGBT U.S. service members ( N = 248). Respondent-driven sampling was used to recruit study participants. U.S. service members were eligible to participate if they were 18 years or older and active-duty members of the U.S. Army, U.S. Navy, U.S. Marine Corps, or U.S. Air Force. This study included a sizeable portion of transgender service members ( N = 58, 23.4%). Sociodemographic characteristics, characteristics of military service, health, and sexual and stalking victimization in the military were assessed. Regression was used to examine relationships between health and service outcomes and sexual and stalking victimization during military service. Final adjusted models showed that experiencing multiple forms of victimization in the military increased the odds of visiting a mental health clinician and having elevated somatic symptoms, posttraumatic stress disorder symptomatology, anxiety, and suicidality. Sexual and stalking victimization during U.S. military service was statistically significantly related to the mental and physical health of LGBT U.S. service members. Interventions to reduce victimization experiences and support LGBT U.S. service members who experience these types of violence are indicated. Research that examines the role of LGBT individuals’ experiences and organizational and peer factors, including social support, leadership characteristics, and institutional policies in the United States military is needed.

scholarly journals Telemedicine Chronic Viral Hepatitis C Treatment during the Lockdown Period in Romania: A Pilot Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3694
Author(s):  
Irina Paula Doica ◽  
Dan Nicolae Florescu ◽  
Carmen Nicoleta Oancea ◽  
Adina Turcu-Stiolica ◽  
Mihaela-Simona Subtirelu ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Medication Adherence ◽  
Pilot Study ◽  
Multidisciplinary Approach ◽  
Therapy Monitoring ◽  
Antiviral Agents ◽  
Item Score ◽  
Hcv Therapy ◽  
Viral Hepatitis C ◽  
Significant Difference

The COVID-19 pandemic is currently delaying the process of chronic hepatitis C (HCV) eradication, since most of the chronic diseases are neglected. Thus, there is a need for alternative programs for HCV therapy implementation and disease monitoring. Our aim was to provide a multidisciplinary approach, so that HCV-infected patients from distant locations may benefit from HCV antivirals during the COVID-19 outbreak and within the lockdown period in Romania. Previously diagnosed HCV patients willing to participate in this telemedicine pilot study were included. Patient characteristics and medical adherence were assessed and compared to the year preceding the pandemic. We proposed a multidisciplinary approach by using a telemedicine program for HCV therapy monitoring. Patients also received a satisfaction questionnaire after delivering the sustained virologic response (SVR) result. A total of 41 patients agreed to participate in this study. The medication adherence was 100% for patients included in the telemedicine group, with a statistically significant difference from the medication adherence of the patients treated in 2019. The satisfaction item score was 4.92 out of 5 and our results (r = −0.94, p < 0.0001) suggested that older patients embraced the telemedicine program less, but with the same success in terms of SVR (100%) and medication adherence (100%). Our pilot study offers the first example of a telemedicine program in Romania for HCV therapeutic management. During the lockdown period, telemedicine has served as a reliable tool and novel alternative for conventional monitoring of patients treated with direct antiviral agents and should be further considered even following the pandemic.

scholarly journals Incidence of Ankle Sprains Among Active-Duty Members of the United States Armed Services From 1998 Through 2006

2010 ◽  
Vol 45 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Kenneth L. Cameron ◽  
Brett D. Owens ◽  
Thomas M. DeBerardino
Keyword(s):  
At Risk ◽  
Incidence Rate ◽  
Ankle Sprain ◽  
Military Service ◽  
Active Duty ◽  
Service Members ◽  
Ankle Sprains ◽  
Injury Patterns ◽  
The Us ◽  
Armed Services

Abstract Context: Ankle sprains have been reported as one of the most common injuries sustained by members of the US Armed Services. However, little is known about the incidence rate and injury patterns associated with ankle sprains in this population. Objective: To examine the incidence of ankle sprains among active-duty members of the US Armed Services from 1998 through 2006. A secondary objective was to describe the sex, age, and service-specific injury patterns in this young, physically active population. Design: Cohort study. Patients or Other Participants: All active-duty service members from the day they enter military service until the day they leave military service and US Army Reserve and National Guard service members during periods of active duty and mobilization. Main Outcome Measure(s): Injury data were extracted from the Defense Medical Epidemiological Database from 1998 through 2006. All data for ankle sprains, coded according to the International Classification of Diseases (9th revision), were included. Cases were limited to those injuries reported as first occurrences. Incidence rates (IRs) were calculated per 1000 person-years by sex, age, and service. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) were used to assess the strength of association between the incidence of ankle sprain and the independent variables of sex, age, and service. Results: From 1998 through 2006, 423 581 service members sustained ankle sprains and 12 118 863 person-years at risk to injury were documented in this population. The incidence rate was 34.95 (95% CI  =  34.85, 35.06) per 1000 person-years at risk. Females were 21% more likely (IRR  =  1.21, 95% CI  =  1.21, 1.23) to sustain an ankle sprain than males. Sex-specific IR varied by age and service. Differences in the rate of ankle sprains were also noted by age and service. Conclusions: The incidence of ankle sprains among US service members was 5 times greater than that previously reported in civilian population studies. Sex, age, and branch of military service are important factors related to the incidence of ankle sprains in this population.

Incidence of insomnia and obstructive sleep apnea in active duty United States military service members

SLEEP ◽  
2021 ◽  
Author(s):  
Brian A Moore ◽  
Lynn M Tison ◽  
Javier G Palacios ◽  
Alan L Peterson ◽  
Vincent Mysliwiec
Keyword(s):  
United States ◽  
Obstructive Sleep Apnea ◽  
Military Service ◽  
Active Duty ◽  
Incidence Rates ◽  
Service Members ◽  
United States Military ◽  
Obstructive Sleep ◽  
Military Service Members ◽  
The U.S

Abstract Study Objectives Epidemiologic studies of obstructive sleep apnea (OSA) and insomnia in the U.S. military are limited. The primary aim of this study was to report and compare OSA and insomnia diagnoses in active duty the United States military service members. Method Data and service branch densities used to derive the expected rates of diagnoses on insomnia and OSA were drawn from the Defense Medical Epidemiology Database. Single sample chi-square goodness of fit tests and independent samples t-tests were conducted to address the aims of the study. Results Between 2005 and 2019, incidence rates of OSA and insomnia increased from 11 to 333 and 6 to 272 (per 10,000), respectively. Service members in the Air Force, Navy, and Marines were diagnosed with insomnia and OSA below expected rates, while those in the Army had higher than expected rates (p &lt; .001). Female service members were underdiagnosed in both disorders (p &lt; .001). Comparison of diagnoses following the transition from ICD 9 to 10 codes revealed significant differences in the amounts of OSA diagnoses only (p &lt; .05). Conclusion Since 2005, incidence rates of OSA and insomnia have markedly increased across all branches of the U.S. military. Despite similar requirements for overall physical and mental health and resilience, service members in the Army had higher rates of insomnia and OSA. This unexpected finding may relate to inherent differences in the branches of the military or the role of the Army in combat operations. Future studies utilizing military-specific data and directed interventions are required to reverse this negative trend.

scholarly journals Liver Fibrosis Progression and Mortality in Hepatitis B– and C–Coinfected Persons Treated With Directly Acting Antiviral Agents: Results From ERCHIVES

2019 ◽  
Vol 71 (3) ◽  
pp. 664-666 ◽  
Author(s):  
Adeel A Butt ◽  
Peng Yan ◽  
Samia Aslam ◽  
Abdul-Badi Abou-Samra ◽  
Kenneth E Sherman ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Confidence Intervals ◽  
Antiviral Agents ◽  
Virologic Response ◽  
Fibrosis Progression ◽  
B Virus

Abstract For persons with baseline Fibrosis-4 1.46–3.25, cirrhosis incidence/1000 patient-years was 49.3 among hepatitis B virus (HBV)/hepatitis C virus (HCV) coinfected and 18.2 among HCV monoinfected (P = .03). Cirrhosis risk was numerically higher but statistically nonsignificant among HBV/HCV coinfected (hazards ratio [HR] 1.51; 95% confidence intervals [CI], .37–6.05) but lower among those who attained sustained virologic response (HR, .52; 95% CI, .42–.63).

scholarly journals PERIACETABULAR OSTEOTOMY IN ACTIVE DUTY U.S. MILITARY PERSONNEL: A SINGLE CENTER’S EXPERIENCE WITH A MINIMUM OF TWO YEARS FOLLOW-UP

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0014
Author(s):  
Andrew S. Murtha ◽  
Matthew R. Schmitz
Keyword(s):  
United States ◽  
Military Service ◽  
Periacetabular Osteotomy ◽  
The United States ◽  
Active Duty ◽  
Service Members ◽  
Military Service Members ◽  
Active Service ◽  
The Impact

Background: The primary focus of periacetabular osteotomy (PAO) literature has been survivorship until hip arthroplasty. This endpoint overlooks its impact on young, active patients. Hypothesis/Purpose: This study sought to assess the impact of the PAO on the careers of active duty members of the United States Armed Forces. Methods: A retrospective review identified 38 patients who underwent PAO performed by a single surgeon at an academic, military medical center from January 2014 through April 2017. Twenty-one of the patients were active duty United States military service members (16 female, 5 male) and had a minimum 28 months of post-operative follow-up at the time of review. Preoperative and postoperative duty restrictions were noted and referrals to the U.S Army and U.S. Air Force Medical Evaluation Boards (MEB) were queried. Results: The average age at surgery was 25.6 years (range, 19-40y). Preoperatively, sixteen patients (94.1%) were on duty restrictions, one had been referred to the MEB, and records were not available on three patients who separated from the military prior to review. Average follow-up was 3.4 years (range, 2.3 – 5.4y). Among the patients without a preoperative MEB referral, 85.0% remained on active duty (n = 12) or completed their military service commitment (n=5). Of the fourteen patients with temporary duty restrictions preoperatively, 35.7% (n=5) were relieved of their restrictions and returned to full duty and 50% (n=7) were retained on active service with permanent duty restrictions. Such permanent duty restrictions typically consisted of modifications to the aerobic component of the semiannual military fitness testing. Six patients (28.6%) were referred to the MEB including one who was referred prior to PAO. Of these patients, two were deemed fit to retain on active service with permanent duty restrictions, two were medically separated for non-hip conditions, and two were medically separated for a hip condition. The average Veteran Affairs (VA) disability score related to hip pathology in patients referred to MEB was 16% (range 0-40%). Conclusion: This is the first study to look at the PAO in active duty military service members. In patients with symptomatic acetabular dysplasia, PAO may provide an opportunity to relieve preoperative duty restrictions and allow for continued military service. Further study with the inclusion of patient reported outcomes are necessary assess the impact of the procedure in this active patient population.

scholarly journals The Health and Readiness of Service Members: ACEs to PACEs

2020 ◽  
Vol 185 (Supplement_1) ◽  
pp. 348-354 ◽  
Author(s):  
Angela Lamson ◽  
Natalie Richardson ◽  
Erin Cobb
Keyword(s):  
Adverse Childhood Experiences ◽  
Military Service ◽  
Active Duty ◽  
Early Career ◽  
Service Members ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Active Duty Personnel ◽  
The Military

ABSTRACT Introduction Over the past three decades, a growing research base has emerged around the role of adverse childhood experiences (ACEs) in the biological, psychological, social, and relational health and development of children and adults. More recently, the role of ACEs has been researched with military service members. The purpose of this article was to provide a brief description of ACEs and an overview of the key tenets of the theory of toxic stress as well as a snapshot of ACEs and protective and compensatory experiences (PACEs) research with active duty personnel. Methods Ninety-seven active duty personnel completed the study including questions pertaining to demographics, adverse childhood experiences, adult adverse experiences, and PACEs survey. Results Significant findings pertaining to ACEs and PACEs were found by service member’s sex and rank, with higher ACE scores for men and enlisted service members. Conclusions The contrast by rank and sex in relation to ACEs punctuates the need for attention to ACEs and protective factors among early career service members in order to promote sustainable careers in the military.

scholarly journals ‘Master My Demons’: art therapy montage paintings by active-duty military service members with traumatic brain injury and post-traumatic stress

2018 ◽  
Vol 45 (4) ◽  
pp. 353-360 ◽  
Author(s):  
Marygrace Berberian ◽  
Melissa S Walker ◽  
Girija Kaimal
Keyword(s):  
Traumatic Brain Injury ◽  
Art Therapy ◽  
Traumatic Stress ◽  
Military Service ◽  
Active Duty ◽  
Service Members ◽  
Post Traumatic Stress ◽  
Active Duty Military ◽  
Military Service Members ◽  
Post Traumatic

This study involved a thematic analysis of montage paintings and of related clinical records of 240 active-duty military service members collected during their art therapy treatment for traumatic brain injury and underlying psychological health concerns, including post-traumatic stress, at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Congruent with other research findings, the qualitative analyses of this study suggest that the group art therapy experiences fostered improvement in interpersonal relatedness, hopefulness and gratification for the service members in treatment, aiding in externalisation, progressive exposure and construction of a trauma narrative imperative for recovery. The mixed media nature of the montage painting supported the expression of a range of postcombat symptoms. Results from this study highlighted the complexity of military culture, necessitating a broader scope of analyses for how art therapy helps service members express and communicate their challenges to care providers, peers and family as well as regulate emotion in the short and long term.

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