scholarly journals Spontaneous Pneumopericardium in a U.S. Marine: Do not Lose Heart

2019 ◽  
Vol 185 (3-4) ◽  
pp. e518-e521
Author(s):  
David Sherrier ◽  
Radhames E Lizardo
Keyword(s):  
Subcutaneous Emphysema ◽  
Military Service ◽  
Fast Track ◽  
Unusual Case ◽  
Vital Signs ◽  
Marine Corps ◽  
Hilly Terrain ◽  
Military Service Members ◽  
Elevation Changes ◽  
History Of

Abstract We report an unusual case of extensive subcutaneous emphysema, pneumomediastinum, and pneumopericardium identified in an otherwise healthy U.S. Marine who was enrolled in the Marine Corps School of Infantry. His training regimen included prolonged periods of yelling and elevation changes during sustained hiking through hilly terrain. The patient presented to the Fast Track with normal vital signs but complained of dyspnea, cough, and subjective fevers. Although he lacked a history of trauma, he was found to have pneumopericardium, pneumomediastinum, and subcutaneous emphysema without pneumothorax. He was admitted to the general surgery service for observation and was ultimately released back to his unit after 24 hours. To our knowledge, pneumopericardium has never been attributed to persistent yelling in the setting of a lower respiratory tract infection and should be considered in the differential of atraumatic chest symptomatology in otherwise healthy military service members.

scholarly journals Symptom Reporting Patterns of US Military Service Members with a History of Concussion According to Duty Status

2018 ◽  
Vol 34 (2) ◽  
pp. 236-242 ◽  
Author(s):  
Lisa H Lu ◽  
Doug B Cooper ◽  
Matthew W Reid ◽  
Bilal Khokhar ◽  
Jennifer E Tsagaratos ◽  
...  
Keyword(s):  
Military Service ◽  
Symptom Reporting ◽  
Service Members ◽  
Us Military ◽  
Military Service Members ◽  
History Of

scholarly journals A-116 Predicting Chronic Neurobehavioral Symptoms based on Acute Injury Characteristics and Symptoms in U.S. Military Service Members with and without history of TBI

2020 ◽  
Vol 35 (6) ◽  
pp. 909-909
Author(s):  
Lippa S ◽  
Bailie J ◽  
Brickell T ◽  
French L ◽  
Hungerford L ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Military Service ◽  
Service Members ◽  
Injury Characteristics ◽  
Military Service Members ◽  
History Of ◽  
Neurobehavioral Symptoms ◽  
Severe Tbi

Abstract Objective Recovery following traumatic brain injury (TBI) is complex. Often following mild TBI, recovery occurs within days or weeks, though this is not always the case. Following more severe TBI, some recover quickly, while many never fully recover. This study examines acute predictors of chronic neurobehavioral symptoms in U.S. military service members (Age: M = 33.9 years, SD = 10.2) without injury (n = 86), or with history of uncomplicated mild traumatic brain injury (TBI; n = 56), complicated mild, moderate, or severe TBI (mod-sev TBI; n = 43), or bodily injury (n = 25). Method Participants completed the Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist, Alcohol Use Disorder Checklist, Combat Exposure Scale, and TBI Quality of Life and passed symptom validity tests at 0–8 months and ≥ 2 years post-injury. Forward stepwise logistic regression included 26 potential predictors (demographics, injury characteristics, military characteristics, and self-report measures at baseline) of International Statistical Classification of Diseases and Related Health Problems-10 Postconcussional Syndrome (PCSy) at follow-up. Results Cognitive Concerns (Exp(B) = .896, p = .001), Sleep (Exp(B) = 1.874, p < .001), Somatosensory Symptoms (Exp(B) = 1.194, p = .012), and mod-sev TBI (Exp(B) = 2.959, p = .045) significantly predicted follow-up PCSy. When baseline NSI symptoms were removed from the model, Cognitive Concerns (Exp(B) = .902, p < .001), Post-traumatic stress (Exp(B) = 1.173, p = .001), and Resilience (Exp(B) = .950, p < .031) significantly predicted PCSy. For all included measures in both models, higher symptoms at baseline predicted increased likelihood of follow-up PCSy. Both models correctly classified 81.3% of participants. Conclusion Findings suggest patients reporting psychological distress and cognitive concerns acutely should be targeted for treatment to mitigate prolonged neurobehavioral symptoms.

A case of Fournier’s gangrene diagnosed with POCUS

POCUS Journal ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 3
Author(s):  
Marco Badinella Martini, MD ◽  
Antonello Iacobucci, MD
Keyword(s):  
Type 2 Diabetes ◽  
Emergency Department ◽  
Alzheimer Disease ◽  
Physical Examination ◽  
Subcutaneous Emphysema ◽  
Vital Signs ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
History Of

An 87-year-old man with a history of type 2 diabetes and severe Alzheimer disease was admitted to the emergency department with a lesion of the perineum for two days. The patient appeared agitated and not collaborating on the visit. His vital signs were normal. Physical examination revealed an edematous, suppurative, and foul-smelling perineal-scrotal lesion, with possible subcutaneous emphysema.

Neuropsychological Performance and Subjective Symptom Reporting in Military Service Members With a History of Multiple Concussions

2018 ◽  
Vol 33 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Douglas B. Cooper ◽  
Glenn Curtiss ◽  
Patrick Armistead-Jehle ◽  
Heather G. Belanger ◽  
David F. Tate ◽  
...  
Keyword(s):  
Military Service ◽  
Subjective Symptom ◽  
Symptom Reporting ◽  
Service Members ◽  
Neuropsychological Performance ◽  
Military Service Members ◽  
History Of

Military Service Member Perspectives About Occupational Therapy Treatment in a Military Concussion Clinic

2018 ◽  
Vol 39 (4) ◽  
pp. 232-238 ◽  
Author(s):  
Alison M. Cogan ◽  
Janice Huang ◽  
Joyce Philip
Keyword(s):  
Occupational Therapy ◽  
Therapeutic Relationship ◽  
Military Service ◽  
Intervention Strategies ◽  
Service Members ◽  
Care Clinic ◽  
Military Service Members ◽  
History Of ◽  
Military Service Member ◽  
Therapy Treatment

The purpose of this study is to describe important features of occupational therapy practice for treatment of military service members with chronic symptoms and a history of mild traumatic brain injury (mTBI) in a military concussion care clinic from service members’ perspectives with support from occupational therapy practitioners. Two series of focus groups were conducted with service members with chronic mTBI-related symptoms ( n = 6) and practitioners ( n = 5). Data were analyzed concurrently with collection. We identified five main themes: therapeutic relationship, consistent inclusion of family members, combat versus noncombat injuries, loss of military identity, and assessment against population norms. The findings of this study suggest that service members’ evaluations of occupational therapy are based on the overall experience of the encounter, centered by the therapeutic relationship, rather than specific intervention strategies or technology.

scholarly journals Acute presentation of choriocarcinoma: a case study and review of the literature

CJEM ◽  
2002 ◽  
Vol 4 (02) ◽  
pp. 111-114 ◽  
Author(s):  
Andrew Worster ◽  
Sangita Sharma ◽  
Farouk Mookadam ◽  
John Opie
Keyword(s):  
Pulse Pressure ◽  
Unusual Case ◽  
Vital Signs ◽  
Hepatic Metastases ◽  
Arterial Pulse ◽  
Acute Presentation ◽  
Arterial Pulse Pressure ◽  
History Of ◽  
Symptoms And Signs

ABSTRACTWe report an unusual case of a 27-year-old male with an acute presentation of choriocarcinoma. The patient presented with unstable vital signs, severe anemia and a widened arterial pulse pressure following a several day history of testicular pain. He was subsequently diagnosed as having testicular choriocarcinoma with multiple hepatic metastases and large hemorrhagic para-aortic lymph nodes. The widened pulse pressure persisted during fluid resuscitation and correction of both the anemia and hypotension, and only narrowed after the initiation of chemotherapy. A literature review indicates that metastatic testicular choriocarcinoma is a rare but aggressive malignancy that often presents with acute symptoms and signs that cause patients to seek emergency care. We summarize the reported cases of “acute” testicular choriocarcinoma presentation and briefly discuss its relationship to widened arterial pulse pressure.

scholarly journals Spontaneous Pneumomediastinum with a Rare Presentation

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Ehsan Bolvardi ◽  
Elham Pishbin ◽  
Mohsen Ebrahimi ◽  
Azadeh Mahmoudi Gharaee ◽  
Farhad Bagherian
Keyword(s):  
Subcutaneous Emphysema ◽  
Vital Signs ◽  
Physical Exertion ◽  
Rare Presentation ◽  
Benign Condition ◽  
Spontaneous Pneumomediastinum ◽  
Free Air ◽  
Close Observation ◽  
Chest Examination ◽  
History Of

Spontaneous pneumomediastinum is an unusual and benign condition in which air is present in mediastinum. A 20-year-old male patient presented to ED with complaint of hoarseness and odynophagia from the day before, after weightlifting. The patient was nonsmoker and denied history of other diseases. On physical examination he had no dyspnea with normal vital signs. Throat examination and pulmonary auscultation were normal and no crepitation was palpable. We could not find subcutaneous emphysema in neck and chest examination. In neck and chest X-ray we found that air is present around the trachea. There was no apparent pneumothorax in CXR. In cervical and chest CT free air was present around trachea and in mediastinum. Subcutaneous emphysema was also evident. But there was no pneumothorax. The patient was admitted and went under close observation, oxygen therapy, and analgesic. The pneumomediastinum and subcutaneous emphysema gradually resolved within a week by conservative therapy and he was discharged without any complication. Many different conditions could be trigged because of pneumomediastinum but it is rarely seen in intense physical exertion such as weightlifting and bodybuilding. Two most common symptoms are retrosternal chest pain and dyspnea. But the patient here complained of hoarseness and odynophagia.

scholarly journals 0810 Sleep Disturbances In Returning Veterans That Are Homeless And Combat-exposed

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A308-A308
Author(s):  
K J Speed ◽  
H J Crean ◽  
T J Bishop ◽  
R Hoff ◽  
W J Pigeon
Keyword(s):  
Military Service ◽  
Sleep Disturbances ◽  
Combat Exposure ◽  
Increased Risk ◽  
Military Service Members ◽  
Veteran Status ◽  
History Of ◽  
Insomnia Symptoms ◽  
Insomnia Severity

Abstract Introduction Challenges with sleep (i.e., nightmares and insomnia) impact military service members both during and following deployment, but may occur more frequently in combat-exposed individuals. In addition, among the challenges faced following the transition from active duty to Veteran status are periods of homelessness, which may further contribute to sleep disturbances. Methods The present analyses utilized data from the Survey of Experiences of Returning Veterans, a national survey of recently returning combat Veterans focused on the examination of sex differences following exposure to traumatic events. The sample (n = 793) consisted of 58% males; females were oversampled and all branches were represented. Ordinal and multiple linear regressions were used to investigate the role of combat exposure and homelessness in predicting nightmare distress and insomnia severity. Results An ordinal regression found that combat exposure (b = -.02, p <0.001), homelessness (b = -.31, p = 0.010), and insomnia severity (b = -.10, p <0.001) each significantly predicted nightmare distress. These variables increased risk (SAS parameterizes these models so that negative coefficients are associated with increased risk). Demographic variables were not significantly related to nightmare distress. Similarly, combat exposure (β = .100, p = .002) was associated with insomnia severity, as was nightmare distress (β = .522, p < .001). The moderational role of gender and homeless in the above models are also tested. Conclusion For those who have been combat exposed, have a history of homelessness, and report insomnia symptoms there is an increased odds of reporting nightmare distress, sleep disturbance is even more likely to occur. Although combat exposure and nightmare distress were predictive of insomnia severity, history of homelessness was not. These findings suggest that nightmare distress and insomnia symptoms are a significant concern in our returning combat-exposed Veterans, with nightmares being even more problematic for those at risk of homelessness. Support This study was funded by VHA CSR&D grant ZDA-01. Dr. Speed is supported, in part, by the VA Advanced Fellowship Program in Mental Health Illness Research and Treatment, the VISN 2 Center of Excellence for Suicide Prevention at the Canandaigua VAMC.

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