Applying Pharmacogenomic Guidelines to Combat Medical Care

ABSTRACT Pharmacogenomics is a pillar of personalized medicine that has the potential to deliver optimized treatment in many medical settings. Military medicine in the deployed setting is unique and therefore warrants separate assessment pertaining to its potential capabilities and impact. Pharmacogenomics for United States Active Duty Service Members medical care in the deployed setting has not, to our knowledge, been previously reviewed. We present potential applications of pharmacogenomics to forward medical care through two comprehensive references for deployed medical care, the Tactical Combat Casualty Care Guidelines (TCCC) and Emergency War Surgery (EWS) fifth edition. All drugs within the deployment manuals, TCCC guidelines and EWS book, were identified and the list was cross-referenced to the Clinical Pharmacogenetics Implementation Consortium guidelines and genes–drugs interactions list as well as the Food and Drug Administration Table of Pharmacogenomics Biomarkers in Drug Labeling. Ten pharmacologic categories were identified, consisting of 15 drugs, along with the classes, aminogylcosides, beta-blockers, and volatile anesthetics. Drugs and pharmacogenomics liabilities were tabulated. Eight specific drugs or classes are expounded upon given the belief of the authors of their potential for impacting future treatment on the battlefield in the setting of prolonged field care. This review outlines several genes with liabilities in the prolonged field care setting and areas that may produce improved care with further study.

Arabskie zapożyczenia leksykalne w języku hiszpańskim

The large number of words from Arabic found in modern Spanish is proof of the deep influence Arabic has had on the Spanish language. Historical sociolinguistic processes which have lasted to the present day indicate that the influence of Arabic culture has been neither brief or superficial. Instead, it has, and continues to have great significance for the language situation of Spain. Much linguistic research has shown how loans from Arabic have been assimilated as they have become part of the lexical resources of modern Spanish. Arabic culture and civilization in the Iberian Peninsula (711-1942) above all involved the sciences, literature, art, architecture, engineering, agriculture, the military, medicine. At that time, Al-Andalus was one of the most influential European centers of science and cultural exchange in Europe. Contacts between Arabic and the Romance languages found in the Iberian Peninsula resulted in numerous loans both from Arabic to the Romance languages and from the Romance languages to Arabic. These topics have been the subject of extensive research conducted from historical, cultural and linguistic points of view. Despite the existence of numerous works concerning Arabic loans, this area requires, further, deeper research. In this article, selected issues concerning Arabic loans in Spanish are analyzed as are the adaptive processes they have undergone and the level of their integration into Spanish. The basis of the analysis is made up of oral and written texts collected in the Corpus de Español del Siglo XXI [CORPES XXI, RAE] – a corpus of contemporary Spanish from the 21st century.

Order on Their Home Fronts: Imagining War and Social Control in 1950s NATO

This chapter looks at deliberations about control of the population in NATO’s Civil Defence Committee and the Senior Committee for Civil Emergency Planning, and their roots in modern culture and science. Treating fear emerged as an important part of the modern psychological sciences in the twentieth century. Applied to military medicine with the World Wars, it became its own scientific field. The results were transported to civil defence research, where the question of panic became a feature of the nuclear reality. As maintenance of government control and control of the population became top priorities in the aforementioned committees, visions of the panicked mob came to be its own dystopic image. Underpinned by psychological sciences, a sociotechnical imaginary of preparedness emerged.

Teleophthalmology in the United States Army: A Review From 2004 Through 2018

ABSTRACT Introduction We describe results of the U.S. Army Ocular Teleconsultation program from 2004 through 2018 as well as the current condition, benefits, barriers, and future opportunities for teleophthalmology in the clinical settings and disease areas specific to the U.S. Military. Materials and Methods This was a retrospective, noncomparative, consecutive case series. A total of 653 ocular teleconsultations were reviewed; 76 concerned general policy questions and underwent initial screening to determine the year each request was received, the average and median initial consultant response time, the number of participating consultants, the country from which the request originated, the military status and branch of each U.S. patient for which a request was submitted, and the nationality, age, and military status of foreign patients for whom consults were requested. The remaining 577 requests were further analyzed to determine the diagnostic category of the request, whether or not an evacuation recommendation was provided by a consultant, the relationship of the request to trauma, if and what type of nonocular specialty consultant(s) participated in the consultation request, and if and what type of ancillary imaging accompanied the request. Results The number of requests was 13 in 2004, compared to 80 in 2011 and 11 in 2018. The average response time in 2018 was 2.27 hours compared to 9. 73 hours in 2004. The number of participating ocular specialists was 5 in 2004, compared to 39 in 2013 and 13 in 2018. Requests originating from Iraq and Afghanistan comprised 61.1% (399/653) of requests. The U.S. Army personnel comprised the largest percentage of consults at 38.6% (252/653). Nonmilitary patients from the USA accounted for 18.5% (121/653) of consults. Non-U.S. patients including coalition forces, contractors, detainees, and noncombatants accounted for 14.4% (94/653) of consults, of which 22% (21/94) were children. Anterior segment consults accounted for 45.1% (260/577) of consults, with corneal surface disease being the largest subset within this diagnostic category. Evacuation was recommended in 22.7% (131/577) of overall cases and 41.1% (39/95) of trauma cases. Requests were associated with either combat-related or accidental trauma in 16.5% (95/577) of cases. Dermatology and neurology were the most commonly co-consulted specialties, representing 40.0% (32/80) and 33.75% (27/80) of consults, respectively. Photographs of suspected ocular pathology accompanied 37.4% of consults, with the likelihood requesters included photographs being greatest in cases involving pediatric ophthalmology (7/9, 77.8%) and oculoplastics (86/120, 71.7%). Conclusions Army teleophthalmology has been an indispensable resource in supporting and advancing military medicine, helping to optimize the quality, efficiency, and accessibility of ophthalmic care for U.S. Military personnel, beneficiaries, allied forces, and local nationals worldwide. A dedicated ophthalmic care and coordination system which utilizes new advances in teleconsultation technology could further enhance our current capability to care for the ophthalmic needs of patients abroad, with opportunity for improving domestic care as well.

Military Medical Students’ Perspectives on Medical Education in the COVID-19 Era

ABSTRACT In response to the COVID pandemic, Uniformed Services University (USU) suspended clerkships. As the nation’s military medical school, USU had to keep students safe while still preparing them to be military physicians. In this commentary, we, a group of USU students, explore what this experience taught us about military medicine.

The 100th birth anniversary of Ravil Garifovich Imangulov

October 12, 2021, marks the 100th anniversary of the birth of the Head of the Department of Medical Protection, Head of the Department of Armed Defeat and Protection of the Medical Academy, the Great Patriotic War, Doctor of Medical Sciences, Professor, and Colonel of the Medical Service, Ravil Garifovich Imangulov. For many years, R.G. Imangulov fruitfully worked in the field of military medical science and gone through all formational stages of a scientist and a teacher from an adjunct to the head of the department and professor-consultant of the Academic Council of the Military Medical Academy. During his service at the Military Medical Academy, Professor R.G. Imangulov took an active part in testing weapons of mass destruction and special field experimental studies in various regions of the country, aimed at the practical implementation of the latest achievements in the field of medical and technical means of anti-chemical and anti-radiation protection. For a long time, under his leadership and with his direct participation, fundamental research was carried out on the fundamentals of medical protection of troops and population from mass destruction weapons. His achievements in the field of medical protection against mass destruction weapons, both educational and scientific and practical disciplines, are of great importance for Russian military medicine. His fruitful years of activity did not only result in monographs, textbooks, teaching aids, scientific reports, and articles, but also the adaptation of official normative documents for the military personnel protection from mass destruction weapons, technical and medical means of individual, and collective protection.