Untreated low back pain (LBP) in older adults can lead to disability and development of chronicity. Due the potential medical comorbidities negative risks associated with pharmacological use, chronic LBP management for requires a responsive approach. The objective this study is evaluate probability (1) opioid prescription receipt (2) opioid-sedative coprescription, sample military-service-connected patients enrolled Veterans Health Administration (VHA) or TRICARE, ages 30-85 years, receiving...

ABSTRACT Introduction Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become increasingly prevalent and the potential to delay gastric emptying. The American Society of Anesthesiologists (ASA) released guidance regarding perioperative management patients receiving GLP-1 RAs, but it is unclear extent which hospitals in U.S. Military Health System implemented policies consistent with this guidance. Methods A questionnaire was sent active duty anesthesiologists Certified Registered...

Abstract As healthcare systems adopt data-driven methods to determine resource allocation for treating low back pain (LBP), it is critical evaluate equity in time-to-follow-up care after an index visit and long-term occupational outcomes. This retrospective observational study included medical records of 525,252 active duty US service members who received LBP diagnosis from June 2016 February 2022. Poisson generalized additive models evaluated time-to-LBP follow-up (primary outcome)...

Post traumatic stress disorder (PTSD) symptoms are common in military service members (SMs), but stigma can impede treatment initiation. Smartphone applications (apps) available anywhere, anytime, with the potential to both mitigate impact of and reduce PTSD symptom severity. We provided 144 SMs or family members, subthreshold (PTSD Checklist [PCL] scores 28-49), apps promoting psychoeducation, social engagement, relaxation randomized them 6 weeks resilience enhancement (brief...

The goal was to evaluate institutional inequities in the US Military Health System knee arthroplasty receipt within three years of osteoarthritis diagnosis when accounting for other treatments received (eg, physical therapy, medications).

The management of postoperative pain is a major health care issue. While the cost intravenous acetaminophen (IVA) significantly greater than its oral (OA) counterpart, less known regarding comparative effectiveness these routes. purpose this study was to determine whether perioperative IVA equivalent in reducing compared with OA for laparoscopic cholecystectomy (LapChole).Double-blinded, prospective, randomized placebo-controlled trial.Womack Army Medical Center, Fort Bragg, North...

BACKGROUND: Ketamine is routinely used within the context of combat casualty care. Despite early concerns that ketamine administration may be associated with elevated risk posttraumatic stress disorder (PTSD), more recent evidence suggests no relationship. Because PTSD occurs regular frequency in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Service Members (SMs) and combat-related injuries are higher likelihood PTSD, it important to investigate relationship between exposure...

ABSTRACT Introduction Tonsillectomy ranks high among the most common pediatric surgical procedures in United States. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are routinely prescribed to manage post-tonsillectomy pain, but may carry risk of hemorrhage. Materials and Methods This retrospective, longitudinal, secondary-data analysis study compared incidence surgically managed hemorrhage (sPTH) patients ibuprofen at Brooke Army Medical Center (BAMC) after tonsillectomy...

Women at risk for breast cancer report elevated psychological distress, which has been adversely associated with cancer-relevant behaviors and biology.

Postsurgical follow-up calls enable nurses to assess a patient's condition, provide tailored education, and improve the experience. Despite benefits, barriers phone-based assessments may include patient nonresponse lack of time due demanding clinical schedules. The purpose this trial was examine feasibility utility smartphone app, mCare, for assessing pain, pain impact, peripheral nerve block effects in patients.Pilot randomized control trial.Eligible patients at military treatment facility...

Hyponatremia and hypernatremia, as conventionally defined (<135 mEq/L >145 mEq/L, respectively), are associated with increased perioperative morbidity mortality. However, the effects of subtle deviations in serum sodium concentration within normal range not well-characterized.The purpose this analysis is to determine association between borderline hyponatremia (135-137 mEq/L) hypernatremia (143-145 on mortality.A retrospective cohort study was performed using data from American College...

Introduction Parenting has been shown to affect smoking among children in U.S. majority groups, but less is known about this association multiethnic urban populations. Our study examines the role of parenting on a highly diverse sample. Methods Health surveys were collected from eighth graders (N =459) 2 low-income schools. Structural equation models examined direct and indirect effects authoritative lifetime smoking. A moderated mediation analysis whether vary racial/ethnic groups. Results...

The objective of this study was to determine whether physical performance during virtual environment (VE) tasks in the Computer-Assisted Rehabilitation Environment (CAREN) could differentiate between service members (SMs) with a history traumatic brain injury (TBI) and without comorbid post-traumatic stress disorder (PTSD). Data were obtained by independent review clinical notes, outcomes, validated questionnaires from 214 SMs (208 males) TBI assessed CAREN 2010 2015. Three preliminary VEs...

Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even those without a clinical diagnosis. The variability outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend have elevated basal levels, though less is known regarding responses trauma-related stimuli. We assessed whether virtual combat environment impact the relationship between symptom clusters and elements of functioning. Eighty-seven...

This study examined the relationships between symptom domains relevant to post-traumatic stress disorder (PTSD) diagnosis, PTSD screening, and chronic pain-related symptoms (pain intensity, pain interference, physical function, fatigue, depression, anxiety, anger, satisfaction with social roles) experienced by active duty military service members pain.ross-sectional study.This was conducted at Interdisciplinary Pain Management Center (IPMC) Madigan Army Medical 2014 2018.Active receiving...

Abstract Background Ongoing postoperative pain assessments are vital to optimizing management and attenuating the development of poor health outcomes after surgery. This study aimed characterize acute multidimensional trajectories impact on physical function, sleep, mood, stress examine clinical characteristics demographics associated with trajectory membership. Additionally, this compared levels intensity prescription opioid use at 2 weeks 1 month postoperatively across symptom...

The present pilot study hypothesized that degree of exposure to prenatal testosterone interacts with a history lifetime physical abuse (LPA) predict the cognitive (anger rumination) and behavioral (intimate partner interpersonal violence) components aggression within incarcerated methamphetamine (MA) users. In addition, we LPA flexibility (Stroop Color‐Word performance). Male inmate MA users (N = 60) completed neuropsychological paper/pencil tests. Hand photocopies were also obtained index...