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1.
Nat Commun ; 15(1): 2716, 2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38548759

RESUMEN

Neural stem and progenitor cell (NSPC) maintenance is essential for ensuring that organisms are born with proper brain volumes and head sizes. Microcephaly is a disorder in which babies are born with significantly smaller head sizes and cortical volumes. Mutations in subunits of the DNA organizing complex condensin have been identified in microcephaly patients. However, the molecular mechanisms by which condensin insufficiency causes microcephaly remain elusive. We previously identified conserved roles for condensins in repression of retrotransposable elements (RTEs). Here, we show that condensin subunit knockdown in NSPCs of the Drosophila larval central brain increases RTE expression and mobility which causes cell death, and significantly decreases adult head sizes and brain volumes. These findings suggest that unrestricted RTE expression and activity may lead to improper brain development in condensin insufficient organisms, and lay the foundation for future exploration of causative roles for RTEs in other microcephaly models.


Asunto(s)
Adenosina Trifosfatasas , Drosophila melanogaster , Microcefalia , Complejos Multiproteicos , Animales , Humanos , Drosophila melanogaster/genética , Drosophila melanogaster/metabolismo , Microcefalia/genética , Proteínas de Unión al ADN/metabolismo , Drosophila/genética , Encéfalo/metabolismo
2.
medRxiv ; 2022 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-36597524

RESUMEN

We have conducted a study of the COVID-19 severity with the chest x-ray images, a private dataset collected from our collaborator St Bernards Medical Center. The dataset is comprised of chest x-ray images from 1,550 patients who were admitted to emergency room (ER) and were all tested positive for COVID-19. Our study is focused on the following two questions: (1) To predict patients hospital staying duration, based on the chest x-ray image which was taken when the patient was admitted to the ER. The length of stay ranged from zero hours to 95 days in the hospital and followed a power law distribution. Based on our testing results, it is hard for the prediction models to detect strong signal from the chest x-ray images. No model was able to perform better than a trivial most-frequent classifier. However, each model was able to outperform the most-frequent classifier when the data was split evenly into four categories. This would suggest that there is signal in the images, and the performance may be further improved by the addition of clinical features as well as increasing the training set. (2) To predict if a patient is COVID-19 positive or not with the chest x-ray image. We also tested the generalizability of training a prediction model on chest x-ray images from one hospital and then testing the model on images captures from other sites. With our private dataset and the COVIDx dataset, the prediction model can achieve a high accuracy of 95.9%. However, for our hold-one-out study of the generalizability of the models trained on chest x-rays, we found that the model performance suffers due to a significant reduction in training samples of any class.

3.
BMC Public Health ; 11: 69, 2011 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-21281496

RESUMEN

BACKGROUND: Combat-intense, lengthy, and multiple deployments in Iraq and Afghanistan have characterized the new millennium. The US military's all-volunteer force has never been better trained and technologically equipped to engage enemy combatants in multiple theaters of operations. Nonetheless, concerns over potential lasting effects of deployment on long-term health continue to mount and are yet to be elucidated. This report outlines how findings from the first 7 years of the Millennium Cohort Study have helped to address health concerns related to military service including deployments. METHODS: The Millennium Cohort Study was designed in the late 1990s to address veteran and public concerns for the first time using prospectively collected health and behavioral data. RESULTS: Over 150,000 active-duty, reserve, and National Guard personnel from all service branches have enrolled, and more than 70% of the first 2 enrollment panels submitted at least 1 follow-up survey. Approximately half of the Cohort has deployed in support of operations in Iraq and Afghanistan. CONCLUSION: The Millennium Cohort Study is providing prospective data that will guide public health policymakers for years to come by exploring associations between military exposures and important health outcomes. Strategic studies aim to identify, reduce, and prevent adverse health outcomes that may be associated with military service, including those related to deployment.


Asunto(s)
Estado de Salud , Personal Militar , Estudios de Cohortes , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Estudios Prospectivos , Estados Unidos
4.
Appl Biosaf ; 26(4): 179-192, 2021 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36034096

RESUMEN

Introduction: We previously reported on the United States' regulatory environment evolving to accommodate an emerging boom in gene therapy research. Several important developments have transpired in the 2 years since that article was published, including the coronavirus disease 2019 (COVID-19) pandemic and the drive for large-scale testing of vaccines containing recombinant or synthetic nucleic acid molecules. This report highlights key developments in the field with a focus on biosafety and issues of note to biosafety professionals with responsibilities over clinical research. Discussion: We provide guidance for performing risk assessments on the currently approved gene therapy products as well as the most utilized types of investigational products in clinical trials. Areas of focus include the prominent approaches utilized in the three major areas of research: oncology, infectious diseases, and rare diseases. Conclusion: The COVID-19 pandemic has created several opportunities for continued growth in gene therapy. National vaccination campaigns will result in greater public acceptance of gene therapy research. Technological advancements that made the vaccine race possible will spur the next generation of research. Advancements born in the developed world set the stage for the creation of therapeutics to treat greater numbers in the developing world and have the potential for massive benefits to global public health. Biosafety professionals and Institutional Biosafety Committees play key roles in contributing to the safe evidence-based advancement of gene therapy research. Biosafety professionals responsible for clinical research oversight must be aware of emerging technologies and their associated risks to support the safe and ethical conduct of research.

5.
J Clin Epidemiol ; 60(2): 192-201, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17208126

RESUMEN

OBJECTIVES: The 12-month prevalence of common mental illnesses in the United States is estimated to be 26%, accounting for an increasing fraction of all disability in the general population. The U.S. military is a unique group involved in response and defense during times of conflicts and disasters. The mental health of service members affects organizational productivity and effectiveness and is of great importance to the health of U.S. military members and public health in general. STUDY DESIGN AND SETTING: In the present report, the authors describe the baseline prevalence of mental disorders in a large U.S. military cohort, the Millennium Cohort, established for a 22-year longitudinal study of the health effects of military service. Using crude and weighted prevalence and multivariable logistic regression, the mental health morbidity of the Millennium Cohort is reported for various demographics. RESULTS: These analyses suggest that although the cohort compares favorably to other populations, there are military subpopulations, including women, younger, less educated, single, white, short-term service, enlisted, and Army members, who are at greater odds for some mental disorders. CONCLUSION: With ongoing U.S. involvement in combat operations around the world, these baseline data are essential to assessing long-term mental health morbidity in U.S. military service members.


Asunto(s)
Trastornos Mentales/epidemiología , Personal Militar , Psiquiatría Militar , Adolescente , Adulto , Estudios de Cohortes , Factores de Confusión Epidemiológicos , Femenino , Indicadores de Salud , Humanos , Modelos Logísticos , Masculino , Morbilidad , Prevalencia , Estados Unidos , Veteranos
6.
J Clin Epidemiol ; 60(2): 181-91, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17208125

RESUMEN

OBJECTIVE: In response to health concerns of military members about deployment and other service-related exposures, the Department of Defense (DoD) initiated the largest prospective study ever undertaken in the U.S. military. STUDY DESIGN AND SETTING: The Millennium Cohort uses a phased enrollment strategy to eventually include more than 100,000 U.S. service members who will be followed up through the year 2022, even after leaving military service. Subjects will be linked to DoD and Veterans Affairs databases and surveyed every 3 years to obtain objective and self-reported data on exposures and health outcomes. RESULTS: The first enrollment phase was completed in July 2003 and resulted in 77,047 consenting participants, well representative of both active-duty and Reserve/Guard forces. This report documents the baseline characteristics of these Cohort members, describes traditional, postal, and Web-based enrollment methods; and describes the unique challenges of enrolling, retaining, and following such a large Cohort. CONCLUSION: The Millennium Cohort was successfully launched and is becoming especially relevant, given current deployment and exposure concerns. The Cohort is representative of the U.S. military and promises to provide new insight into the long-term effects of military occupations on health for years to come.


Asunto(s)
Estado de Salud , Medicina Militar , Personal Militar , Selección de Paciente , Adolescente , Adulto , Estudios de Cohortes , Costos y Análisis de Costo , Femenino , Grupos Focales , Humanos , Internet , Masculino , Proyectos Piloto , Control de Calidad , Encuestas y Cuestionarios , Estados Unidos , Veteranos
7.
BMC Public Health ; 7: 340, 2007 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-18039387

RESUMEN

BACKGROUND: The US military is currently involved in large, lengthy, and complex combat operations around the world. Effective military operations require optimal health of deployed service members, and both mental and physical health can be affected by military operations. METHODS: Baseline data were collected from 77,047 US service members during 2001-2003 as part of a large, longitudinal, population-based military health study (the Millennium Cohort Study). The authors calculated unadjusted, adjusted, and weighted means for the Medical Outcomes Study Short Form 36-item Survey for Veterans physical (PCS) and mental component summary (MCS) scores over a variety of demographic and military characteristics at baseline. RESULTS: The unadjusted mean PCS and MCS scores for this study were 53.4 (95% confidence interval: 53.3-53.4) and 52.8 (95% confidence interval: 52.7-52.9). Average PCS and MCS scores were slightly more favorable in this military sample compared to those of the US general population of the same age and sex. Factors independently associated with more favorable health status included male gender, being married, higher educational attainment, higher military rank, and Air Force service. Combat specialists had similar health status compared to other military occupations. Having been deployed to Southwest Asia, Bosnia, or Kosovo between 1998 and 2000 was not associated with diminished health status. CONCLUSION: The baseline health status of this large population-based military cohort is better than that of the US general population of the same age and sex distribution over the same time period, especially in older age groups. Deployment experiences during the period of 1998-2001 were not associated with decreased health status. These data will serve as a useful reference for other military health studies and for future longitudinal analyses.


Asunto(s)
Indicadores de Salud , Salud Mental , Personal Militar/estadística & datos numéricos , Aptitud Física , Veteranos/estadística & datos numéricos , Adulto , Factores de Edad , Estudios de Cohortes , Intervalos de Confianza , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Personal Militar/clasificación , Personal Militar/psicología , Psicometría , Factores Sexuales , Factores Socioeconómicos , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Veteranos/psicología , Guerra
8.
BMC Complement Altern Med ; 7: 16, 2007 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-17506899

RESUMEN

BACKGROUND: Recently, numerous studies have revealed an increase in complementary and alternative medicine (CAM) use in US civilian populations. In contrast, few studies have examined CAM use within military populations, which have ready access to conventional medicine. Currently, the prevalence and impact of CAM use in US military populations remains unknown. METHODS: To investigate CAM use in US Navy and Marine Corps personnel, the authors surveyed a stratified random sample of 5,000 active duty and Reserve/National Guard members between December 2000 and July 2002. Chi-square tests and multivariable logistic regression were used to assess univariate associations and adjusted odds of CAM use in this population. RESULTS AND DISCUSSION: Of 3,683 service members contacted, 1,446 (39.3%) returned a questionnaire and 1,305 gave complete demographic and survey data suitable for study. Among respondents, more than 37% reported using at least one CAM therapy during the past year. Herbal therapies were among the most commonly reported (15.9%). Most respondents (69.8%) reported their health as being very good or excellent. Modeling revealed that CAM use was most common among personnel who were women, white, and officers. Higher levels of recent physical pain and lower levels of satisfaction with conventional medical care were significantly associated with increased odds of reporting CAM use. CONCLUSION: These data suggest that CAM use is prevalent in the US military and consistent with patterns in other US civilian populations. Because there is much to be learned about CAM use along with allopathic therapy, US military medical professionals should record CAM therapies when collecting medical history data.


Asunto(s)
Actitud Frente a la Salud , Terapias Complementarias/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Personal Militar/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Distribución de Chi-Cuadrado , Femenino , Conductas Relacionadas con la Salud , Encuestas de Atención de la Salud , Humanos , Modelos Logísticos , Masculino , Anamnesis/estadística & datos numéricos , Estados Unidos/epidemiología
9.
J Am Coll Cardiol ; 44(1): 201-5, 2004 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-15234435

RESUMEN

OBJECTIVES: The purpose of this study was to assess the follow-up of patients with vaccinia-associated myocarditis. BACKGROUND: With the threat of biological warfare, the U.S. Department of Defense resumed a program for widespread smallpox vaccinations on December 13, 2002. One-year afterwards, there has been a significant increase in the occurrence of myocarditis and pericarditis among those vaccinated. METHODS: Cases were identified through sentinel reporting to military headquarters, systematic surveillance, and spontaneous reports. RESULTS: A total of 540,824 military personnel were vaccinated with a New York City Board of Health strain of vaccinia from December 2002 through December 2003. Of these, 67 developed myopericarditis at 10.4 +/- 3.6 days after vaccination. The ST-segment elevation was noted in 57%, mean troponin on admission was 11.3+/- 22.7 ng/dl, and peak cardiac enzymes were noted within 8 h of presentation. On follow-up of 64 patients (96%) at a mean of 32 +/- 16 weeks, all patients had objective normalization of echocardiography, electrocardiography, laboratory testing, graded exercise testing, and functional status; 8 (13%) reported atypical, non-limiting persistent chest discomfort. CONCLUSIONS: Post-vaccinial myopericarditis should be considered in patients with chest pain within 30 days after smallpox vaccination. Normalization of echocardiography, electrocardiography, and treadmill testing is expected, and nearly all patients have resolution of chest pain on follow-up.


Asunto(s)
Miocarditis/inducido químicamente , Vacuna contra Viruela/efectos adversos , Biomarcadores/sangre , Creatina Quinasa/sangre , Sistema de Conducción Cardíaco/fisiopatología , Humanos , Incidencia , Miocarditis/diagnóstico , Miocarditis/epidemiología , Miocarditis/fisiopatología , Pericarditis/inducido químicamente , Pericarditis/diagnóstico , Pericarditis/epidemiología , Troponina I/sangre , Troponina T/sangre , Presión Ventricular/fisiología
10.
Clin Infect Dis ; 34(Suppl 5): S208-14, 2002 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-12019466

RESUMEN

Four weeks after the terrorist attacks on the World Trade Center and the Pentagon, US combat troops began bombing missions over Afghanistan in Operation Enduring Freedom. Additional Reserve and National Guard personnel were called to active duty to support the war effort and to ensure security throughout the United States. All of these troops will require health care and assistance during and after this war on terrorism. They will benefit from recent federal legislation that has increased access to health care and from the changes implemented by the Departments of Defense and Veterans Affairs since the Gulf War. An innovative Defense Department "Force Health Protection" strategy places greater emphasis on helping service members and families stay healthy and fit and on preventing injury and illness. The two agencies also have developed new post-deployment clinical practice guidelines, established deployment research centers, and made further improvements in preventive medicine, health surveillance, and risk communication and are thus better prepared for this newest generation of war veterans.


Asunto(s)
Medicina Militar , Afganistán , Atención a la Salud/economía , Atención a la Salud/tendencias , Humanos , Medio Oriente , Medicina Militar/economía , Medicina Militar/tendencias , Medición de Riesgo , Veteranos , Guerra
11.
J Occup Environ Med ; 46(8): 775-82, 2004 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-15300128

RESUMEN

There is much concern over the potential for short- and long-term adverse mental health effects caused by the terrorist attacks on September 11, 2001. This analysis used data from the Millennium Cohort Study to identify subgroups of US military members who enrolled in the cohort and reported their mental health status before the traumatic events of September 11 and soon after September 11. While adjusting for confounding, multivariable logistic regression, analysis of variance, and multivariate ordinal, or polychotomous logistic regression were used to compare 18 self-reported mental health measures in US military members who enrolled in the cohort before September 11, 2001 with those military personnel who enrolled after September 11, 2001. In contrast to studies of other populations, military respondents reported fewer mental health problems in the months immediately after September 11, 2001.


Asunto(s)
Salud Mental , Personal Militar , Terrorismo , Adolescente , Adulto , Consumo de Bebidas Alcohólicas , Femenino , Indicadores de Salud , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estados Unidos
12.
Adv Psychosom Med ; 25: 102-22, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15248370

RESUMEN

In the 1991 Gulf War less than 150 of nearly 700,000 deployed US troops were killed in action. Today, however, over 1 in 7 US veterans of the war has sought federal healthcare for related-health concerns, and fully 17% of UK Gulf War veterans describe themselves as suffering from the 'Gulf War syndrome', a set of poorly defined and heterogeneous ailments consisting mainly of chronic pain, fatigue, depression and other symptoms. Even though over 250 million dollars of federally funded medical research has failed to identify a unique syndrome, the debate regarding potential causes continues and has included oil well smoke, contagious infections, exposure to chemical and biological warfare agents, and posttraumatic stress disorder. Historical analyses completed since the Gulf War have found that postwar syndromes consisting of chronic pain, fatigue, depression and other symptoms have occurred after every war in the 20th century. These syndromes have gone by a variety of names such as Da Costa's syndrome, irritable heart, shell shock, neurocirculatory asthenia, and battle fatigue. Though the direct causes of these syndromes are typically elusive, it is clear that war sets in motion an undeniable cycle of physical, emotional, and fiscal consequences for war veterans and for society. These findings lead to important healthcare questions. Is there a way to prevent or mitigate subsequent postwar symptoms and associated depression and disability? We argue that while idiopathic symptoms are certain to occur following any war, a population-based approach to postwar healthcare can mitigate the impact of postwar syndromes and foster societal, military, and veteran trust. This article delineates the model, describes its epidemiological foundations, and details examples of how it is being adopted and improved as part of the system of care for US military personnel, war veterans and families. A scientific test of the model's overall effectiveness is difficult, yet healthcare systems for combatants and their families are already being put to pragmatic tests as troops return from war in Iraq and Afghanistan and from other military challenges.


Asunto(s)
Fatiga/terapia , Manejo del Dolor , Síndrome del Golfo Pérsico/psicología , Trastornos por Estrés Postraumático/prevención & control , Enfermedad Crónica , Evaluación de la Discapacidad , Fatiga/diagnóstico , Fatiga/epidemiología , Humanos , Dolor/diagnóstico , Dolor/epidemiología , Aceptación de la Atención de Salud , Síndrome del Golfo Pérsico/epidemiología , Vigilancia de la Población/métodos , Terrorismo/psicología , Factores de Tiempo , Veteranos/psicología
13.
JAMA ; 289(24): 3283-9, 2003 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-12824210

RESUMEN

CONTEXT: In the United States, the annual incidence of myocarditis is estimated at 1 to 10 per 100,000 population. As many as 1% to 5% of patients with acute viral infections involve the myocardium. Although many viruses have been reported to cause myopericarditis, it has been a rare or unrecognized event after vaccination with the currently used strain of vaccinia virus (New York City Board of Health). OBJECTIVE: To describe a series of probable cases of myopericarditis following smallpox vaccination among US military service members reported since the reintroduction of vaccinia vaccine. DESIGN, SETTING, PARTICIPANTS: Surveillance case definitions are presented. The cases were identified either through sentinel reporting to US military headquarters surveillance using the Defense Medical Surveillance System or reports to the Vaccine Adverse Event Reporting System using International Classification of Diseases, Ninth Revision. The cases occurred among individuals vaccinated from mid-December 2002 to March 14, 2003. MAIN OUTCOME MEASURE: Elevated serum levels of creatine kinase (MB isoenzyme), troponin I, and troponin T, usually in the presence of ST-segment elevation on electrocardiogram and wall motion abnormalities on echocardiogram. RESULTS: Among 230,734 primary vaccinees, 18 cases of probable myopericarditis after smallpox vaccination were reported (an incidence of 7.8 per 100,000 over 30 days). No cases of myopericarditis following smallpox vaccination were reported among 95,622 vaccinees who were previously vaccinated. All cases were white men aged 21 years to 33 years (mean age, 26.5 years), who presented with acute myopericarditis 7 to 19 days following vaccination. A causal relationship is supported by the close temporal clustering (7-19 days; mean, 10.5 days following vaccination), wide geographic and temporal distribution, occurrence in only primary vaccinees, and lack of evidence for alternative etiologies or other diseases associated with myopericarditis. Additional supporting evidence is the observation that the observed rate of myopericarditis among primary vaccinees is 3.6-fold (95% confidence interval, 3.33-4.11) higher than the expected rate among personnel who were not vaccinated. The background incidence of myopericarditis did not show statistical significance when stratified by age (20-34 years: 2.18 expected cases per 100,000; 95% confidence interval [CI], 1.90-2.34), race (whites: 1.82 per 100,000; 95% CI, 1.50-2.01), and sex (males: 2.28 per 100,000; 95% CI, 2.04-2.54). CONCLUSION: Among US military personnel vaccinated against smallpox, myopericarditis occurred at a rate of 1 per 12 819 primary vaccinees. Myopericarditis should be considered an expected adverse event associated with smallpox vaccination. Clinicians should consider myopericarditis in the differential diagnosis of patients presenting with chest pain 4 to 30 days following smallpox vaccination and be aware of the implications as well as the need to report this potential adverse advent.


Asunto(s)
Personal Militar , Miocarditis/etiología , Pericarditis/etiología , Vacuna contra Viruela/efectos adversos , Vacunación/efectos adversos , Adulto , Sistemas de Registro de Reacción Adversa a Medicamentos , Angina de Pecho/diagnóstico , Biopsia , Diagnóstico Diferencial , Humanos , Programas de Inmunización , Masculino , Miocarditis/diagnóstico , Miocarditis/epidemiología , Miocarditis/virología , Pericarditis/diagnóstico , Pericarditis/epidemiología , Pericarditis/virología , Estados Unidos/epidemiología , Vacunación/estadística & datos numéricos , Virus Vaccinia/aislamiento & purificación
14.
Mil Med ; 167(3): 179-85, 2002 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11901562

RESUMEN

The Department of Defense has applied lessons learned since the Persian Gulf War to develop the force health protection (FHP) strategy. The goal of this new, unified strategy is to protect the health of military members from medical and environmental hazards associated with military service to the maximum extent possible. FHP is an evolving strategy that seeks to balance the military health system's responsibilities to promote and sustain health and wellness throughout each person's military service; prevent acute and chronic illnesses and injuries during training and deployment; and rapidly stabilize, treat, and evacuate casualties. In addition, FHP demands a continuous assessment of the current and future health of military members through medical surveillance, longitudinal health studies, adequate medical record documentation, and clinical follow-up. Effective communication with military members, leaders, veterans, families, and the public regarding military members' health status and the health risks of military service is a key element of the FHP strategy.


Asunto(s)
Medicina Militar , Tratamiento de Urgencia , Política de Salud , Servicios de Salud , Humanos , Personal Militar , Prevención Primaria , Estados Unidos
15.
Mil Med ; 168(8): 606-13, 2003 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12943034

RESUMEN

It is unlikely that Gulf War veterans are suffering chronic effects from illnesses caused by chemical warfare nerve agent exposure. Extensive investigation and review by several expert panels have determined that no evidence exists that chemical warfare nerve agents were used during the Gulf War. At no time before, during, or after the war was there confirmation of symptoms among anyone, military or civilian, caused by chemical warfare nerve agent exposure. However, studies of Gulf War veterans have found belief that chemical weapons were used, significantly associated with both severe and mild-moderate illnesses. The psychological impact of a chemical warfare attack, either actual or perceived, can result in immediate and long-term health consequences. The deployment or war-related health impact from life-threatening experiences of the Gulf War, including the perceived exposure to chemical warfare agents, should be considered as an important cause of morbidity among Gulf War veterans.


Asunto(s)
Guerra Química/psicología , Personal Militar , Trastornos por Estrés Postraumático/psicología , Guerra , Sustancias para la Guerra Química/efectos adversos , Humanos , Irak , Masculino , Sarín/efectos adversos , Trastornos por Estrés Postraumático/epidemiología , Estados Unidos/epidemiología
16.
Mil Med ; 167(6): 483-8, 2002 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12099084

RESUMEN

Does military service, in particular operational deployment, result in a higher risk of chronic illness among military personnel and veterans? The Millennium Cohort Study, the largest Department of Defense prospective cohort study ever conducted, will attempt to answer this question. The probability-based sample of 140,000 military personnel will be surveyed every 3 years during a 21-year period. The first questionnaire, scheduled for release in summer 2001, will be sent to 30,000 veterans who have been deployed to southwest Asia, Bosnia, or Kosovo since August 1997 and 70,000 veterans who have not been deployed to these conflict areas. Twenty thousand new participants will be added to the group in each of the years 2004 and 2007 to complete the study population of 140,000. The participants will have the option of completing the study questionnaire either on the paper copy received in the mail or through the World Wide Web-based version, which is available at www.MillenniumCohort.org. This will be one of the first prospective studies ever to offer such an option. The initial survey instrument will collect data regarding demographic characteristics, self-reported medical conditions and symptoms, and health-related behaviors. Validated instruments will be incorporated to capture self-assessed physical and mental functional status (Short Form for Veterans), psychosocial assessment (Patient Health Questionnaire), and post-traumatic stress disorder (Patient Checklist-17). Information obtained from the survey responses will be linked with other military databases, including data on deployment, occupation, vaccinations, health care utilization, and disability. In addition to revealing changes in veterans' health status over time, the Millennium Cohort Study will serve as a data repository, providing a solid foundation upon which additional epidemiological studies may be constructed.


Asunto(s)
Enfermedad Crónica/epidemiología , Estado de Salud , Personal Militar/estadística & datos numéricos , Estudios de Cohortes , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Estudios Prospectivos , Investigación , Factores de Riesgo , Estados Unidos/epidemiología , Veteranos
17.
Mil Med ; 167(1): 44-7, 2002 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11799812

RESUMEN

Pilot testing has begun on the Recruit Assessment Program (RAP). The RAP is a proposed Department of Defense (DoD) program for the routine collection of baseline demographic, medical, psychosocial, occupational, and health risk factor data from all U.S. military personnel at entry into the armed forces. The RAP currently uses an optically scannable paper questionnaire, which will provide data for the first building block of an electronic medical record within the DoD and the Department of Veterans Affairs. The RAP will serve several important functions, including automating enrollment into the military health care system, improving patient care and preventive medicine efforts, and providing critical data for investigations of health problems among military personnel and veterans. If the feasibility of the RAP is demonstrated and the program is fully implemented throughout the DoD, it could provide a substantial improvement in health care delivery. For the first time, DoD and Department of Veterans Affairs physicians, public health officers, and researchers will have access to comprehensive baseline health status data.


Asunto(s)
Encuestas Epidemiológicas , Sistemas de Registros Médicos Computarizados , Personal Militar/estadística & datos numéricos , Estudios de Factibilidad , Humanos , Estados Unidos
19.
Am J Epidemiol ; 160(7): 642-51, 2004 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-15383408

RESUMEN

Myopericarditis has been a rare or unrecognized event after smallpox vaccinations with the New York City Board of Health strain of vaccinia virus (Dryvax; Wyeth Laboratories, Marietta, Pennsylvania). In this article, the authors report an attributable incidence of at least 140 clinical cases of myopericarditis per million primary smallpox vaccinations with this strain of vaccinia virus. Fifty-eight males and one female aged 21-43 years with confirmed or probable acute myopericarditis were detected following vaccination of 492,730 US Armed Forces personnel from December 15, 2002, through September 30, 2003. The cases were identified through sentinel reporting to military headquarters, active surveillance using the Defense Medical Surveillance System, or reports to the Vaccine Adverse Event Reporting System. The observed incidence (16.11/100,000) of myopericarditis over a 30-day observation window among 347,516 primary vaccinees was nearly 7.5-fold higher than the expected rate of 2.16/100,000 (95% confidence interval: 1.90, 2.34) among nonvaccinated, active-duty military personnel, while the incidence of 2.07/100,000 among 145,155 revaccinees was not statistically different from the expected background rate. The cases were predominantly male (58/59; 98.3%) and White (51/59; 86.4%), both statistically significant associations (p = 0.0147 and p = 0.05, respectively).


Asunto(s)
Personal Militar , Pericarditis/epidemiología , Pericarditis/etiología , Vacuna contra Viruela/efectos adversos , Enfermedad Aguda , Adulto , Sistemas de Registro de Reacción Adversa a Medicamentos/estadística & datos numéricos , Femenino , Humanos , Incidencia , Masculino , Vigilancia de la Población , Factores Sexuales
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