Stress, mental health, and cognition: a brief review of relationships and countermeasures.

Today's network-centric battlefield environment is highly stressful and cognitively demanding. Many warfighters are feeling overwhelmed and end up being medically evacuated from theater due to mental health problems [i.e., post traumatic stress disorder (PTSD) and depression]. Of a sample of troops evacuated for psychiatric reasons, 21% (106 out of 509) had psychiatric histories prior to deploying to the theater of operations. Most cases were either related to stress (i.e., PTSD, n - 33, 310%) or to depression (n = 72, 66%). Stress disorders and depression predominate among the psychiatric causes for medical evacuation. This review paper discusses stress theories as they pertain to warfighting, the types of stress and stress disorders most prevalent on modern battlefields, the relationships among stress, psychiatric disease, and cognitive performance, and potential methods to decrease some types of stress-related acute and chronic disorders (i.e., virtual-reality stress inoculation training).

The future of military medicine has not arrived yet, but we can see it from here.

Throughout history, military medical personnel have provided care for their comrades in arms, often at the expense of their own lives. For many centuries, these medical personnel have applied the highest available level of knowledge and technology to the care of their patients. This paper discusses the current state of the technological art for the care of combat casualties, and discusses some of the newest technology solutions currently being developed for the provision of field medical care. The ongoing efforts of the Defense Advanced Research Projects Agency (DARPA), the U.S. Army Medical Research and Materiel Command (MRMC), and the U.S. Army Telemedicine and Advanced Technology Research Center (TATRC) are highlighted.

Effective countermeasure against poisoning by organophosphorus insecticides and nerve agents.

The nerve agents soman, sarin, VX, and tabun are deadly organophosphorus (OP) compounds chemically related to OP insecticides. Most of their acute toxicity results from the irreversible inhibition of acetylcholinesterase (AChE), the enzyme that inactivates the neurotransmitter acetylcholine. The limitations of available therapies against OP poisoning are well recognized, and more effective antidotes are needed. Here, we demonstrate that galantamine, a reversible and centrally acting AChE inhibitor approved for treatment of mild to moderate Alzheimer's disease, protects guinea pigs from the acute toxicity of lethal doses of the nerve agents soman and sarin, and of paraoxon, the active metabolite of the insecticide parathion. In combination with atropine, a single dose of galantamine administered before or soon after acute exposure to lethal doses of soman, sarin, or paraoxon effectively and safely counteracted their toxicity. Doses of galantamine needed to protect guinea pigs fully against the lethality of OPs were well tolerated. In preventing the lethality of nerve agents, galantamine was far more effective than pyridostigmine, a peripherally acting AChE inhibitor, and it was less toxic than huperzine, a centrally acting AChE inhibitor. Thus, a galantamine-based therapy emerges as an effective and safe countermeasure against OP poisoning.