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The Military Health System (MHS) is an interconnected network of Service Members whose mission is to support the lives and families of those who support our country. Everyday in the MHS advancements are made in the lab, in the field, and here at home. These are just a few articles highlighting those accomplishments that don't always make it to the front page of local papers.

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Update: Exertional Rhabdomyolysis, Active Component, U.S. Armed Forces, 2014–2018

Article
4/1/2019
U.S. Marines sprint uphill during a field training exercise at Marine Corps Air Station Miramar, California. to maintain contact with an aviation combat element, teaching and sustaining their proficiency in setting up and maintaining communication equipment.  (Photo Courtesy: U.S. Marine Corps)

Among active component service members in 2018, there were 545 incident diagnoses of rhabdomyolysis likely due to exertional rhabdomyolysis, for an unadjusted incidence rate of 42.0 cases per 100,000 person-years. Subgroup-specific rates in 2018 were highest among males, those less than 20 years old, Asian/Pacific Islander service members, Marine Corps and Army members, and those in combat-specific or “other/unknown” occupations. During 2014–2018, crude rates of exertional rhabdomyolysis increased steadily from 2014 through 2016 after which rates declined slightly in 2017 before increasing again in 2018. Compared to service members in other race/ethnicity groups, the overall rate of exertional rhabdomyolysis was highest among non-Hispanic blacks in every year except 2018. Overall and annual rates were highest among Marine Corps members, intermediate among those in the Army, and lowest among those in the Air Force and Navy. Most cases of exertional rhabdomyolysis were diagnosed at installations that support basic combat/recruit training or major ground combat units of the Army or the Marine Corps. Medical care providers should consider exertional rhabdomyolysis in the differential diagnosis when service members (particularly recruits) present with muscular pain or swelling, limited range of motion, or the excretion of dark urine (possibly due to myoglobinuria) after strenuous physical activity, particularly in hot, humid weather.

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Medical Surveillance Monthly Report

Update: Exertional Hyponatremia, Active Component, U.S. Armed Forces, 2003–2018

Article
4/1/2019
Drink water the day before and during physical activity or if heat is going to become a factor. (Photo Courtesy: U.S. Air Force)

From 2003 through 2018, there were 1,579 incident diagnoses of exertional hyponatremia among active component service members, for a crude overall incidence rate of 7.2 cases per 100,000 person-years (p-yrs). Compared to their respective counterparts, females, those less than 20 years old, and recruit trainees had higher overall incidence rates of exertional hyponatremia diagnoses. The overall incidence rate during the 16-year period was highest in the Marine Corps, intermediate in the Army and Air Force, and lowest in the Navy. Overall rates during the surveillance period were highest among Asian/Pacific Islander and non-Hispanic white service members and lowest among non-Hispanic black service members. Between 2003 and 2018, crude annual incidence rates of exertional hyponatremia peaked in 2010 (12.7 per 100,000 p-yrs) and then decreased to 5.3 cases per 100,000 p-yrs in 2013 before increasing in 2014 and 2015. The crude annual rate in 2018 (6.3 per 100,000 p-yrs) represented a decrease of 26.5% from 2015. Service members and their supervisors must be knowledgeable of the dangers of excessive water consumption and the prescribed limits for water intake during prolonged physical activity (e.g., field training exercises, personal fitness training, and recreational activities) in hot, humid weather.

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Medical Surveillance Monthly Report

Update: Heat Illness, Active Component, U.S. Armed Forces, 2018

Article
4/1/2019
Drink water the day before and during physical activity or if heat is going to become a factor. (Photo Courtesy: U.S. Air Force)

In 2018, there were 578 incident diagnoses of heat stroke and 2,214 incident diagnoses of heat exhaustion among active component service members. The overall crude incidence rates of heat stroke and heat exhaustion diagnoses were 0.45 cases and 1.71 cases per 1,000 person-years, respectively. In 2018, subgroup-specific rates of incident heat stroke diagnoses were highest among males and service members less than 20 years old, Asian/Pacific Islanders, Marine Corps and Army members, recruit trainees, and those in combat-specific occupations. Subgroup-specific incidence rates of heat exhaustion diagnoses in 2018 were notably higher among service members less than 20 years old, Asian/Pacific Islanders, Army and Marine Corps members, recruit trainees, and service members in combat-specific occupations. During 2014–2018, a total of 325 heat illnesses were documented among service members in Iraq and Afghanistan; 8.6% (n=28) were diagnosed as heat stroke. Commanders, small unit leaders, training cadre, and supporting medical personnel must ensure that the military members whom they supervise and support are informed about the risks, preventive countermeasures, early signs and symptoms, and first-responder actions related to heat illnesses.

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Medical Surveillance Monthly Report

Modeling Lyme Disease Host Animal Habitat Suitability, West Point, New York

Article
4/1/2019
A deer basks in the morning sun at Joint Base San Antonio-Fort Sam Houston, Texas.  (Photo Courtesy: U.S. Air Force)

As the most frequently reported vector-borne disease among active component U.S. service members, with an incidence rate of 16 cases per 100,000 person-years in 2011, Lyme disease poses both a challenge to healthcare providers in the Military Health System and a threat to military readiness. Spread through the bite of an infected blacklegged tick, infection with the bacterial cause of Lyme disease can have lasting effects that may lead to medical discharge from the military. The U.S. Military Academy at West Point is situated in a highly endemic area in New York State. To identify probable areas where West Point cadets as well as active duty service members stationed at West Point and their families might contract Lyme disease, this study used Geographic Information System mapping methods and remote sensing data to replicate an established spatial model to identify the likely habitat of a key host animal—the white-tailed deer.

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Medical Surveillance Monthly Report

Madigan Army Medical Center's emergency room helps shape MHS GENESIS

Article
4/1/2019
Krista Marcum, a staff nurse in Madigan Army Medical Center's emergency room, offers an MHS GENESIS demonstration to Defense Health Agency staff visiting Madigan. Marcum said these demonstrations often lead to MHS GENESIS-related brainstorming and problem solving. (U.S. Army photo by John Wayne Liston)

The ER encourages a culture of end user engagement; anyone can make a suggestion for an improvement to MHS GENESIS

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Pacific Partnership 2019 introduces helicopter en route medical care

Article
3/29/2019
A Philippine Fire Department rescue worker lifts a simulated earthquake victim onto a Philippine Air Force rescue helicopter during the Pacific Partnership 2019 exercise in Tacloban, Philippines. The goal of the Pacific Partnership is to improve interoperability of the region's military forces, governments, and humanitarian organizations during disaster relief operations, while providing humanitarian, medical, dental, and engineering assistance to nations of the Pacific all while strengthening relationships and security ties between the partner nations (U.S. Air Force photo by Tech. Sgt. Andrew Jackson)

The exercise is an important part of disaster risk reduction

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Emerging technology improves ability to see ‘invisible’ wounds

Article
3/29/2019
As well as providing high-resolution clinical imaging capabilities, the 3T Magnetic Resonance Imaging (MRI) scanner used at the NICoE provides researchers access to cutting-edge image acquisition methods, such as multiband diffusion tensor imaging (DTI) and echo planar imaging (EPI) sequences. (Photo courtesy of NICoE)

Ultimate goal is better understanding, quality of life for warfighters

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Your environment and your body: How exposure to mold and lead may impact your health

Article
3/29/2019
Depending on where your provider is located, you may seek care at a military hospital or clinic or from your TRICARE-authorized provider. (Courtesy photo)

Possible exposure to lead or damp, moldy indoor spaces may impact your health.

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Exposure to Lead | Mold

The National Intrepid Center of Excellence promotes warfighter brain health during Brain Injury Awareness Month

Article
3/28/2019
U.S. Public Health Service Lt. Sherray Holland, education and outreach lead at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center, participates in the 2019 Brain Injury Awareness Day event at Capitol Hill, in Washington, D.C. (Photo by NICoE Public Affairs)

For the fifth year, the NICoE hosted a TBI resource fair at Walter Reed National Military Medical Center

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Spring travel? TRICARE goes with you

Article
3/27/2019
Before you travel this spring, make sure you’re prepared to handle any health issues that may arise. Keep in mind that your rules for getting care depend on your health plan and travel destination. (U.S. Air Force photo by Master Sgt. Jeff Walston)

Whether traveling stateside or overseas, make sure you know what to do in case you or your loved ones become sick or injured on vacation

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TRICARE Health Program

Beaumont Army Medical Center only laparoscopic surgery test site in region

Article
3/26/2019
Army Capt. Derek Kirby, medical resident, General Surgery Program, William Beaumont Army Medical Center, practices laparoscopic techniques using pegs on a laparoscopic simulator at WBAMC’s Simulation Center. WBAMC was recently recognized as a Fundamentals of Laparoscopic Surgery testing site, the only medical facility to be recognized as such in a 400 mile radius. This recognition will allow medical residents and physicians to attain the certification locally, a requirement for graduating general surgery residents. (U.S. Army photo by Marcy Sanchez)

Laparoscopic surgery has been an evolving technology for many years

Get to know your TRICARE Prime plan

Article
3/25/2019
Take Command of Your Health

If you’re on active duty, you’re automatically enrolled in TRICARE Prime

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Pediatric clinic works to keep children healthy

Article
3/22/2019
Air Force Senior Airman Shania Stanford, 366th Medical Support Squadron pediatric clinic aerospace medical technician, checks Jude's vitals during an appointment at Mountain Home Air Force Base, Idaho. The pediatric clinic takes care of Airmen and their families by ensuring the overall health of their children. (U.S. Air Force photo by Airman 1st Class Andrew Kobialka)

The pediatric clinic’s objective is to care for children from birth to the age of 18

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Pacific Partnership 2019 participates in community health engagement in Tacloban

Article
3/21/2019
Navy Lt. Sharon Hoff (right) listens to a patient’s heartbeat as Philippine Army Capt. Glorife Saura from the Armed Forces of the Philippines Medical Corps records patient vital signs. Pacific Partnership participants and Tacloban City medical professionals worked together to provide medical and veterinary services throughout the day at Tigbao Diit Elementary School. (U.S. Navy photo by Mass Communication Specialist 1st Class Nathan Carpenter)

Pacific Partnership 2019 exchanges create lasting bonds of friendship and trust

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Eat well, live well

Article
3/20/2019
From left, Air Force Capt. Abigail Schutz, 39th Medical Operations Squadron health promotions element chief, Staff Sgt. Jennifer Mancini, 39th MDOS health promotions technician, and Tech. Sgt. Brian Phillips, 39th MDOS health promotions flight NCO in charge, pose for a photo at Incirlik Air Base, Turkey. Learning about proper nutrition can help service members stay healthy and ensure they’re in optimal warfighting shape. (U.S. Air Force photo by Staff Sgt. Matthew Wisher)

Fad diets come and go, but basic nutrition has staying power

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Health Readiness | Nutrition
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