During this year’s Military Health System Research Symposium, a series of presentations highlighted critical military medical issues related to combat casualty care, operational medicine, clinical and rehabilitative medicine, and infectious diseases. While dozens of panels were held over the course of four days, a “scientific plenary” session featured several of the most significant research focused on furthering the health care of service members.
Trauma Care on the Battlefield and at Home
MHSRS highlighted how research not only benefits our warfighters but offers solutions. Presenters gave high-level overviews of their research, sharing insights and advancements that may improve care on and off the battlefield.
Dr. Edward Mazuchowski from Forensic Pathology Associates in Allentown, Pennsylvania, shared his research on “United States Military Fatalities during Operation New Dawn, Operation Inherent Resolve, and Operation Freedom’s Sentinel.” Mazuchowski reiterated a now-known data point from the past 20 years of conflicts: One of the leading causes of casualties are hemorrhages. The study of fatalities can guide prevention and treatment efforts focusing on common and unique injuries and diseases. Findings may help inform clinical guidelines, training, requirements for equipment, and future research. His work aims to help develop more strategies focusing on all stages of prevention.
Dr. Michael Roy of the Uniformed Services University of the Health Sciences in Bethesda, Maryland, discussed the “Evaluation of U.S. Special Operations Personnel During Heavy Weapons Training: the Investigating Training Associated Blast Pathology (INVICTA) Study.” Roy reviewed cases of chronic traumatic encephalopathy, or CTE, in athletes with repetitive subconcussive exposures, and service members with repeated subconcussive blast exposure. Findings indicated service members suffer from blast effects, and research is guiding the development of protective measures and methods to mitigate blast exposure.
Dr. Jason Sperry with the University of Pittsburgh, in Pittsburgh, Pennsylvania, presented his research on “Whole Blood is Associated with a Lower Independent Risk of Mortality and Improved Hemostasis: Results of a Multi-Center Prospective Observational Study of Patients in Hemorrhagic Shock.” As hemorrhage remains one of the leading causes of battlefield deaths, his research showed the benefits of whole blood resuscitation following injury in the civilian population. Findings showed that patients who received whole blood had earlier cessation of bleeding and improved 30-day mortality.
U.S. Army Col. Jennifer Stowe, with the U.S. Army Aeromedical Research Laboratory in Enterprise, Alabama, presented research on “Forward Operating Base Expert Telemedicine Resource Utilizing Mobile Application for Trauma (FOXTROT).” Her team conducted research focused on eye trauma and ophthalmic surgery interventions. With many service members being deployed to more remote locations, it was necessary to find a way to provide ophthalmic care to any posting. By utilizing telemedicine, medical personnel in remote areas were able to better diagnose eye injuries in the field, which could mean the difference between diminished or loss of sight.
The Future of Pain Management and Mental Health
As pain management and mental health are an ongoing focus for the Department of Defense, MHSRS presenters showcased research into pain and behavioral health care, as well as additional topics on various concerns for military medicine.
Lauren Walker from the Uniformed Services University of the Health Sciences in Bethesda, Maryland, presented research on “Mental Health Diagnoses and Suicide Attempts in Combat-injured Service Members: A DOD/VA Retrospective Cohort Study.” Her team found there were increased suicide attempts in those who were injured in combat compared to those who had not deployed or had not suffered an injury during time in combat. They investigated the comparison between those who were receiving mental health care over those who were not, and the rates of attempts for suicide between the groups. Other factors such as alcohol usage, those with post-traumatic stress disorders, anxiety, depression, bipolar, and adjustment disorders factored into their research. Their research continues, as they identify and adjust various factors in their study.
Dr. Dianne Flynn from Madigan Army Medical Center, located on Joint Base Lewis-McChord, Washington, discussed “Predictors of Sustained Response to Functional Restoration in a Military Population with Chronic Pain.” The DOD is prioritizing making access to interdisciplinary pain care, with several military hospitals establishing pain centers to focus on a broad spectrum of therapies, including physical therapy, psychology, yoga, and chiropractic care. By including areas such as cognitive, behavioral, and other therapies that can target pain, research suggested an increase in overall satisfaction with treatment.
Dr. David Tate from the University of Utah School of Medicine, in Heber City, Utah, discussed his research on “White Matter Hyperintensities, Cognitive Function, Comorbidities, Blood Biomarkers, and Mild TBI: A LIMBIC-CENC Multicenter Study.” Brain lesions usually occur in individuals over the age of fifty, but research is showing that those who suffer from mild traumatic brain injuries can have such lesions much earlier. Memory and cognitive tasks can diminish as lesions grow.
Dr. Leor Weinberger of VxBiosciences, Oakland, California, discussed the findings of their study, “Therapeutic Interfering Particles: A Novel, Intranasally-administered, Single-dose Agent for the Treatment and Prevention of SARS-CoV-2 Infection.” Their presentation highlighted how virus mutation rates can prohibit effective vaccines for a wide array of viruses. Their research continues, as they look for different therapeutic interfacing particles to help break the mutation cycle.
The scientific plenary introduced new and ongoing research. While the studies continue, the military medical community and warfighters are gaining valuable and life-saving techniques and technologies.