Time filter

Source Type

Rockville, MD, United States

Sikorski C.,Uniformed Services University of the Health Sciences | Emerson M.A.,U.S. Navy | Cowan D.N.,U.S. Army | Niebuhr D.W.,Allied Technology Group Inc
Military Medicine | Year: 2012

Objective: To assess factors associated with medical disability in the U.S. Marine Corps. Methods: Case-control study enrolling 11,554 medical disability cases of U.S. enlisted Marines referred to the Physical Evaluation Board fiscal year 2001 to 2009 and 42,216 controls frequency matched to cases in a 4:1 ratio on year of accession into the service were analyzed utilizing bivariate and multivariate logistic regression analysis. Results: Increased age and body mass index at accession were associated with higher odds of medical disability. Females (odds ratio adjusted [OR adj] = 1.3, 95% confidence interval [CI] = 1.2-1.3) have higher odds of disability than males. "Healthy Warrior Effect" was observed in that those who deployed (OR adj = 0.48, 95% CI = 0.46-0.50) had decreased odds of medical disability than those who did not deploy. Medical waivers at accession (OR adj = 1.12, 95% CI = 1.01-1.23) increased the odds of medical disability. Conclusions: Continued surveillance of the disability evaluation system is needed to help develop preventive measures and to help policy makers establish evidence-based policies on accession, deployment, and retention standards over the lifecycle of service members. © Association of Military Surgeons of the U.S. All rights reserved. Source

Packnett E.R.,U.S. Army | Packnett E.R.,Allied Technology Group Inc | Gubata M.E.,U.S. Army | Cowan D.N.,U.S. Army | And 2 more authors.
Journal of Traumatic Stress | Year: 2012

Since the start of Operation Iraqi Freedom and Operation Enduring Freedom, over 2 million U.S. military members were deployed to Iraq and Afghanistan. The estimated prevalence of posttraumatic stress disorder (PTSD) among soldiers and Marines returning from combat zones varies from 5%-20%; little is known about those individuals whose PTSD renders them unfit for duty. This report describes the rates and correlates of PTSD in soldiers and Marines evaluated for disability. Data for service members who underwent disability evaluation between fiscal years 2005-2010 were analyzed for trends in disability rates, ratings, retirement, and comorbid disability. PTSD rates varied by age, sex, race, rank, branch of service, and component. Most cases were deployed and were considered combat-related. Over the study period, the rate and severity of disability from PTSD increased substantially. Significant increases in disability from PTSD incidence, rating, and retirement were observed in both services. Other medical conditions, largely musculoskeletal and neurological, were present in the majority of cases indicating many cases also experienced disabling physical injuries. Further research is needed to target interventions accurately for redeploying service members to minimize comorbidity associated with disability from PTSD and facilitate continuation in military service or successful transition to civilian life. This article is a US Government work and is in the public domain in the USA. Source

Gubata M.E.,U.S. Army | Urban N.,U.S. Army | Urban N.,Allied Technology Group Inc | Cowan D.N.,U.S. Army | And 2 more authors.
Journal of Psychosomatic Research | Year: 2013

Objective: Mental health disorders contribute substantially to medical and occupational morbidity. The role of fitness and physical activity in the prevention of mental health disorders is not well established, but epidemiologic data suggest that physical activity can protect against anxiety and depression. Method: The analyses presented in this report, from a prospective cohort study, evaluate the association between fitness (as measured by a 5-minute step test), and being overweight (defined as exceeding weight and body fat allowances) at military entrance, with subsequent onset of mental disorder diagnosis in the first year of service. The association between risk factors and mental disorder diagnosis was analyzed using multivariate Poisson regression with the adjusted incidence rate ratio (aIRR) as the measure of association. Results: Among weight-qualified participants, factors associated with increased incidence of mental disorder included failing the physical fitness test (aIRR: 1.36, p < 0.0001), female sex (aIRR: 2.17, p < 0.0001), and smoking (aIRR: 1.49, p < 0.0001). Among fit participants, being overweight was not significantly associated with mental disorder (aIRR: 1.11, p = 0.1540). Conclusions: This test has potential military utility as an adjunct part of the medical examination process. Additional research is needed among civilians to determine if similar associations exist. If so, intervention studies should be conducted to determine if improving physical fitness reduces subsequent psychiatric disorder risk, particularly among young adults entering into stressful situations. © 2013. Source

Niebuhr D.W.,U.S. Army | Li Y.,U.S. Army | Cowan D.N.,U.S. Army | Cowan D.N.,Allied Technology Group Inc | And 5 more authors.
Schizophrenia Research | Year: 2011

Schizophrenia is a pervasive neuropsychiatric disorder of uncertain etiology. Multiple studies have documented immune activation in individuals with schizophrenia. One antigen capable of inducing a prolonged immune response is bovine casein derived from ingested milk products. Increased levels of casein antibodies have been found in individuals with schizophrenia after diagnosis. This study was directed at determining the potential association between schizophrenia and pre-illness onset levels of immunoglobulin G (IgG) antibodies to bovine casein. Parallel analyses for casein antibody levels with bipolar disorder were included as comparison. Cases were service members who received medical discharges from the military with a schizophrenia diagnosis from 1992 to 2005. Serum specimens were selected for 855 cases and 1165 matched healthy controls. IgG antibodies to bovine whole-casein were measured by solid phase enzyme-linked immunosorbent assays (ELISAs). Hazard ratios (HR) were calculated to examine the associations of casein IgG level with risk of schizophrenia by time to diagnosis and by subjects' initial level. Increasing casein IgG antibody levels among those with a high initial level, drawn before diagnosis, was associated with an 18% increase in the hazard risk of schizophrenia per unit increase (value of low-positive standard) in IgG antibody levels (HR = 1.18; 95% CI 1.04, 1.34). This is the first report to identify an association between the risk of schizophrenia and elevated antibodies to bovine casein prior to disease onset. Additional research is required to elucidate the complex genetic environmental interactions involved in the pathogenesis of schizophrenia and to identify potentially modifiable risk factors. © 2011. Source

Li Y.,U.S. Army | Weber N.S.,U.S. Army | Fisher J.A.,U.S. Army | Fisher J.A.,Allied Technology Group Inc | And 7 more authors.
Schizophrenia Research | Year: 2013

Introduction: Multiple studies have documented immune activation in many individuals with schizophrenia suggesting that antigens capable of generating a prolonged immune response may be important environmental factors in many cases of this disorder. While existing studies have found single-agent associations of antibodies to food and neurotropic infectious agents with schizophrenia, a simultaneous examination of multiple agents may shed light on agent interactions or possible etiopathogenic pathways. Methods: We used traditional regression and novel statistical techniques to examine associations of single and combined infectious and food antigens with schizophrenia. We tested 6106 serum samples from 855 cases and 1165 matched controls. Results: Higher antibody levels to casein were borderline significant in the prediction of schizophrenia (HR. = 1.08, p. = 0.06). Study participants with higher cytomegalovirus (CMV) IgG antibody levels had a reduced risk of developing schizophrenia (HR. = 0.90; p. = 0.02). While IgG antibodies to gliadin, Toxoplasma gondii, vaccinia, measles, and human herpesvirus-6 (HHV-6) showed no significant independent associations with schizophrenia, the increase in antibody levels to several combinations of agents, to include casein, measles, CMV, T. gondii and vaccinia, was predictive of an 18-34% increase in the risk of developing schizophrenia. Conclusion: Certain patterns of antibodies, involving some agents, were predictive of developing schizophrenia, with the magnitude of association rising when the level of antibodies increased to two or more agents. A heightened antibody response to a combination of several infectious/food antigens might be an indicator of an altered immune response to antigenic stimuli. © 2013 . Source

Discover hidden collaborations