Aviation medicine safeguards flight safety by addressing three critical areas: managing physiological challenges of the aviation environment, preventing in-flight medical incapacitation and ensuring psychological fitness for flight. The field adopts occupational medicine's hierarchy of risk control to mitigate physiological risks in the operating environment, while employing systematic medical screening with tailored standards based on operational requirements to reduce the likelihood of in-flight incapacitation. A comprehensive approach incorporating mental health education, support systems and regular monitoring helps prevent psychological incapacitation. Recent data from the Singapore Changi Aeromedical Centre reveal that ophthalmological, otolaryngological and respiratory conditions are the primary causes of medical disqualification during air force pilot screening, reflecting the unique physiological demands of military aviation. This review emphasises the ongoing challenge of balancing rigorous medical standards with maintaining an adequate pilot recruitment pool, while highlighting the need for evidence-based approaches to aeromedical assessment and certification.
Humans ; Aerospace Medicine/methods* ; Singapore ; Aviation ; Pilots ; Accidents, Aviation/prevention & control* ; Occupational Health ; Safety ; Occupational Medicine ; Military Personnel

Against the backdrop of the Russia-Ukraine Conflict in 2022, this article reviews the characteristics of traumatic hemorrhage in modern warfare spanning the past century. It investigates several types of tourniquets used by the Russian and Ukrainian armed forces, including limb tourniquets and junctional tourniquets recommended by the Committee on Tactical Combat Casualty Care, tourniquets employed by the Armed Forces of the Russian Federation, and those used by the Armed Forces of Ukraine in the Russia-Ukraine Conflict. The analysis is conducted from perspectives, including the structure, usage methods, and limitations of different tourniquets. Additionally, the article synthesizes the research progress on tourniquets from 3 angles: battlefield adaptability, the impact of tourniquet application methods on patient outcomes, and training in tourniquet usage, offering insights from our team's perspective.
Tourniquets ; Humans ; Russia ; Hemorrhage/therapy* ; Ukraine ; Military Medicine/methods* ; Warfare ; Armed Conflicts

"Timely, near, and expectation" is the main principle of battlefield rescue for military combat stress reaction (CSR). Post-traumatic stress disorder (PTSD) is the most common form of CSR and a long-term persistent mental disorder that is caused by unusual threatening or catastrophic psychological trauma. Chinese medicine (CM) has abundant resources, is simple, easy to master, with few side effects. This article summarizes the cellular and animal experimental mechanisms of CM treatment on PTSD, suggesting that traditional Chinese herbs and acupuncture can protect brain functional areas, and adjust hypothalamus-pituitary-adrenal axis. Traditional Chinese herbs and acupuncture have shown good anti-stress efficacy and fewer side effects in clinical application, which may improve the CSR in the battlefield.
Animals ; Humans ; Hypothalamo-Hypophyseal System ; Medicine, Chinese Traditional ; Military Personnel ; Pituitary-Adrenal System ; Stress Disorders, Post-Traumatic/therapy*

BACKGROUND: The aim of this study was to investigate the clinical characteristics of complex regional pain syndrome (CRPS) in young male patients in South Korea, especially focusing on the association with military service. METHODS: From January 2007 to May 2017, we investigated the electronic medical records of 430 consecutive patients, aged 18 to 30 years, who visited Seoul National University Hospital Pain Center, with a suspected diagnosis of CRPS at the initial visit. The following patient details were available for analysis: demographic and disease-related variables, relevance to military service, medications, and the treatment modalities received. RESULTS: Out of 430 patients, 245 (57.0%) were diagnosed with CRPS, of which, 200 were male patients and 45 were female patients. Of the male patients, 95 (47.5%) developed CRPS during military service. CRPS during military service was more likely to result from sprain/strain, and the incidence of CRPS was significantly higher in the lower extremities in patients from the military service group than in those from the non-military service group. During the follow-up period, 37.9% of male CRPS patients (n = 61/161) were treated successfully. Patients with moderate to severe initial pain intensity, and diagnosed during their military service, showed better outcomes. CONCLUSIONS: Our results demonstrated that manifestation of CRPS in the young Korean population was more common in male and among those male CRPS patients, about half the cases developed during the military service period.
Chronic Pain ; Diagnosis ; Electronic Health Records ; Epidemiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lower Extremity ; Male ; Military Medicine ; Military Personnel ; Neuralgia ; Pain Clinics ; Retrospective Studies ; Seoul ; Stress, Psychological

The definition of a disaster varies across research institutions, although it is generally regarded as a sudden event that demands more resources than the community can offer. Disaster medicine originates from military medicine. It is a new field of medicine that has much in common with emergency medicine, but focuses more on disaster management, targeting populations. It plays a key role both in the pre-event period by helping with disaster preparedness and in the event of a disaster by providing disaster medical services, including on-scene emergency life-saving interventions, thereby contributing to a decrease in the preventable mortality rate. Triage is a system used to sort mass disaster victims according to severity, enabling resources to be allocated, distributed, and utilized more efficiently. During disasters, a hospital should respond to the surge in patients in accordance with the standards and principles of disaster medicine by activating its emergency operation plan, converting the usual medical system into the emergency system, and putting disaster response teams into operation. Disaster medicine is the key discipline for all aspects of preparedness and response to conventional disasters, and even to chemical, biological, radiological, nuclear, and explosive events.
Disaster Medicine ; Disaster Victims ; Disasters ; Emergencies ; Emergency Medicine ; Humans ; Military Medicine ; Mortality ; Triage

Trauma and the need of medical care exist since the beginning of human history. This research is aimed to identify and analyze trauma in antiquity. After a review of bibliography, the first reports of trauma (in Europe) were found in the Greek Epics of Homer. The analysis of these texts showed that injury could be caused to any part of the human body. The main cause of trauma was primarily participation in wars (178 cases), and then participation in sports (6 cases) and other activities (6 cases). This study identified a total of 190 injuries in both Homer epics. The more serious injuries, many of which proved fatal, were observed from participation in military activities.
Athletic Injuries ; history ; Greece ; Greece, Ancient ; History, Ancient ; Humans ; Military Medicine ; Warfare ; Wounds and Injuries ; history

BACKGROUND: An inactivated Hantaan virus vaccine (iHV) has been broadly used as a preventive strategy for hemorrhagic fever with renal syndrome (HFRS) by the South Korean Army. After the vaccination program was initiated, the overall incidence of HFRS cases was reduced in the military population. While there are about 400 HFRS cases annually, few studies have demonstrated the efficacy of the iHV in field settings. Therefore, this study aimed to evaluate the iHV efficacy on HFRS severity. METHODS: From 2009 to 2017, HFRS cases were collected in South Korean Army hospitals along with patients’ vaccination history. HFRS patients were classified retrospectively into two groups according to vaccination records: no history of iHV vaccination and valid vaccination. Vaccine efficacy on the severity of acute kidney injury (AKI) stage and dialysis events were investigated. RESULTS: The effects of the iHV on renal injury severity in between 18 valid vaccinated and 110 non-vaccinated patients were respectively evaluated. In the valid vaccination group, six of the 18 HFRS patients (33.3%) had stage 3 AKI, compared to 60 of the 110 (54.5%) patients in the non-vaccination group. The iHV efficacy against disease progression (VEp) was 58.1% (95% confidence interval, 31.3% to 88.0%). CONCLUSION: The iHV efficacy against the progression of HFRS failed to demonstrate statistically significant protection. However, different severity profiles were observed between the iHV and non-vaccination groups. Additional studies with larger populations are needed to demonstrate the effectiveness of the iHV in patients with HFRS.
Acute Kidney Injury ; Dialysis ; Disease Progression ; Hantaan virus ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome* ; Hospitals, Military ; Humans ; Incidence ; Military Personnel ; Preventive Medicine ; Retrospective Studies ; Vaccination

The Tuskegee Study of Untreated Syphilis in the Negro Male was an observational study on African-American males in Tuskegee, Alabama between 1932 and 1972. The U. S. Public Health Service ran this study on more than 300 people without notifying the participants about their disease nor treating them even after the introduction of penicillin. The study included recording the progress of disease and performing an autopsy on the deaths. This paper explores historical backgrounds enabled this infamous study, and discusses three driving forces behind the Tuskegee Study. First, it is important to understand that the Public Health Service was established in the U. S. Surgeon General's office and was operated as a military organization. Amidst the development of an imperial agenda of the U.S. in the late 19th and early 20th centuries, the PHS was responsible for protecting hygiene and the superiority of “the American race” against infectious foreign elements from the borders. The U.S. Army's experience of medical experiments in colonies and abroad was imported back to the country and formed a crucial part of the attitude and philosophy on public health. Secondly, the growing influence of eugenics and racial pathology at the time reinforced discriminative views on minorities. Progressivism was realized in the form of domestic reform and imperial pursuit at the same time. Major medical journals argued that blacks were inclined to have certain defects, especially sexually transmitted diseases like syphilis, because of their prodigal behavior and lack of hygiene. This kind of racial ideas were shared by the PHS officials who were in charge of the Tuskegee Study. Lastly, the PHS officials believed in continuing the experiment regardless of various social changes. They considered that black participants were not only poor but also ignorant of and even unwilling to undergo the treatment. When the exposure of the experiment led to the Senate investigation in 1973, the participating doctors of the PHS maintained that their study offered valuable contribution to the medical research. This paper argues that the combination of the efficiency of military medicine, progressive and imperial racial ideology, and discrimination on African-Americans resulted in the Tuskegee Syphilis Experiment.
African Continental Ancestry Group ; Alabama ; Autopsy ; Discrimination (Psychology) ; Eugenics ; Humans ; Hydrogen-Ion Concentration ; Hygiene ; Male ; Military Medicine ; Military Personnel ; Observational Study ; Pathology ; Penicillins ; Philosophy ; Public Health* ; Sexually Transmitted Diseases ; Social Change ; Syphilis ; United States Public Health Service ; United States*

The military medical system of the Korean People's Army (KPA) first appeared in August 1946 when a central military hospita was established at the headquarters. Inside the KPA, the military medical and veteran services were first established in February 1948. The military medical officers of the KPA were those who were initially engaged in North Korea's health care sector. Most of the early military medical officers were those who had been trained in the Japanese medical system before liberation and were surgeons. After the establishment of the government in September 1948, Lee Dongwha rapidly introduced the medical system of the Soviet army into the KPA. The KPA military medical system was a mix of Soviet, Japanese and Chinese military medical systems. The medical section of the KPA was similar to that of the Japanese army, and the medical section of the lower army was similar to that of the Soviet army. The stretcher platoon of the KPA were similar to those of the Japanese and Chinese armies. The KPA mainly used Japanese medical equipment at the beginning, and after the establishment of the North Korean regime in September 1948, they were gradually replaced with Soviet products. The military medical office of the KPA were equipped with treatment rooms, laboratories, hospitals, pharmacy, and inpatient rooms. The military medical office purchased medical journals and specimens for medical research and set up a separate research fund. In addition, the military medical office was equipped with a laboratory for medical experiments and raised laboratory animals. The KPA military medical system was specialized in the fields of infectious disease prevention and preventive medicine. At the time, infectious disease in North Korea was mainly caused by bacteria and viruses in unsanitary living environments. The KPA set up a special anti-infectious disease department in consideration of the soldiers living in the collective facilities. The second characteristic of the KPA military medical system is preventive medicine. Since early 1946, North Korea has been interested in preventive medicine and has established various medical facilities and personnel. In line with this history of preventive medicine, the preventive department was installed in the KPA military medical system.
Animals, Laboratory ; Asian Continental Ancestry Group ; Bacteria ; Communicable Diseases ; Democratic People's Republic of Korea ; Financial Management ; Health Care Sector ; Hospitals, Military ; Humans ; Inpatients ; Military Personnel* ; Pharmacy ; Preventive Medicine ; Surgeons ; Veterans

Military medicine has had a long history in China since the emergence of the war. Chinese medicine, especially Chinese herbs, was widely used in China as well as other Asian countries for the prevention and treatment of diseases in the military for hundreds of years. However, the use of Chinese medicine in military health service has never been well studied. In this article, we briefly summarize the application status of Chinese herbal medicine in military health service in China, putting particular emphasis on special military environment, in an attempt to build a bridge between Chinese medicine and military health service and promote the quality of health service for the military and maintain world peace.
Drugs, Chinese Herbal ; therapeutic use ; Environment ; Health Services ; Humans ; Military Medicine ; Military Personnel