Tuesday, April 6, 2010

Surgeon General Opens Summit

“Taking care of patients is the military’s primary goal and we have never failed to answer our nation’s call to help save lives” according to Navy Surgeon General Vice Admiral Adam Robinson, Jr. speaking at the Battlefield Health Care Summit held in Northern Virginia on March 29-30, 2010.

He outlined the Navy’s RDT&E efforts by saying that the Navy has ten medical research laboratories. Some of the research efforts include tracking respiratory diseases along with developing rapid diagnostics, studying resuscitative technologies, and developing large epidemiology databases such as the “Millennium Cohort Study” funded by DOD and the VA to study the long term health effects of military service.

The Surgeon General highlighted the experiences of the Navy Medical Research Unit known as NAMRU-3 located in Cairo. The Unit works collaboratively with the Ministries of Health, Agriculture, and Defense in multiple countries in the region on surveillance and public health and specifically tackles issues such as HIV/AIDS along with other emerging and re-emerging diseases.

In addition, significant malaria research efforts are conducted in Ghana where the population experiences some of the world’s highest malaria attack rates. Most recently, NAMRU-3 has become a critical player in the global fight against Avian Influenza giving support to Egypt and the World Health Organization’s Eastern Mediterranean Regional Office.

The Surgeon General pointed out that Navy medicine research is highly focused on TBI and psychological health treatments, medical systems to support maritime and expeditionary operations, wound management throughout the continuum of care, and hearing restoration protection for maritime, surface and air support personnel.

One important research goal has been to find a way to evaluate a strip test for wound closure. Determining when a wound is ready for closure is highly subjective. Most wounds heal without problems but there are still wounds that are difficult to treat.

Some wounds on a slide look similar before they are closed, but while one wound will heal—others will not. Researchers have now identified a small number of biomarkers that indicate a wound is ready to close.

The researchers are now working to turn a panel of markers into a convenient, disposable application. This would enable the Navy to not only push the identification of wound closure potential outside Military Treatment Facilities, but also help civilian hospitals in smaller communities that lack the technologies to conduct lab-based tests. By accomplishing earlier wound closure, significant savings can be achieved.

Researchers are always looking at ways to treat hemorrhaging resulting from explosives. Researchers in the Department of Surgery at NMRC have done a study to assess the efficacy of using freeze-dried platelet particles in a laceration injury. The results have demonstrated that the freeze dried platelet product increases survival by significantly reducing blood loss.

The data obtained has formed the basis for an ongoing preclinical trial to assess two platelet products in a laproscopically-induced hemorrhage model. If the trial is successful, the products will progress to a clinical trial.

Massive soft tissue and bone deficits are another big concern for the military. This concern for Heterotopic Ossification (HO) or abnormal bone growth in patients is a medical issue especially for those patients that have been exposed to IEDs in war zones. Ongoing Navy research is looking at the mechanisms that determine how Mesenchymal Stem Cells (MSC) differentiates into different tissues such as bone, fat, and muscle. Understanding how this happens, may enable the MSCs to be controlled and open up a new avenue on ways to treat battlefield injuries.

As part of a multidisciplinary regenerative medicine research effort, surgeons are treating OIF/OEF trauma casualties that present HO. This is particularly important since abnormal bone growth can often impair the use of prosthetic devices and in general can hinder the healing process.

The Surgeon General mentioned several products under development and now in the pipeline that will help service members. The military is faced with the need to replace existing field anesthesia machines. Suppliers of the machines are stopping production, going out of business, or conducting limited production runs at prohibitive costs. So, researchers are working to augment capabilities to provide anesthesia through an integrated design solution. By 2014, the military expects to have an integrated patient support device and anesthesia machine operating in a standalone mode.

Another product in the pipeline includes the development of the Cybertech Cricothyrotomy Kit, a one handed operation device with a retractable scalpel that provides automatic full retraction when the integrated tissue spreader is advanced into the incision. This device appears to be a prime dual use candidate for far-forward military care providers and civilian EMS personnel.

For more information on the IDGA Battlefield Healthcare Summit, go to www.battlefieldhealthcare.com. For details on the upcoming IDGA Military Healthcare Convention and Conference to be held June 22-25 in San Antonio, Texas, go to www.militaryhealthcareconvention.com.