Dr. David M. Burns. "Remember that fear always lurks behind perfectionism. Confronting your fears and allowing yourself the right to be human can, paradoxically, make you a far happier and more productive person." [Motivational Quotes of the Day]
3:50:40 PM    

Gulf War Syndrome publications

Umwin C., Blatchley N., Coker W.. et al Health of UK servicemen who served in Persian Gulf War. The Lancet. Vol. 353, Issue 9148 , Jan. 1999, Pg 169-178.

ABSTRACT

Background  Various symptoms in military personnel in the Persian Gulf War 1990–91 have caused international speculation and concern. We investigated UK servicemen.

Methods  We did a cross-sectional postal survey on a random sample of Gulf War veterans (Gulf War cohort, n=4248) and, stratified for age and rank, servicemen deployed to the Bosnia conflict (Bosnia cohort, n=4250) and those serving during the Gulf War but not deployed there (Era cohort, n=4246). We asked about deployment, exposures, symptoms, and illnesses. We analysed men only. Our outcome measures were physical health, functional capacity (SF-36), the general health questionnaire, the Centers for Disease Control and Prevention (CDC) multisymptom criteria for Gulf War illness, and post-traumatic stress reactions.

Findings  There were 8195 (65·1%) valid responses. The Gulf War cohort reported symptoms and disorders significantly more frequently than those in the Bosnia and Era cohorts, which were similar. Perception of physical health and ability were significantly worse in the Gulf War cohort than in the other cohorts, even after adjustment for confounders. Gulf War veterans were more likely than the Bosnia cohort to have substantial fatigue (odds ratio 2·2 [95% CI 1·9–2·6]), symptoms of post-traumatic stress (2·6 [1·9–3·4]), and psychological distress (1·6 [1·4–1·8]), and were nearly twice as likely to reach the CDC case definition (2·5 [2·2–2·8]). In the Gulf War, Bosnia, and Era cohorts, respectively, 61·9%, 36·8%, and 36·4% met the CDC criteria, which fell to 25·3%, 11·8%, and 12·2% for severe symptoms. Potentially harmful exposures were reported most frequently by the Gulf War cohort. All exposures showed associations with all of the outcome measures in the three cohorts. Exposures specific to the Gulf were associated with all outcomes. Vaccination against biological warfare and multiple routine vaccinations were associated with the CDC multisymptom syndrome in the Gulf War cohort.

Interpretation  Service in the Gulf War was associated with various health problems over and above those associated with deployment to an unfamiliar hostile environment. Since associations of ill health with adverse events and exposures were found in all cohorts, however, they may not be unique and causally implicated in Gulf-War-related illness. A specific mechanism may link vaccination against biological warfare agents and later ill health, but the risks of illness must be considered against the necessity of protection of servicemen.

                         

Ismail K., Everitt B, Blatchley N. et al Is there a Gulf War syndrome? The Lancet. Vol. 353, Issue 9148 , Jan. 1999, Pgs 179-182.

ABSTRACT

Background  UK veterans of the Gulf War report more ill health than servicemen who were not deployed to the Gulf War. We investigated whether the pattern of symptom reporting by veterans of the Gulf War differed from that in active servicemen who had not fought in the Gulf War or who had fought in other conflicts.

Methods  We used a population-based cross-sectional design. We sent a standardised survey that asked about 50 physical symptoms to three UK military cohorts; men who had served in the Gulf War, those who had served in the Bosnia conflict, and men who had been in active service but not deployed to the Gulf War (Era cohort). We used exploratory factor analysis to identify underlying factors and describe the factor structure of the symptoms reported in the Gulf War cohort. Confirmatory factor analysis was used to test the fit of this factor structure in the Bosnia and Era cohorts.

Findings  Three factors in the Gulf War cohort together accounted for about 20% of the common variance. We labelled the factors mood, respiratory system, and peripheral nervous system, according to the symptoms that loaded on to them. In the confirmatory factor analysis, the factor structure identified in the Gulf War cohort fitted reasonably well in the Bosnia and Era cohorts.

Interpretation  Although results from complex modelling procedures need to be interpreted with caution, our findings do not support a unique Gulf War syndrome. The mechanisms behind increased self-reporting of symptoms need further investigation.

(The second paper was published by the MOD though some names appear on both.)

2:47:43 PM    

I love this picture.

X-ray, Alkindi Hospital, Baghdad

2:43:20 PM    

The BMJ has some medical perspectives of the current political situation in the UK and US.

The Moral Questions of War

2:42:09 PM    

Not a melting pot, more a paella/gumbo

BMJ- Practicising Medicine in a Multicultural Society.

2:38:36 PM    

Imagine

An excellent campaign by Amnesty USA, titled Imagine.

2:36:58 PM