Signs, Symptoms, and Ill-Defined Conditions in Persian Gulf War Veterans

Roy, Michael J.; Koslowe, Patricia; Kroenke, Kurt; Magruder, Charles

doi:10.1097/00006842-199811000-00001

Cited by 56 publications

(18 citation statements)

References 29 publications

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“…[39] Ancient Chinese medicine theory encourages women taking Chinese herbal medicine to build up their blood supply in order to reserve strength for each menstruation cycle because women expect a significant amount of blood to be lost during that. [4041] The anemia-related fatigue, dizziness, and palpitations might be the major reasons that lead to the patient's behavior of seeking TCM and receiving prescriptions of conventional drugs and CHPs concurrently.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Use of Conventional Drugs with Chinese Herbal Products in Taiwan: A Population-based Study

Chen

Wang

2013

Journal of Traditional and Complementary Medicine

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The increased use of Chinese herbal products (CHPs) worldwide has raised the concern of herb–drug interactions. The aim of this study was to determine the prevalence and utilization patterns of concurrent use of conventional drugs and CHPs in Taiwan. The usage and frequency of services in the co-prescription of a CHP and a conventional drug were evaluated. Subjects were recruited from a simple random sample of 1,000,000 subjects from over 22 million beneficiaries of the National Health Insurance in 2007. The logistic regression method was employed to estimate the odds ratios (ORs) for the co-prescription of a CHP and a conventional drug (CH + D) and a conventional drug alone (D-alone). The prevalence of the CH + D was 14.1%. Females, regular salary earners, and elderly (65 years and above) were more likely to consume a CHP and a conventional drug concurrently. Painkillers, especially acetaminophen, and anti-cough medicines were the top two conventional drugs that were most frequently co-prescribed with a CHP. Anti-cough medication is the most common conventional drug co-prescribed with CHP, after painkillers. We recommend that safety issues be investigated in future research and integrating both healthcare technologies may be beneficial for the overall health and quality of life of patients.

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Section: Discussionmentioning

confidence: 99%

Concurrent Use of Conventional Drugs with Chinese Herbal Products in Taiwan: A Population-based Study

Chen

Wang

2013

Journal of Traditional and Complementary Medicine

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“…Nightmare frequency as determined as the mean number of nightmares recalled upon awakening each morning per week, which was logged in the sleep diary. Because trauma-exposed individuals with chronic nightmares reported a broad range of dysphoric dreams (2–5), participants were asked to log all distressing dreams (nightmares) they experienced. This broader definition of nightmares was intended to provide a more ecologically valid assessment of the effects of prazosin or BSI on distressing dreams in military veterans with PTSD symptoms.…”

Section: Methodsmentioning

confidence: 99%

Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US Military Veterans

Germain

Richardson

Moul

et al. 2012

Journal of Psychosomatic Research

202

184

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Objective Pharmacological and cognitive-behavioral treatments targeting insomnia and nightmares have been shown to be effective in the treatment of military veterans with sleep complaints comorbid with symptoms of stress-related disorders, including Post-Traumatic Stress Disorder (PTSD), but the two approaches have not been directly compared. This randomized controlled trial compared the effects of prazosin vs. a behavioral sleep intervention (BSI), targeting nightmares and insomnia against a placebo pill control condition on sleep and daytime symptoms. Methods Fifty United States military veterans (mean age 40.9 years, SD = 13.2 years) with chronic sleep disturbances were randomized to prazosin (n = 18), BSI (n = 17), or placebo (n = 15). Each intervention lasted eight weeks. Participants completed self-report measures of insomnia severity, sleep quality, and sleep disturbances. All kept a sleep diary throughout the intervention period. Polysomnographic studies were conducted pre- and post-intervention. Results Both active treatment groups showed greater reductions in insomnia severity and daytime PTSD symptom severity. Sleep improvements were found in 61.9% of those who completed the active treatments and 25% of those randomized to placebo. Conclusion BSI and prazosin were both associated with significant sleep improvements and reductions in daytime PTSD symptoms in this sample of military veterans. Sleep-focused treatments may enhance the benefits of first-line PTSD treatments.

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“…This finding is consistent with previous studies that have shown that sleep disturbances are highly prevalent and strongly correlated with PTSD in combat deployment military veterans. [42][43][44][45][46][47][48][49][50][51] Although sleep difficulties often follow TBI or blast exposure, 52 the present study suggests that prior blast exposure or TBI alone, in the absence of current chronic concussive symptoms, does not adversely affect sleep quality, insomnia, disruptive sleep disturbances, or objective sleep measures beyond the effects of PTSD. Indeed, post hoc analyses revealed that service members and veterans with PTSD endorsed higher scores on the ISI, PSQI, and PSQIA than those without PTSD diagnosis, regardless of presence or absence of blast exposure.…”

Section: Discussionmentioning

confidence: 89%

Effects of Blast Exposure on Subjective and Objective Sleep Measures in Combat Veterans with and without PTSD

Stocker

Paul

Mammen

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: This study examined the extent to which self-reported exposure to blast during deployment to Iraq and Afghanistan affects subjective and objective sleep measures in service members and veterans with and without posttraumatic stress disorder (PTSD). Methods: Seventy-one medication-free service members and veterans (mean age = 29.47 ± 5.76 years old; 85% men) completed self-report sleep measures and overnight polysomnographic studies. Four multivariate analyses of variance (MANOVAs) were conducted to examine the impact of blast exposure and PTSD on subjective sleep measures, measures of sleep continuity, non-rapid eye movement (NREM) sleep parameters, and rapid eye movement (REM) sleep parameters. Results: There was no significant Blast × PTSD interaction on subjective sleep measures. Rather, PTSD had a main effect on insomnia severity, sleep quality, and disruptive nocturnal behaviors. There was no significant Blast × PTSD interaction, nor were there main effects of PTSD or Blast on measures of sleep continuity and NREM sleep. A significant PTSD × Blast interaction effect was found for REM fragmentation. Conclusions:The results suggest that, although persistent concussive symptoms following blast exposure are associated with sleep disturbances, selfreported blast exposure without concurrent symptoms does not appear to contribute to poor sleep quality, insomnia, and disruptive nocturnal disturbances beyond the effects of PTSD. Reduced REM sleep fragmentation may be a sensitive index of the synergetic effects of both psychological and physical insults. I NTRO DUCTI O NMild traumatic brain injury (mTBI) is one of the signature injuries of the Global War on Terror, and is among the leading factors contributing to disability and death among military service members of Operations Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF).1-4 mTBI is defined as a loss of consciousness lasting up to 30 minutes, alteration of consciousness/mental state from a moment up to 24 hours, and posttraumatic amnesia lasting 1 day or less, in the absence of detectable abnormal structural imaging findings.5 Between 30% and 40% of combat infantry and other military personnel who have served in OEF/OIF have been exposed to blast forces resulting from explosives, particularly improvised explosive devices (IEDs).6,7 While mTBI sustained from blast injuries are not the only means of sustaining mTBI (i.e., blunt trauma), blast injuries represent the most common type of mTBI reported in returning military personnel.3,8 Of those exposed to blasts, the reported prevalence rates of subsequent mTBI in warfighters vary between 4.9% to 22%. 6,7,9,10 The projected 2-year costs associated with chronic mTBI, which refers to symptoms and impairments that last more than three months post-injury, could average as much as $591 billion. 10Sleep disturbances are prevalent among both warfighters and civilians with subacute (i.e., < 3 months in duration) and chronic mild traumatic brain injury (cmTBI), and can impede recovery.11,12 As many...

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Signs, Symptoms, and Ill-Defined Conditions in Persian Gulf War Veterans

Cited by 56 publications

References 29 publications

Concurrent Use of Conventional Drugs with Chinese Herbal Products in Taiwan: A Population-based Study

Concurrent Use of Conventional Drugs with Chinese Herbal Products in Taiwan: A Population-based Study

Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US Military Veterans

Effects of Blast Exposure on Subjective and Objective Sleep Measures in Combat Veterans with and without PTSD

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