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Objective: Specialized training of medical teams for chemical warfare agent (CWA) events is important to save lives. We aimed to evaluate the retention of knowledge (ROK) and self-perceived competency (SPC) of military medical personnel in delivering treatment during CWA events., Methods: A questionnaire and a multiple-choice examination were sent to military physicians and paramedics, evaluating their CWA, ROK, and SPC (study group [SG]). Their assessment was compared to medical personnel immediately post training (reference group [RG]). SG was subdivided into two groups: G1 ≤ 1 year and G2 > 1 year, past training., Results: Overall, 135 participants responded (35-RG, 65% physicians). Self-reported ROK and SPC were significantly higher in RG compared to SG and in G1 compared to G2. Test scores were higher in RG compared to SG, but similar in G1 and G2 groups. SPC was lower compared to ROK in the entire cohort and subgroups. A moderate correlation was found between the self-and test-assessed scores (Pearson correlation coefficient 0.45, p < 0.001). Physicians received significantly (p = 0.01) higher test scores in RG compared with paramedics., Conclusions: ROK and SPC among military medical personnel for treatment of CWA casualties deteriorate significantly as early as 1 year post training, SPC > ROK. Thus, we recommend CWA refresher training at least every year., (Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.)

Background: Several reports suggest that stroke incidence is gradually declining, possibly owing to improvements in primary and secondary prevention. The objective of our study was to assess whether the trends of stroke hospitalization rates, common risk factors, and in-hospital outcomes affected both males and females similarly., Methods: A retrospective review was made of discharge letters of acute ischemic stroke hospitalizations during 1988, 1996, and 2006 in a tertiary referral hospital. Data regarding demographics, common risk factors, and the in-hospital outcomes were collected., Results: A total of 1,287 cases were recorded (mean age 68.7 ± 11.8 years, 53.3% males). The annual age-adjusted rates of stroke hospitalizations per 1,000 persons in 1988, 1996, and 2006 were 2.31, 1.64, and 1.64, respectively (p<0.001). The age-adjusted rates decreased in males (3.0, 1.77, and 1.67; p<0.001); there was no significant trend among females (1.68, 1.53, and 1.62; p = 0.864). The positive trends of age-adjusted rates of hypertension and dyslipidemia were significantly steeper in females than in males. No significant difference in the trends of adjusted in-hospital mortality rates between the sexes was found. Significant decline in the length of stay was demonstrated for both sexes, with no significant difference in the measure of decline between the groups., Conclusions: Stroke hospitalization rates decreased for men but not for women. Regardless of whether the discordance in stroke-incidence trends between males and females was caused by biological factors (different risk factor profile) or disparities in healthcare provision, it seems that the challenge of stroke prevention in the next decade is in lowering the risk of stroke in females.