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Wounded warriors to be treated at center: National Intrepid Center of Excellence will start accepting patients in the fall [The Frederick News-Post, Md.](Frederick News-Post (MD) Via Acquire Media NewsEdge) Aug. 22--BETHESDA -- Warriors struggling to overcome brain injury and psychological trauma have a new resource: the National Intrepid Center of Excellence in Bethesda. The center, located on the National Naval Medical Center campus, features an array of therapy methods and state-of-the-art medical equipment to diagnose, treat and research some of the toughest cases of traumatic brain injury and post-traumatic stress disorder. Because each patient will require such individualized care, the center will accept only 20 patients at a time, each of whom will stay in Bethesda no longer than two weeks. The patients accepted into the program are those who are still having problems a year or two after seeking medical treatment, "cases that are kind of confounding the physicians who have been treating them," said Vadim Smirnoff, the center's IT program manager. After the patients return home, the center will keep in touch with the patients' doctors and "have a very active role in treatment planning," Smirnoff said. The National Intrepid Center of Excellence opened June 24 and will start accepting patients this fall. The $65 million center was designed and built by the Intrepid Fallen Heroes Fund -- financed entirely by private donations -- and then donated to the Department of Defense. The center also conducts extensive research into brain damage and new therapy methods. All the medical images taken -- MRIs, PET/CTs and more -- are added to a large repository, along with images from other medical facilities around the country, for research purposes. Creating a data management system that was compatible with the medical equipment and sophisticated enough to handle the research and clinical missions of the center was left to the Naval Medical Logistics Command at Fort Detrick. All the medical images taken at the center need to be sent to both the patient's file and the research repository, a somewhat unique requirement. In March 2009, NMLC was called in to install its Picture Archive and Communication System, with 16 terabytes of memory and room to grow. "We don't normally get the chance to do things from the ground up," PACS Program Manager Ed Doorn said, adding that "this was still a hole in the ground when we started." Doorn and his boss, Lt. Cmdr. Daniel Kachenchai, director for medical equipment and logistics solutions, said the project took less time than most because they didn't have to work around people's schedules and cluttered offices. The project was fairly simple once they found a contractor, though they found themselves needing to adjust for "a lot of things that aren't quite the norm with the Navy," Doorn said. For example, patient files may need to be shared with the U.S. Department of Veterans Affairs, since not all the patients will still be active duty service members. The research files will need to be shared with other research facilities, not just military but throughout the government and at universities and private laboratories. Though NMLC will be done with its assignment when it completes a government acceptance test in early September to ensure the system works properly, Kachenchai assured that "we're going to have a strategic relationship with this facility until the end," stepping in if new needs arise or new external connections need to be made. Having a reliable data management system will be important at the National Intrepid Center of Excellence, since its many diagnostic and therapeutic tools will generate a huge amount of information. One tool is the computer-assisted rehabilitation environment, which features a round platform on hydraulics in the center of a room. The platform has a treadmill with a harness in the center and is surrounded by a virtual reality screen. The patient is then asked to navigate hills and other terrain, or to respond to combat situations, and the platform's movement makes the situation all the more realistic. "They can walk, run, move in this simulated environment," Smirnoff said, and cameras capture their movement for further study. The center also has a virtual reality suite with firearms simulators and vehicle simulators, which replicate stressful environments and actions and allow doctors to help diagnose patients based on their reactions. One suite in the building is set up like an apartment, with a fully stocked kitchen, a laundry room, a bathroom, a bedroom and a living room. Doctors can observe the patient interacting with his or her family, as well as performing routine tasks like cleaning clothes or cooking a meal, to look for emotional, short-term memory or sequencing problems. The building also has a variety of rooms for music therapy, recreation therapy, physical therapy, sleep studies and more. And for some of the most difficult cases of brain injury, the center has equipment to project MRIs and PET scans into 3-D images, with the help of movie theater-like 3-D glasses. Doctors can see the images from new angles, which can "accentuate problems that may not have been visible before," Smirnoff said. To see more of the Frederick News-Post or to subscribe to the newspaper, go to http://www.fredericknewspost.com. Copyright (c) 2010, The Frederick News-Post, Md. Distributed by McClatchy-Tribune Information Services. 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