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2019 issues



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Current Issue

VA Now Allows New Therapy Option for Treatment-Resistant Depression

Condition Significantly Increases Veterans’ Healthcare Costs ORLANDO, FL—VA clinicians now will be able to prescribe a form of ketamine to help patients with treatment-resistant depression. The condition is associated with healthcare resource utilization and costs... View Article

Current Issue

IBD Treatment Can Increase Squamous Cell Cancer Risk

PHILADELPHIA—Treatment with thiopurines is associated with an increased risk of squamous cell carcinoma of the skin in patients with inflammatory bowel diseases, according to a new study. Researchers from the Corporal Michel J. Crescenz VAMC... View Article

Current Issue

High Satisfaction with Teledermatology at Atlanta VAMC

ATLANTA—Teledermatology is comparable to face-to-face visits in providing accurate diagnoses and effective treatments, but it is not clear how patients feel about teledermatology models that more directly convey provider recommendations to patients. A study in... View Article

Current Issue

Erectile Dysfunction Drugs and Skin Cancer in Veterans

LEXINGTON, KY—Is there a relationship between phosphodiesterase 5 inhibitor drugs, prescribed for erectile dysfunction, and skin cancers? A large-scale study of veterans sought to determine that. A retrospective review using the VAs Informatics and Computing... View Article

Current Issue

Technology Experts Question MISSION Act Electronic Systems

WASHINGTON—VA is working under a tight deadline to implement the community care provisions of the MISSION Act, the new law that goes into effect this summer and revises and codifies access standards for veterans receiving... View Article

Current Issue

VA Study Raises Questions About Value of Readmission Metrics

SAN FRANCISCO—While the VA performs well overall on key 30-day readmission rates, a study by researchers at the San Francisco VAMC questioned the utility of the measures for most of the health system’s hospitals. The... View Article

Current Issue

Ongoing IT Problems at VA Could Hamper Shared EMR System With DoD

WASHINGTON—High turnover among leadership, gaps in accountability, and long-standing problems in cybersecurity represent significant challenges for VA in its ongoing efforts to improve its IT infrastructure, oversight officials told legislators last month. These challenges will... View Article

Current Issue

DCVAMC Acting Pharmacy Chief Ivan Cephas: ‘Caring Is the Reason’

WASHINGTON—Ivan Cephas, PharmD, the acting chief of pharmacy at the DCVAMC, would be the first to say that what he does is not above and beyond the call of duty. Despite having been awarded the... View Article

Department of Veterans Affairs (VA)

Three VAMC Campus Suicides in a Week Heighten Concerns About Prevention

WASHINGTON—Concern over the rate of veteran suicides reached a fever pitch last month after three veterans took their lives at VA facilities over a span of five days. Two of the deaths occurred in Georgia—one... View Article

Current Issue

Thousands of Lives Were Saved by Military Medicine Innovations in Recent Wars

Mortality Reduced more than 44% During Iraq, Afghanistan Conflicts SAN ANTONIO—The ability of military medicine to constantly innovate in saving the lives of wounded warriors reduced mortality 44.2% during the conflicts in Iraq and Afghanistan,... View Article

Current Issue

VA Reverses Stance, Won’t Challenge ‘Blue Water’ Veteran Court Ruling

WASHINGTON—In an about-face, the VA will recommend that the federal government not challenge a recent court decision ruling that the department cannot deny benefits to Vietnam-era Blue Water Navy veterans claiming Agent Orange exposure. The... View Article

Current Issue

Healthcare is vital to all of us some of the time, but public health is vital to all of us all of the time. —C. Everett Koop (1916-2013)

It has been with no small amount of dismay that I have watched national maps of the measles outbreak grow progressively redder on the national news as the epidemic continues to spread across the nation.... View Article

April 2019

Combat, Not Deployment, Appears to Increase Risk of New-Onset Asthma

BETHESDA, MD—Many reports have suggested that servicemembers who deployed to Iraq and Afghanistan developed respiratory illnesses at higher-than-expected rates, but study results looking at increased rates of asthma have been mixed. A new study by... View Article

April 2019

VA Continues Efforts to Reduce Drug Diversion; Focuses on Opiates

WASHINGTON—In the past two years, the VA has implemented a nine-step process to minimize drug diversion, but cases continue to slip through. In December 2018, the VA’s Office of the Inspector General reported two instances... View Article

April 2019

Overcoming Radiation Resistant Prostate Cancer

LOS ANGELES—For nearly half of the patients with localized advanced prostate cancer, radiation therapy is the primary intervention and standard of care for recurrent disease following surgery. The problem is that nearly 30% to 50%... View Article

April 2019

JAK Enzymes Can Treat Leukemia, Lymphoma

NASHVILLE, TN—Precision oncology prescribes the use of molecularly-targeted therapy directed by identification of genomic alterations. A new study suggested the approach is particularly applicable to neoplasms that are resistant to standard cytotoxic chemotherapy, such as... View Article

April 2019

Response of Veterans to PD-1 Checkpoint Inhibitors

RENO, NV—The clinical outcomes and the incidence of adverse events for programmed death-1 checkpoint inhibitors in cancer patients at a VA clinic were different from the data that have been published, according to a new... View Article

April 2019

Steroid Overuse Suggests Benefit to Flipping PCP/Specialist Paradigm in COPD

SEATTLE—New guidelines published in 2017 upended recommendations for use of inhaled corticosteroids in patients with chronic obstructive pulmonary. Two years later, many VA patients still receive discordant care. To fix the problem, the VA’s Health... View Article

April 2019

Personalization, In-Home Adaptation Necessary to Improve CPAP Adherence

INDIANAPOLIS—To improve adherence to continuous positive airway pressure treatment, more emphasis needs to be put on support for sleep apnea patients in their homes, where the equipment actually is used. That’s according to a new... View Article

April 2019

Executive Order Creates Task Force to Combat Veteran Suicide

WASHINGTON—President Donald Trump has signed an executive order aimed at lowering the rate of veteran suicides. The order—the President’s Roadmap To Empower Veterans and End a National Tragedy of Suicide—creates a Cabinet-level task force led... View Article

April 2019

VA Struggles to Overcome Women’s Healthcare Disparities

WASHINGTON—VA is straining its capacity and struggling against a culture that can sometimes be hostile to women as it responds to what VA officials consider a “tsunami wave of women veterans” over the last decade.... View Article

April 2019

No Link Between Anthrax Vaccine, ‘Lone AFib’

ATLANTA—Concerns have been raised about a possible link between receipt of anthrax vaccine adsorbed and atrial fibrillation in military personnel without identifiable underlying risk factors or structural heart disease. A study in Human Vaccines &... View Article

April 2019

Improving OAC Adherence in Atrial Fibrillation Patients

DURHAM, NC—Treatment of atrial fibrillation patients isn’t always in line with clinical guidelines, but improving adherence to oral anticoagulation has proven to be challenging, according to a new study. The article in Circulation reported on... View Article

April 2019

CVD Risks Differ by Sex in VA Patients

WASHINGTON—Does the incidence of cardiovascular disease differ by sex among veterans as it does with the general U.S. population? A study in the Journal of Women’s Health sought to answer that question. VA researchers from... View Article

April 2019

VA Researcher Seeks to Include Veterans’ Voices in Healthcare Decisions

SEATTLE—It’s a big job to ensure that VA’s healthcare system is equipped to provide the best possible care to veterans. It might be an even bigger job to make sure that veterans across the country... View Article

April 2019

PTSD Alone Doesn’t Increase Cardiovascular Risk in Veterans

Study Urges Close Monitoring of Physical, Psychological Co-Morbidities ST. LOUIS—Even though veterans diagnosed with post-traumatic stress disorder are 41% more likely to developing cardiovascular disease than those without, PTSD alone doesn’t fully explain the higher... View Article

April 2019

VA Announces Plans to Create 3D-Printed Artificial Lung

3D Printing Already Personalizes Care in Other Ways ANN ARBOR, MI—VA scientists in Michigan recently announced they are working to create a three-dimensional-printed artificial lung. The lab-created lung could transform treatment for some of the... View Article

April 2019

Legislators Express Outrage Over Military Sexual Trauma Issues Subhead: Senator Describes Her Experience as Air Force Rape Victim

WASHINGTON—A recent survey of the military service academies found that sexual assault has spiked over the last two years, up 50% since 2016. This news sparked fresh outrage from legislators, resulting in a hearing focusing... View Article

April 2019

House Committee Looks at Influence Trump Friends Have Had on VA

WASHINGTON—Three months into the new Democrat-led Congress, legislators are continuing to press VA on possible misconduct by high-level VA employees and consultants. That includes expanding the investigation into VA’s relationship with civilian advisers conducting meetings... View Article

April 2019

“You can design and create, and build the most wonderful place in the world. But it takes people to make the dream a reality.” —Walt Disney (1901-1966)

A friend recently texted me a Military.com article by columnist Tom Philpott entitled, “More than 17,000 Uniformed Medical Jobs Eyed for Elimination.” I read the item with no small amount of trepidation and concern, since... View Article

2019 issues

Current Treatment Halves Cardiovascular Disease Risk in Hep C Patients

PITTSBURGH—In more good news for veterans who have received treatment for hepatitis C virus, VA researchers have found that treatment not only reduces the risk of complications from liver disease, it also dramatically reduces the... View Article

2019 issues

VA Models Allow Earlier Identification of HCV Patients at Risk of Progression

ANN ARBOR, MI—New prognostic models developed by VA researchers can help clinicians identify which patients who have or have had chronic hepatitis C virus infection will develop cirrhosis or hepatocellular carcinoma. While the VA has... View Article

2019 issues

Fewer Than Half of Eligible Servicemembers Complete HPV Vaccine Series

FORT BRAGG, NC—Immunization rates of human papilloma virus (HPV) have risen among active duty forces, but many fail to complete the full vaccine series, despite recommendations from the Defense Health Agency.   “DHA fully endorses... View Article

2019 issues

History of Abuse, PTSD Worsen Menopausal Symptoms

SAN FRANCISCO—Emotional abuse from a partner or spouse can increase the risk of heightened menopause symptoms, as can post-traumatic stress disorder, according to a VA-led study. Little is known about the prevalence of traumatic exposures... View Article

2019 issues

Military Women Face Barriers to Getting, Using Contraception

CAMBRIDGE, MA—Past studies have shown that the unintended pregnancy rate is higher among U.S. servicewomen than the general population and that servicewomen sometimes face barriers to contraceptive use. Yet, according to a study in Military... View Article

2019 issues

How Does Breast Density Affect Cancer Risk, Tumor Type?

GAINESVILLE, FL—What is the association of mammographic breast density with breast cancer risk by tumor aggressiveness and by menopausal status and current postmenopausal hormone therapy? That question was addressed in an article in Breast Cancer... View Article

2019 issues

Physician Documents, Promotes Veteran Honor Guards in VA Hospices

PHILADELPHIA—Michelle Brassil, MD, had been warned when she began her fellowship at the Cpl. Michael J. Crescenz VA Medical Center’s Community Living Center in Philadelphia. “Don’t be surprised if you’re emotional,” her supervisor told her.... View Article

2019 issues

Lack of DoD/VA Decision-Maker Could Hamper EHR Implementation

WASHINGTON—Plans are moving ahead for VA’s 10-year, $16 billion effort to modernize its electronic health record system, but legislators still have questions about the project’s timeline and funding, as well as concerns about the project’s... View Article

2019 issues

Democrats Look at VA Role of Trump’s Mar-a-Lago Associates

WASHINGTON—Congress announced last month that it will be opening an investigation into alleged improper influence by three civilian consultants to President Donald Trump on administration of the VA. The three men—Ike Perlmutter, CEO of Marvel... View Article

2019 issues

Surgery Delay Does Not Explain Racial Differences in Breast Cancer Survival

BETHESDA, MD—Black women die from breast cancer at a higher rate than white women, but exactly why remains unclear. A new study from the Military Health System just shot down one of the leading explanations... View Article

2019 issues

Greatest VA Weight Gains in Women Veterans Without Diabetes

ATLANTA—How does a diagnosis of diabetes affect weight management among U.S. veterans? A study in the journal Obesity (Silver Spring) sought to assess weight trends and diabetes prevalence among U.S. veterans.1 Atlanta VAMC researchers and... View Article

2019 issues

Diabetes Patients Do Well in Military Healthcare-to-VA Transition

SAN DIEGO—When service members leave active duty and receive healthcare in a different setting, care for conditions such as diabetes can suffer. A study in Military Medicine pointed out that changes in healthcare have been... View Article

2019 issues

NPs, PAs Have as Good Diabetes Outcomes as Physicians

DURHAM, NC—So-called physician extenders do as good a job as physicians at the VA in helping to achieve good outcomes in diabetes patients, according to a new study. The report in Annals of Internal Medicine... View Article

Current Issue

Effectiveness of Topical Pain Creams Questioned in Military Study

BALTIMORE, MD – Extremely high payouts from federal health insurance plans for prescription topical pain creams or gels led Congress to mandate a study on the effectiveness of the products. The new study published in... View Article

Current Issue

VA Announces Proposed Standards for Access to Mission Act Outside Care

WASHINGTON—VA has released its proposed new access standards, defining new eligibility criteria for veterans seeking care by non-VA providers. The standards are part of the VA MISSION Act signed into law in June 2018, and... View Article

Current Issue

VA Announces New Partnerships to Expand Telehealth Services

WASHINGTON.—VA Secretary Robert Wilkie announced new partnerships with several prominent companies and veterans’ organizations to make access to health services easier for veterans, regardless of their location. Collaborators announced at the recent Anywhere to Anywhere,... View Article

Current Issue

Veterans on Standard Diabetes Care Face Dangers from Hypoglycemia Subhead: Post-hoc VADT Analysis Links Low Blood Sugar to CV Events

BALTIMORE, MD—A post-hoc analysis of the Veterans Affairs Diabetes Trial (VADT) once again shines a spotlight on the dangers of hypoglycemia in veterans treated for Type 2 diabetes. The study published in Diabetes Care found... View Article

Current Issue

“Medice, cura te ipsum” – Luke 4:23

Physician, heal thyself is the English translation of the ancient Latin proverb quoted in the title. Various forms of this quote are found in a variety of classical texts, and it is generally accepted that... View Article

Current Issue

New Antibiotic Provides Powerful Option for Resistant Pneumonia, Skin Infections

A next-generation tetracycline, omadacycline could improve care for veterans with community-acquired bacterial pneumonia (CABP) and acute skin and skin structure infections (ABSSSI).

Current Issue

New Military Pharmacy Program Frees Patients from Long Waits

More than a dozen military treatment facility pharmacies have implemented a pilot customer service system that gives patients greater control over how they spend their time while waiting for prescriptions to be filled.