2019 issues



More for You

August 2019

VA Study Shows Benefit of PCSK9 Inhibitors After Maximizing Other Therapies

HOUSTON—Veterans who have experienced acute coronary syndrome within the past year face a substantial risk of a repeat event. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors significantly reduce that risk, but determining who would benefit... View Article

August 2019

Tests Show No Lung Changes for Recent Veterans

SAN ANTONIO—Significant airborne hazards were reported during military conflicts in southwest Asia, including geologic dusts, burn pit emissions, chemical exposures, and increased rates of smoking. Yet, despite significant concerns about the respiratory health of deployed... View Article

August 2019

Following Guidelines Reduced Morality in Veterans at High Risk of Recurrent Stroke

Only 15.3% of Eligible Patients Received All Interventions INDIANAPOLIS—Meticulously following clinical guidelines in VA patients who suffered transient ischemic attack or nonsevere ischemic stroke reduced by nearly one-third their risk of death within a year,... View Article

August 2019

Ensuring Community Providers Meet Veteran Suicide Prevention Standards

WASHINGTON—As leaders from across multiple federal agencies begin work on a roadmap to combat veteran suicide, they are searching for ways to turn existing efforts in towns, cities, counties and neighborhoods across the country into... View Article

August 2019

Debate Continues on Esketamine Efficacy and Safety for Depression Treatment

VA Panel Puts Limits on Use of Drug PHILADELPHIA—Is esketamine a revolutionary treatment for depression or just another moderately effective adjunctive medication with some potentially serious risks? The VA’s Medical Advisory Panel leaned toward the... View Article

August 2019

“13. The delivery of good medical care is to do as much nothing as possible.” “Laws of the House of God,” —Samuel Shem

I have been a part of U.S. Medicine and this column for several years now. I am occasionally asked where my ideas come from for the editorials I produce. Many ideas, of course, are pulled... View Article

July 2019

Virtual Reality Tested for Phantom Limb Pain in Veteran Amputees

SAN DIEGO—Virtual reality appears to be a feasible way to treat phantom limb pain at the VA, according to a small new study. The report in Pain Medicine sought To describe the development of a... View Article

July 2019

VA Researcher Helps Develop Promising New Pain Drug

NEW ORLEANS—A new drug with less risk for addiction and overdose compared to currently available opioid medications is showing promise, according to a recently published research article. The drug, developed at Southeast Louisiana Veterans Health... View Article

July 2019

Racial Disparities Found in BRCA Testing, Counseling

DURHAM, NC—Despite increases in BRCA mutation testing, racial/ethnic disparities in counseling and testing have persisted for decades, a study argued. The review published in the Journal of Racial and Ethnic Health Disparities said its purpose... View Article

July 2019

VA Guideline Addresses Dental Management of Head/Neck Cancer Patients

SAN FRANCISCO—Few protocols have been published for the dental management of patients with head and neck cancer to prevent complications from head and neck radiation therapy, according to a new study.  The report in the... View Article

July 2019

Patients Treated with Thiopurines Have Higher Skin Cancer Mortality

PHILADELPHIA—Treatment with thiopurines is associated with an increased risk of squamous cell carcinoma of the skin in patients with inflammatory bowel diseases. An article in Clinical Gastroenterology and Hepatology discussed results of a study that... View Article

HIV

Low to No Alcohol Use Optimizes Health Outcomes in HIV Patients

SEATTLE—For years, physicians have encouraged patients diagnosed with human immunodeficiency virus to minimize or avoid drinking alcohol. But how much does it really matter? “Controlled alcohol use over time, especially nonuse or very low-level use,... View Article

HIV

Army Researchers Identify a CV Bonus from Early ART Initiation in HIV

SAN ANTONIO, TX—ART has never looked better, at least if you’re an individual recently diagnosed with human immunodeficiency virus.  Researchers at the Brooke Army Medical Center in San Antonio recently determined that antiretroviral therapy reverses... View Article

Department of Veterans Affairs (VA)

VA Manages Drug Costs Better than Medicare Part D

ST. LOUIS – Medicare Part D could save more than $14 billion annually if it paid the same prices for top medications as the VA, according to a new study. A research letter published earlier... View Article

July 2019

Rural Veterans Prescribed More Long-Term Opioids

IOWA CITY, IA—Rural veterans received significantly more opioid prescriptions from the VA than those in urban areas, and that could be behind some of the drug problems in less-populated areas, according to a new study.... View Article

July 2019

Bergendahl Uses Video Gaming to Help Fellow Veterans Recover

Mat Bergendahl, MS, LPC, was with the Air Force Security Forces when the United States invaded Iraq in 2003. Like many servicemembers, he managed to bring along some personal effects. And, like many people his... View Article

Department of Veterans Affairs (VA)

House Passes Bill to Create Education/Employment Arm of VA

WASHINGTON,—Legislators have reintroduced plans to create a fourth administration within the Department of Veterans Affairs—one dedicated to overseeing veterans’ education, transition and employment benefits. Currently these operations fall under the Veterans Benefits Administration, with VBA... View Article

Department of Veterans Affairs (VA)

Administrative Confusions Results in Little Oversight of VA’s Police Force

Suicides, Violence at VMACs Put Spotlight on Security WASHINGTON—As the number of suicides and other violent incidents at VA facilities grows, a spotlight is being thrown on VA’s internal police force and its ability to... View Article

Department of Veterans Affairs (VA)

Veterans Using Dual Health Systems Have More Problems With Medications

CHARLESTON, SC—More than half of the patients treated by VA are also Medicare eligible, and that is increasing the risk for a range of prescription medication problems—from chronic disease medication nonadherence to opioid overdoses—among dual... View Article

Editor in Chief

“When discussing collaboration, people often talk about ‘breaking down silos.’ … ” —William D. Ramsey, MD

“When discussing collaboration, people often talk about ‘breaking down silos.’ I object to that terminology because ‘breaking down’ is a negative image that implies destruction or tearing down of silos. Academically, silos represent our areas... View Article

Diabetes

Metformin Halves All-Cause Mortality in Frail Older Veterans

Other Important VA Studies at the American Diabetes Association 79th Scientific Sessions MIAMI—The first-line drug of choice for Type 2 diabetes, metformin has long been known to effectively reduce blood glucose levels and substantially cut... View Article

July 2019

VA Opposes Law Loosening Benefit Requirements for MST Survivors

WASHINGTON—New legislation would make it easier for victims of military sexual trauma to receive benefits, but the VA is opposing it.  Among other provisions, the bill would lower the burden of proof necessary for MST... View Article

Department of Veterans Affairs (VA)

All VA Healthcare Facilities to Be Completely Smoke-Free by October

New Directive Abolishes Designated Smoking Zones WASHINGTON—Starting in October, all VA healthcare facilities will be official no-smoking zones. While VA now permits smoking in designated areas, the department has issued a new policy restricting smoking... View Article

Cardiovascular Disease

Million Veteran Program Study Raises Questions about Omega-3 Benefits in CAD

BOSTON—Researchers at the Massachusetts Veterans Epidemiology and Research Information Center demonstrated the value of the VA’s ability to harness the health data of thousands or even millions of individuals in a study that calls into... View Article

June 2019

Pharmacist Involvement Improves Accuracy of Direct Oral Anticoagulants

PALO ALTO, CA—For decades, patients prescribed warfarin to reduce the risk of stroke following a diagnosis of atrial fibrillation have made regular visits to pharmacist- or nurse-directed clinics to ensure their international normalized ratio (INR)... View Article

Gout

Pharmacist Involvement Improves Gout Therapy Adherence for Veterans

OMAHA, NE—The most common form of inflammatory arthritis—gout—affects about eight million Americans. The disease causes intensely painful flares, but despite the availability of several drugs to manage this chronic, incurable condition, ongoing adherence to therapy... View Article

June 2019

Veterans With PNES Have Lower QoL vs. Other Seizures

PORTLAND, OR—Do seizure disorders affect veterans differently than patients who have never been in the U.S. military? And does the type of seizure matter? A study published in Epilepsy & Behavior examined those issues.1  VA... View Article

June 2019

Higher Efficacy DMTs Reduce MS Brain Atrophy

BETHESDA, MD—How do disease-modifying therapies (DMTs) affect region-specific brain atrophy in multiple sclerosis? A recent study sought to answer that question. Researchers from the Center for Neuroscience and Regenerative Medicine, at The Henry M. Jackson... View Article

Alzheimer's/Dementia

TBI Might Not Be a Risk Factor for Alzheimer’s Disease

BOSTON—New research is calling into question whether traumatic brain injury is actually a risk factor for Alzheimer’s disease. A report in the journal Alzheimer’s & Dementia discussed recent research with neuropathologic or biomarker evidence of... View Article

Hematology

Certain Hematologic Malignancies Increase Head/Neck Tumors

PORTLAND, OR—With more than 1.3 million people in the United States having been diagnosed with a hematologic malignant tumor currently or in remission, previous research has suggested an increased risk of secondary neoplasms. Yet, the... View Article

Hematology

VA Study: Anemia Often Overlooked in IBD Patients

HOUSTON—Anemia is a common complication of inflammatory bowel disease, and existing guidelines urge vigilance for the condition. Yet, according to a study in Digestive Diseases & Sciences, it is frequently undertreated, resulting in the prevalence... View Article

Hematology

Tracking Major Hemorrhage Risk Factors in CLL Patients

COLUMBIA, SC—Understanding that chronic lymphocytic leukemia patients are at increased risk for major hemorrhage, a study published in Cancer Medicine examined incidence of and risk factors for MH in CLL patients before introduction of newer... View Article

June 2019

Mental Health Treatment Alone Won’t Stem Veteran Suicides

Joint House VA, Military Subcommittee Hearing Tackles Issue WASHINGTON—In a rare joint hearing by the House Armed Services Subcommittee on Military Personnel and VA Subcommittee on Health, legislators examined how DoD and VA are working... View Article

Department of Veterans Affairs (VA)

VA Isn’t Addressing Recommendations by Oversight Agencies

Too Many Leadership Vacancies Are Part of the Problem WASHINGTON—Deeply ingrained management problems are preventing VA from addressing priority recommendations from oversight agencies, leaving the department with long-standing weaknesses in its healthcare and disability benefits... View Article

June 2019

High Satisfaction with Teledermatology at Atlanta VAMC

ATLANTA—The VA has rolled out a number of telehealth initiatives over the last years, with remote visits to dermatologists being offered to more and more veterans. But how well is the program working? A new... View Article

HIV

HIV Patients Had Lower PC Incidence in VA Study

NEW YORK—Non-AIDS defining cancers are increasingly important contributors to health outcomes for aging persons with HIV (PWH), according to a recent conference presentation. The presentation also pointed out that, although prostate cancer is prevalent in... View Article

June 2019

Military Spouse/Lawyer Helps Overcome Career Barriers to Moves

As an attorney for the Board of Veterans Appeals, Libby Jamison, JD, has a front seat to stories of individuals mired in red tape who are struggling to get their needs met by what can... View Article

Health

Cardiovascular Health Worse for Active-Duty Soldiers Than Same-Age Civilians

PHILADELPHIA – While active-duty Army personnel are generally considered to be among the healthiest Americans, a new study found that not to be the case. In fact, researchers found that those servicemembers have worse overall... View Article

June 2019

A Fourth of Female Veterans Report Stranger Harassment at VAMCs

WASHINGTON—Women veterans regularly experience harassment by male veterans at VA facilities, and that harassment has a direct and lasting impact on their healthcare, VA researchers reported recently. Investigators from the VA Greater Los Angeles Health... View Article

Department of Veterans Affairs (VA)

VA MRSA Prevention Program Successfully Reduced Cases 43%

CDC, VA Authors Reject Calls to Lessen Interventions SALT LAKE CITY—Concerned about methicillin-resistant Staphylococcus aureus, one of the most common causes of healthcare-associated infections, the VA piloted a MRSA prevention program in 18 VAMCs beginning... View Article

Editor in Chief

“God help us, if, the first time something fails—and something will fail—we crush whoever it was … whoever’s responsible,” —Gen. John “Mike” Murray

Gen. Mike Murray made this comment as he became the first commander of the Army Futures Command. The command’s website describes the mission of the organization with the following statement: “Army Futures Command leads a... View Article

Cancer

HIV Patients Had Lower PC Incidence in VA Study

NEW YORK—Non-AIDS defining cancers are increasingly important contributors to health outcomes for aging persons with HIV (PWH), according to a recent conference presentation which also pointed out that, although prostate cancer is prevalent in aging... View Article

Cancer

VA Study Finds No Link Between ADT, Dementia

LA JOLLA, CA—Research has been conflicting on whether androgen deprivation therapy is related to dementia. A research letter in JAMA Oncology pointed out that two studies reported a strong statistically significant association between ADT and... View Article

Cancer

Agent Orange Exposure Not Associated With Worse PC Outcomes

MADISON, WI—How does a history of Agent Orange exposure affect prostate cancer survival in VA patients receiving androgen deprivation therapy for advanced prostate cancer? That was the question addressed in a Journal of Urology study.1... View Article

Cancer

Oral Cancer Therapies Create Critical Demand for Pharmacists

CHICAGO—The pace of U.S. Food and Drug Administration approval of oral anticancer medications has rapidly increased, from less than one a year at the turn of the century to 10 in 2018. While patients generally... View Article

Current Issue

VA Awakens to Prevalence of Sleep Apnea in Veterans with Severe Mental Illness

PITTSBURGH—Serious mental illness increases the likelihood of sleep apnea by 26%, according to researchers at the VA Pittsburgh Healthcare System. Their study, recently published in Psychosomatics, also found that nearly 9% of all veterans had... View Article

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