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2019 issues



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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.

Current Issue

Physical Fitness Associated With Lower Parkinson’s Rates

While exercise is important physical therapy for Parkinson's disease, it might be more than that.

Current Issue

Surgical Staging Often Inadequate for Gallbladder Cancer

Guidelines frequently aren’t followed when it comes to radical cholecystectomy with regional lymphadenectomy for patients with T1b gallbladder cancer.

Current Issue

Prescribed Opioids Increase Risk of Pneumonia in Veterans

A study looking at whether taking prescribed opioids increased pneumonia risk in veterans with HIV vs. those without came to a disturbing conclusion: The likelihood is increased in both.

Current Issue

Legislators Question Whether VA Can Efficiently Implement Mission Act

Six months after President Donald Trump signed the VA MISSION Act–a bill that will, among other things, streamline and expand veterans’ access to non-VA healthcare providers–many legislators are concerned whether VA has the ability to implement the extensive provisions in the bill without the painful speed bumps experienced with past legislation.

Current Issue

VA Fails to Use All Outreach Resources to Combat Veteran Suicide

Despite declaring veteran suicide as its No. 1 clinical priority, VA’s suicide prevention outreach efforts dropped off in 2017 and 2018, and a lack of clear goals and inconsistent leadership has impacted its success, according to a Government Accountability Office report.

Current Issue

Disabled Veteran Helps Others Like Her Get Back Into the Workforce

Ten years ago, Coniece Washington was walking through the Washington, DC, VA Medical Center when she saw a job notice tacked to a board: certified rehabilitation counselor.

Current Issue

Antibiotics Overprescribed After Common Urological Procedures at VHA

Antibiotics appear to be routinely overprescribed for routine urological procedures within the VHA, according to a new study.

Current Issue

Use of Hospice During Treatment Has Limited VA Use

Unlike in most private sector settings, veterans with advanced cancer can receive hospice care concurrently with treatments such as radiation and chemotherapy.

Current Issue

VA Overall Appointment Wait Times Shorter than the Private-Sector

Despite intense scrutiny of wait times for veterans seeking VA care over the last three years, a new study pointed out that delays in the private sector weren’t statistically less in 2014 and that, possibly because of the focus, wait times now are significantly shorter for the VA compared to private-sector healthcare facilities.

Current Issue

Senate Blocks Agent Orange Exposure Extension to Blue Water Veterans

Blue Water Navy veterans who claim to be impacted by toxic exposure while serving off the coast of Vietnam were forced to grapple with disappointment once again as the 115th Congress ended without passing legislation addressing their VA benefits.

Current Issue

VA Seeks to Resolve Questions about Prazosin for PTSD Nightmares

For years, prazosin has appeared to be one of the most effective medications for treating the nightmares associated with post-traumatic stress disorder, but that treatment is being called into questions by findings from two recent studies that patients with PTSD who received a placebo did as well or better than those who received prazosin.

Current Issue

Most Veterans Receiving VA Mental Healthcare Support Some Gun Restrictions

A survey of veterans receiving mental healthcare through VA found that the vast majority would favor at least one option to restrict firearm access with the goal of reducing dangers of self-harm.

Current Issue

“An investment in knowledge pays the best interest.” –Benjamin Franklin (1706-1790)

Julius Caesar commented, “No one is so brave that he is not disturbed by something unexpected.” My wife, Pam, and I recently traveled to Florida to visit my mother and father, who are in their... View Article

Current Issue

Target Lung Disease to Improve Rheumatoid Arthritis Survival

A recent VA study emphasized the importance of targeting comorbid lung disease to improve long-term outcomes in rheumatoid arthritis (RA).

Current Issue

VA Research Demonstrates Importance of Personalization in DLBCL Treatment

Diffuse large b-cell lymphoma accounts for approximately one-third of all cases of non-Hodgkin lymphoma, which is classified by the VA as a presumptive disease for veterans exposed to Agent Orange while serving in Vietnam.

Current Issue

Army Research Challenges Long-Standing Platelet Storage Recommendations

For nearly 50 years, platelets have been stored at room temperature. Research conducted by investigators at the U.S. Army Institute of Surgical Research Center in San Antonio very well could change that.

Current Issue

New Venous Thromboembolism Guidelines Could Change Treatment at VA

Venous thromboembolism, which includes deep venous thrombosis and pulmonary embolism, is the most common preventable cause of hospital death, according to the VA.

Current Issue

Combat Prehospital Analgesia Agents Have Changed in Last Decade

Over time, Tactical Combat Casualty Care) guidelines regarding prehospital analgesia agents have changed, according to a new review.

Current Issue

Hypertension, MGUS Associated with Herbicide Exposure in Vietnam Veterans

Based on a new review, two conditions–one extremely common and the other rare–appear to be related to herbicide exposure during the Vietnam War era.

Current Issue

Detailed Medical History Crucial for Lung Disease Diagnosis

Both general medicine physicians and specialists can find interstitial lung disease (ILD) and pulmonary fibrosis confusing, according to a recent study.

Current Issue

VA: Oversight Improving for Questionable Contracted Disability Exams

A recent audit by the Government Accountability Office has lawmakers and veterans service organizations frustrated with the Veterans Benefits Administration’s inability to track the quality of work done by outside contractors and concerned that veterans have not been receiving accurate disability ratings.

Current Issue

VA ‘On Track’ for Appeals Reform; GAO Questions Timetable

VA is “on track” to implement a law designed to give veterans more options to have their claims appeals reviewed, as well as speed up the process, agency officials assured lawmakers last month.

Current Issue

VAMCs Usually as Good or Better Than Private Hospitals in Same Communities

Veterans are being given more options for obtaining care outside of the VA healthcare system. The question raised in new research is whether doing so improves care.

Current Issue

Report Could Add 23 Presumptive Conditions for Gulf War Veterans

A new report from the National Academies of Sciences, Engineering, and Medicine found that sufficient evidence supported an association between exposure to seven factors and detrimental reproductive effects in men or women who served in the Gulf War or developmental effects in their children.

Current Issue

Efficiency at Expense of Effectiveness? Legislators Blast VBA Management

Recent problems with initiatives implemented by the Veterans Benefits Administration point to much larger, systemic issues in how the agency rolls out new programs, according to the VA Office of the Inspector General.

Current Issue

Use of Non-VHA Pharmacies Increases Risks of Scheduled Drug Overdoses

Using multiple sources to get prescribed pain medications and other Schedule II through V drugs increases risks for veterans, a new study finds.

Current Issue

“The risk of a wrong decision is preferable to the terror of indecision.” –Maimonides (1135-1204)

Much to my family’s chagrin, the influence of British humor on my personality and sense of humor began as a preteen. I would stay up late at night for episodes of “Benny Hill” and my... View Article

Current Issue

Melanomas Associated With Internal Malignancy Risk

Genetic and environmental risk factors have been associated with the development of multiple primary melanomas (MPM) but a new study questioned whether those patients might have increased predisposition to developing internal malignancies.

Current Issue

Some RCC Risk Factors Can Be Modified

Obesity, hypertension and smoking are the three modifiable risk factors that could aggressively be targeted to reduce renal cell carcinoma, according to a new study.

Current Issue

Shared Antimicrobial Stewardship Surveillance System Saves Three VAMCs $2.3 Million

Three VAMCs that formed a collaborative group to optimize use of a shared clinical surveillance system saved more than $2.3 million in two years.

Current Issue

DHA Releases Interim Guidance for HIV Pre-Exposure Prophylaxis

The Defense Health Agency (DHA) has released interim guidance designed to optimize clinical use of human immunodeficiency virus (HIV) pre-exposure prophylaxis and reduce variability in access to prophylactic medication.

Current Issue

With Advancing Age, Veterans with HIV Face Novel Challenges

Thirty years ago, veterans with human immunodeficiency virus and their physicians focused on survival.