2011 Compendium of Federal Medicine

Introduction by Brenda L. Mooney, Editorial Director, U.S. Medicine

Even a few decades ago, it would have been difficult to predict the central role women now play in the defense of our country or the complexities of providing for their unique health-care needs, as described in this issue’s articles… Read More

Often Misdiagnosed as Alzheimer’s Disease, Chronic Traumatic Encephalopathy Could Play a Role in Veterans’ Dementia

When Ann McKee, MD, studied the brain tissue of a former offensive lineman for the Detroit Lions and eight-time Pro Bowl player in 2009, she made an important discovery. The football player, who had died from complications associated with dementia… Read More

Despite Success in Managing Warfarin Usage, VA’s Anticoagulation Units’ Role Likely to Change With New Drugs

Some 148,000 patients in the VA system receive anticoagulation therapy to prevent and treat cardiac disease, stroke and deep vein thrombosis (DVT), but the primary anticoagulation drug, Warfarin, which has been in use since the 1950s, is complex to manage,… Read More

Where There’s Smoke: DoD Investigates Causes of Deployment-Related Pulmonary Symptoms Reported by Troops

The media headlines are almost as incendiary as the dramatic pictures of burn pits splashed across the front page. Blamed for generally harmful and even potentially toxic exposure, burn pits have become a focus of speculation in media outlets from… Read More

Numbers May Be Small, But Difficulty Managing Crohn’s Disease is Big Concern

Although the number of Crohn’s disease patients in the VHA and TRICARE systems is relatively small, the notoriously complex disease provides large challenges for the physicians who treat it. In fiscal year 2009, the Military Health System diagnosed… Read More

How Long Before Early Adoption of Insulin Becomes Rule Instead of Exception for Difficult to Control Type 2 Diabetes?

Improved glycemic control in patients with type 2 diabetes is grounded in lifestyle modifications and pharmacologic therapy. Whether to introduce insulin early as a pharmacotherapy for patients with type 2 diabetes is a question that doesn’t have an easy, pat… Read More

With 90% of U.S. Influenza Deaths in Elderly, New High Dose Vaccine Seeks Lower Mortality, Morbidity Rates

Despite the widespread availability of seasonal flu vaccines, influenza continues to be responsible for significant morbidity and mortality in the United States. Each year, influenza causes 3.1 million hospitalization days and 34.1 million outpatient visits at an estimated direct medical… Read More

Gout Specialists Seek to Improve Care for Veterans With Painful Condition

An estimated three million Americans are afflicted with gout, the result of a higher-than-normal level of uric acid in the body. The acid builds up in the joints, forming crystals, which cause the joint to swell and become inflamed. The… Read More

Psychiatric Issues in HCV-Infected Veterans Must Be Managed With Underlying Disease

Managing the physical disease alone is not enough with veterans infected with hepatitis C and who also have high rates of mental health conditions. Addressing the psychiatric issues is especially critical when interferon-based therapies—where depression is a contraindicatio—are the preferred… Read More

New Self-Assessment Tool Helps Physicians Monitor HIV Medication Adherence

When it comes to treatment adherence, HIV is far from the easiest disease to manage. The sheer number of medications, combined with the precision with which they must be taken, can stymie patients and physicians alike. While this fact has… Read More

More Effective Diagnosis Methods Are Critical in Reducing Lung Cancer Mortality

One of the greatest challenges in treating lung cancer is diagnosing the disease early enough to treat effectively. That’s why any new research on early indicators of the disease —such as a recent study on the relationship of smoking cessation… Read More

Researchers Continue Military’s Long Battle Against Malaria, Seek to Develop Vaccine

In their efforts to outmaneuver the highly elusive malaria parasite, researchers at the U.S. Military Malaria Vaccine Program (USMMVP) are more than intellectually and professionally committed. Many of them literally have skin in the game. “Pretty much every principal… Read More

Once Used to Keep Women from Top Ranks, Menopause Now Managed Within VA, Military Health Systems

When President Harry Truman signed the Women’s Armed Services Integration Act into law in 1948, it was touted as opening full military service and veterans’ benefits to women, but many restrictions remained in place. Women were not allowed to fly… Read More

Menstrual Suppression Could Help Deployed Women Avoid Discomfort, Inconvenience

The role of women in the military is changing. Whereas they may have acted as support personnel in earlier conflicts, they now play an active part in combat support and counterinsurgency operations.1 As of September 2010, there were 208,271 women… Read More

With No MS Cure in Sight, VA Centers of Excellence Seek to Maximize Treatment

No cure is on the horizon for multiple sclerosis (MS), the pathology of which remains a mystery to researchers. The unpredictable disease, which degrades the insulating myelin of nerves, can strike with varying speeds, to varying degrees of severity, and… Read More

Although Herpes Zoster Rates Have Nearly Doubled in VA, Vaccination Levels Remain Extremely Low

The incidence of herpes zoster (shingles) in veterans seeking care at VA hospitals continues its steady increase, rising even since a 2010 report documented a near doubling of the rate using VHA Decision Support System data from 2000 to 2007.… Read More

Military Pain Management: A Cultural Change for the 21st Century

The management of combat trauma pain with morphine and other opioid medications and the introduction of battlefield anesthesia was a tremendous medical breakthrough for wounded warriors and military medicine. The first American use of battlefield anesthesia is thought to have… Read More

Schizophrenia Increases Complexity of Aiding Veterans Without Homes

While no one is certain how many homeless veterans suffer from schizophrenia, experts agree that their numbers are significant—and because of the nature of their illness and living conditions, they often present with a variety of health care challenges. … Read More

Table of Contents

Introduction Researchers Continue Military’s Long Battle Against Malaria, Seek to Develop Vaccine Working against significant odds to develop a highly-protective vaccine against a parasitic disease, military researchers are seeking to prevent malaria, which kills as many as a… Read More