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April 2018

Mental Health Diagnoses Increase Coronary Artery Disease Risks in Women Veterans

BOSTON — Depression and anxiety can be debilitating on their own. For women veterans, the conditions raise an additional concern: They significantly increase the risk of coronary artery disease (CAD)—the leading cause of death in the United States.

April 2018

For Memory Issues, It’s Not So Much the Concussion as the Blast

BOSTON—Many more servicemembers might have been injured by blasts in Iraq and Afghanistan than previously reported.

COPD

Supplemental Oxygen Needs Rarely Addressed in COPD Inpatients

CHICAGO — Patients hospitalized with chronic obstructive pulmonary disease (COPD) who require supplemental oxygen (O2) are at increased risk of hospital readmissions, but little information exists on the quality of evaluation and documentation regarding the need for supplemental O2 in that population.

Current Issue

MS Surprisingly Prevalent in U.S., Dropping Among Servicemembers

The prevalence of multiple sclerosis in the United States population appears to be nearly double previous estimates. Among servicemembers, however, the rate of new MS diagnoses has dropped significantly in recent years.

March 2018

Focus on Diabetes Control, Cancer Screening Helps Reduce MS Deaths

OKLAHOMA CITY — While multiple sclerosis (MS) itself remains incurable, development of more effective treatments over the past 25 years has increased life expectancy for patients with the disease. Today, MS patients have a life expectancy only about seven years less than individuals without the disease, according to the National Multiple Sclerosis Society.

Clinical Topics Home

Lobectomy Still Has Significant Survival Benefit in Early NSCLC

While increased use of stereotactic body radiation might have played a key role in doubling survival rates for early-stage non-small cell lung cancer (NSCLC) among veterans between 2001 and 2010 compared to conventional radiation, a new study confirms that isn’t always the best way to assure longer survival.

March 2018

Gene Assay Can Help Determine Active Surveillance Usefulness

BEDFORD, MA—Active surveillance (AS) has been widely implemented at the VA as a standard of care for low-risk prostate cancer (PCa). A study in the American Journal of Managed Care posits, however, that patient characteristics such as... View Article

Cancer

Cancer Trials Boom in VA’s New England Region

The number of clinical trials open to veterans with cancer in the New England region (VISN 1) grows every week, leading a return to the prominence the VA had in trial programs in decades past and offering veterans access to the “gold standard” of treatment in oncology.

Addiction

Long-term Opioid Prescribing Declines in VHA, Bucking National Trend

Extended Prescribing Dropped from 9.5% in 2012 to 6.2% in 2016 By Brenda L. Mooney IOWA CITY, IA—Long-term prescribing of opioid painkillers is on the decline at the VA, in contrast to what appears to be happening outside of federal medicine.

Breast Cancer

Chemotherapy Use Declines for Breast Cancer Patients

With growing concern about overtreatment of breast cancer as outcomes have improved over time, not much research has been performed on how chemotherapy use and oncologists' recommendations have changed in recent years.

February 2018

Laparoscopic, Robotic Surgeries Equivalent for Pancreatic Cancer

Pancreatic cancer patients increasingly are receiving minimally invasive pancreaticoduodenectomy (MIPD).

Department of Veterans Affairs (VA)

Advanced NSCLC Patients Still Receive Aggressive Treatment

Aggressive care for cancer patients appears to be increasing at the end of life, and the VA is part of that trend, according to a new study.

February 2018

New Research Addresses Unique Challenges to Brain Health Faced by Servicemembers

Neuroscientists are tackling some of the challenges to brain health predominantly experienced by servicemembers – and that has important implications for the broader population.

Current Issue

Epilepsy Centers of Excellence Provide Options for Veterans With Drug-Resistant Epilepsy

Epilepsy is substantially more common in veterans than the general population and, in up to 40% of them, anti-epileptic drugs (AEDs) fail to control their seizures.

Depression

VA Study Addresses Concerns About Anti-Epileptic Drugs, Suicidal Behavior Link

In 2008, the U.S. Food and Drug Administration issued an alert about increased risk for suicidal ideation and behavior for patients taking anti-epileptic drugs (AEDs).

Diabetes

VHA Data Helps Validate Tool for Hypoglycemia Risk ID

OAKLAND, CA—Data from more than 1.3 million VHA patients was used to help validate a practical tool for identifying people with diabetes who are at the highest risk for being admitted to an emergency department... View Article

Clinical Topics Home

Hypoglycemia Common in Hospice Patients Continuing Insulin Treatment

BOSTON—Clinical guidelines recommend relaxing glycemic control target levels for patients with diabetes and advanced disease and eventual discontinuation of medications as patients near death to avoid hypoglycemia. A new study published in JAMA Internal Medicine... View Article

Clinical Topics Home

VA Study Shows Kidney Disease Ups Diabetes Risk

LOUIS—For years, research has shown that patients with diabetes have an increased risk of kidney disease. But what about the reverse? A new study published in the journal Kidney International provides evidence that kidney dysfunction... View Article

Agencies Home

Is Stroke Hospitalization Higher for Mentally Ill Veterans?

A recent study raises questions about whether stroke survivors with severe mental illness are at risk for increased nonpsychiatric hospitalization at the VHA compared to stroke survivors without prior psychiatric diagnoses.

Cardiovascular Disease

Better Sleep Metrics Can Identify CVD Risk in Sleep Apnea

MIAMI—Obstructive sleep apnea (OSA) is known to increase the risk of early mortality, stroke, and cardiovascular disease (CVD). A study published in the journal Frontiers in Neurology noted that OSA is defined by the apnea–hypopnea... View Article

Cardiology

Using EMR to Improve Statin Adherence in MHS

DURHAM, NC — Even though HMG-CoA reductase inhibitors (statins) lower cholesterol and prevent cardiovascular disease, nearly half of patients stop taking statin medications one year after they are prescribed. A study published by PLoS One noted... View Article

Agencies Home

Veterans Treated by VA Often Have Risk Factors for Elder Abuse

The VHA should take a lead role in combatting elder abuse, which affects at least 10% of older adults in the United States, according to a recent medical journal article.

COPD

Hospitalized COPD Patients More Likely to Also Have PH

HOUSTON — Having comorbid chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH-COPD) increases the risk of hospitalizations and death compared to COPD alone, according to a new study. Identifying PH in COPD is challenging,... View Article

Clinical Topics Home

Longer LOS Doesn’t Reduce COPD Readmissions

Recent financial penalties for high risk-adjusted chronic obstructive pulmonary disease (COPD) readmissions have pushed hospitals to search for ways to reduce readmissions for chronic obstructive pulmonary disease, a new study notes.

Asthma

Study Looks at Soldiers’ Pre-Deployment Respiratory Health

The respiratory health of military personnel deployed to Southwest Asia continues to be an issue of great concern in light of their exposures to a variety of environmental hazards.

Battlefield Medicine

‘Hacking’ to Improve Care for Wounded Warriors

Hacking isn’t always a bad thing, especially if the result is devices that can help protect servicemembers from injuries.

Department of Veterans Affairs (VA)

VA Study Resolves Debate Over Renal Protective Agents Used in Angiography

Is it better to use sodium bicarbonate or -N-acetylcysteine to prevent acute kidney failure related to common angiography procedures?

Oncology

Survey Results Add to Information About ECP Treatment for CTCL

LEBANON, NH — Extracorporeal photopheresis (ECP) is a leukapheresis-based therapeutic procedure that has been approved by the Food and Drug Administration (FDA) for the treatment of advanced cutaneous T-cell lymphoma (CTCL) since 1988. In ECP,... View Article

Oncology

New Treatment Option Extends CTCL Progression Free Survival

STANFORD, CA — Patients with cutaneous T-cell lymphoma (CTCL) might have a promising new treatment option, according to a study presented at a recent conference. In a presentation at the 2017 American Society of Hematology... View Article

December 2017

HCV Eradication Lowers Glucose Levels in Veterans With Diabetes

PORTLAND, OR—Hepatitis C virus (HCV) infection is linked to diabetes and often worsens glycemic control in patients with diabetes. A study published in Diabetes Care investigated whether eradication of HCV infection with direct-acting antiviral (DAAs)... View Article

December 2017

Atazanavir’s Effects on CV Risks in HIV Infected Veterans

SALT LAKE CITY—Patients with HIV infection have an increased risk of cardiovascular disease compared with uninfected individuals. Oftentimes, they receive antiretroviral therapy with atazanavir (ATV), which delays progression of atherosclerosis markers. Whether the treatment also... View Article

December 2017

HCV Complications Increasing for Women Veterans

HOUSTON—The epidemiology clinical course of hepatitis C virus (HCV) infection is affected by gender. Yet, few long-term longitudinal studies have examined trends in the incidence and prevalence of serious liver complications among women compared with... View Article

December 2017

Agent Orange Exposure Doesn’t Reduce CLL Survival

MINNEAPOLIS—Exposure to Agent Orange was not associated with either poor prognostic factors or shortened overall survival in a large veteran population with chronic lymphocytic leukemia (CLL), even though it is associated with development of the... View Article

Cardiology

Aspirin Appears to Be Safe for Some Heart Failure Patients

SAN FRANCISCO – Does use of aspirin increase heart failure (HF) hospitalization or risk of death in patients with reduced ejection fraction receiving an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB)? That was the question... View Article

Agencies Home

Veterans With Heart Failure, Methamphetamine Use Present Growing Challenges for VA

The rate of heart failure associated with methamphetamine (meth) use appears to be on the upswing in veterans, according to preliminary research presented at the American Heart Association's Scientific Sessions 2017.

Cardiology

All-Cause Mortality Reduced in Heart Failure Patients with Lower Discharge Heart Rate

WASHINGTON — Although a lower heart rate is known to be linked with better outcomes in patients with heart failure (HF) with reduced ejection fraction (EF), not as much research is available on the association in... View Article

Clinical Topics Home

VA Study Finds Older Medicare Patients Often Are Overtreated for Diabetes

It’s not only the VA that struggles with the balance between just enough treatment of older Type 2 diabetes patients and too much.

Asthma

Underweight and Smoking Makes for a Lethal Combination in COPD

When counseling a patient with chronic obstructive pulmonary disease (COPD), many clinicians start with two words of advice: “Stop smoking.”

Asthma

VAMC Survey Found High Rates of Asthma, Respiratory Symptoms Among Staff

A survey at a VAMC recorded the prevalence of current diagnosed asthma at 17.6% but also found that nearly half of the healthcare workers reported some asthma-like symptoms.

Cardiovascular Disease

Previous VA Research Borne Out: PCI Provides No Symptom Relief in Stable Angina

In a move that reanimated a long-standing controversy in cardiology, a recently published study supports and extends the findings of landmark research done by the VA more than a decade ago.

Cardiology

Aspirin Appears to Be Safe for Some Heart Failure Patients

SAN FRANCISCO – Does use of aspirin increase heart failure (HF) hospitalization or risk of death in patients with reduced ejection fraction receiving an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB)? That was the question... View Article

Cardiology

All-Cause Mortality Reduced in Heart Failure Patients with Lower Discharge Heart Rate

WASHINGTON – Although a lower heart rate is known to be linked with better outcomes in patients with heart failure (HF) with reduced ejection fraction (EF), not as much research is available on the association in... View Article

Cardiology

Veterans With Heart Failure, Methamphetamine Use Present Growing Challenges for VA

ANAHEIM, CA – The rate of heart failure associated with methamphetamine (meth) use appears to be on the upswing in veterans, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2017. The... View Article

Mental Health

VA Is Struggling to Hire Enough Mental Health Clinicians by Year’s End

VA is falling short on its goals to hire more mental health professionals by the end of this year, VA Secretary David Shulkin, MD, told legislators at a recent Senate hearing on suicide prevention.

Neurology

Prevalence, Evolution of Non-Motor Symptoms in Parkinson’s Disease

Parkinson’s disease (PD) can cause a wide range of motor and nonmotor symptoms (NMS).

Alzheimer's/Dementia

Methylphenidate Improves Apathy in Veterans with Alzheimer’s

Apathy is a common behavioral problem in Alzheimer’s disease and can lead to everything functional impairment to higher medical costs to increased mortality.

Current Issue

Mild TBI Improved by Low-Impulse Electric Stimulation

Low-impulse electrical stimulation (LIP-tES) to the brain shows promise in improving neural function in mild traumatic brain injury (TBI).

Battlefield Medicine

Military’s Early Use of Blood Transfusions Saved Lives of Wounded Warriors

Blood transfusion as quickly as possible was a lifesaver for wounded warriors in Afghanistan.

November 2017

Video-assisted Thoracoscopic Lobectomy Improves NSCLC Survival

Should stereotactic body radiotherapy remain the standard treatment for medically inoperable early-Stage non-small cell lung cancer?

Clinical Topics Home

Metformin Shows Promise for Increasing NSCLC Survival

BETHESDA, MD—Past research has raised the possibility that a common blood sugar-lowering drug could be associated with improved survival in cancer patients with Type 2 diabetes. A study published recently in the International Journal of Cancer assessed... View Article

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