Editor’s Note: U.S. Medicine Direct is now coming to you twice a month, with the second issue focusing on specific clinical topics featured in the U.S. Medicine print edition. This month the special focus is oncology with specialty updates in obesity and respiratory care as well as a specialty column on polytrauma issues such as pain, PTSD and TBI.
Special Focus: Oncology
New Study: Prostate Cancer Diagnosed Five Years Earlier In Vietnam-Era Veterans Exposed to Agent Orange PORTLAND, OR—Vietnam-era veterans exposed to Agent Orange are almost 50% more likely to develop prostate cancer than unexposed veterans, making exposure to the defoliate a higher risk factor than age and on par with family history for veterans, according to recent research. Furthermore, diagnosis of men who develop prostate cancer after exposure to Agent Orange occurs five years earlier, on average, than for those who have not experienced exposure, researchers reported earlier this year. More
Electronic Record Used to Track Colon Cancer Follow-up, Reduce Delays WASHINGTON—With a number of conflicting studies over the last five years looking at the effect of delays between positive colon cancer screenings and the subsequent colonoscopy that could confirm a diagnosis of colorectal cancer (CRC), VA researchers have struggled to determine exactly how a holdup of care effects outcomes. Now, they are turning to technology for the answers. At the Michael DeBakey VAMC in Houston, researchers are working on creating an electronic health record-based trigger system to detect potential delays in colorectal cancer diagnoses, giving VA facilities a way of tracking delays and giving physicians help in speeding up a diagnosis. More
Use of Population-based Criteria Increases Rate of Colorectal Cancer Screening WASHINGTON—Screening for colorectal cancer traditionally has been done on a per-visit basis at the VA. A patient comes in and, based on the physician’s recommendation, undergoes a test for the disease. Researchers at the Albuquerque, NM, VAMC suggested there was a better way and set out to prove it by using a population-based screening method. They also wanted to know if the fecal immunochemical test (FIT) was as efficacious as the standard guaiacum fecal occult blood test (gFOBT). More
New IRB for Military Cancer Research Offers One-Stop Shop WASHINGTON The U.S. Military Cancer Institute (USMCI) Institutional Review Board (IRB)O held its inaugural meeting at National Naval Medical Center to review oncology research protocols in February. The new IRB offers a one-stop shop for researchers to have oncology research protocols reviewed. Typically, DoD investigators who want to pursue a research project at multiple institutions would need to go to each institution for IRB approval. That option is still available. However, the advantage of using the USMCI IRB is that by taking the protocol to one central IRB rather than multiple IRBs, researchers can save time.More
Congressional Funding to DoD for Cancer Research Approved Despite Resistance from Powerful Senator WASHINGTON—Cancer organizations were pleased that funding was not reduced for the peer-reviewed prostate, breast and ovarian cancer programs in DoD’s Congressionally Directed Medical Research Program (CDMRP) in the FY 2011 Defense budget. Concern was raised among cancer advocates when Sen. John McCain, R-AZ, stated that non-defense related spending should be moved out of the DoD budget, including funding for CDMRP’s prostate, breast, ovarian and lung cancer programs, among other programs. He had suggested that funding could come out of the Health and Human Services appropriations, rather than defense spending.More
Specialty Update: Obesity
NIH Releases Strategic Plan for Obesity Research WASHINGTON—Recent months have seen a reinvigorated commitment to research targeted at curbing the obesity epidemic in the United States, including a number of completed studies from VA and DoD and the release of a new strategic plan from NIH. The Strategic Plan for NIH Obesity Research, released last month, provides a coordinated plan for how to invest the substantial amount of resources the agency devotes to obesity-related efforts each year. In 2010, NIH invested $824 million of its budget, along with an additional $147 million through the Recovery Act, in research to reduce the prevalence of obesity and its health consequences. More
Specialty Update: Respiratory Care
VA's Expedites Process to Diagnosis, Treat Lung Cancer PITTSBURGH—In 2000, if you were a patient at the Pittsburgh VAMC and were found to have a lung nodule, it took an average of six weeks to be evaluated for lung cancer. With the possibility of being diagnosed with a life-threatening disease hanging over your head, those six weeks could seem like an eternity. It was a delay that oncology leaders at Pittsburgh found unacceptable, so they started a lung-nodule program in the pulmonary division of the hospital, taking nodule evaluations outside of the traditional clinic process. More
Specialty Update: Polytrauma/Pain/PTSD/TBI
New Toolkit Advises Providers on Care of mTBI Patients With Additional Conditions The care of mTBI patients can be significantly complicated when they also have PTSD, chronic pain or other conditions. While there are Clinical Practice Guidelines (CPGs) specific to treating and managing concussions, PTSD and chronic pain are all separate issues. A toolkit, Co-occurring Conditions Toolkit: Mild Traumatic Brain Injury and Psychological Health, has now been developed by DCoE and other entities to bring those guidelines together and help primary-care providers with the challenge of managing servicemembers and veterans with co-occurring conditions. More
Brenda L. Mooney Editorial Director, U.S. Medicine mooney@usmedicine.com 39 York Street Lambertville, NJ 08530
