June 2014 Focus

by U.S. Medicine

September 16, 2014

In this Issue:

Focus on PTSD/TBI

Brain Injury from Blasts Possible Without TBI Symptoms

VA/Court Partnerships Seek to Keep Troubled Veterans Out of Jail

Pharmacy Update

TRICARE Limits on Use of Community Pharmacies Creates Firestorm

Clinical Consult

Chronic Pain Med Use Increases Depression Incidence

Colorectal Cancer Clinical Consult

Repeat Colonoscopy Recommendations Usually Meet Guidelines


Search Begins for New VHA Chief to Replace Petzel
WASHINGTON – The VA has begun the process of selecting the next head of the VHA, the agency announced this week. The announcement was made by Acting Secretary of Veterans Affairs Sloan Gibson. VHA Undersecretary for Health Robert Petzel, MD, stepped down from this position in May after he and former VA Secretary Eric Shinseki and Petzel appeared before the Senate Committee on Veterans’ Affairs where they were questioned about treatment delays at the VA hospital in Phoenix. The timing of the White House announcement of Petzel’s resignation was criticized because he was already scheduled to retire in 2014. More


Rajendra A. Morey, MD
Brain Injury from Blasts Possible Without TBI Symptoms
SALISBURY, NC – Veterans exposed to explosions during deployment but not reporting usual symptoms of traumatic brain injury (TBI) could still have similar damage to the brain’s white matter. That’s according to the latest study suggesting that sub-concussive events have an effect on the brain, which is especially significant because so many veterans of recent military conflicts in Iraq and Afghanistan have had exposure to explosive forces from bombs, grenades and other devices. More

VA/Court Partnerships Seek to Keep Troubled Veterans Out of Jail
COLUMBIA, MO – For some veterans with unmet mental health needs, readjusting to civilian life can rapidly put them on the wrong side of the criminal justice system. In the past few years, partnerships between the courts and the VA have kept many veterans from continuing a downward spiral into prison by identifying and addressing these issues. Now, 172 veteran treatment courts provide services and oversight to veterans to help them reintegrate into society and stay out of the criminal justice system. More


Douglas Hoey, RPh
TRICARE Limits on Use of Community Pharmacies Creates Firestorm
ALEXANDRIA, VA – A pilot program that requires use of mail order or military pharmacies for certain maintenance medications taken for chronic conditions has sparked a firestorm of controversy, upsetting community pharmacists and some legislators. TRICARE leadership points out, however, that the program was mandated by Congress as part of the 2013 National Defense Authorization Act and that the issue is out of their hands. More

Chronic Pain Med Use Increases Depression Incidence
ST. LOUIS – Chronic use of pain-relieving medication can increase in the risk of developing major depression, according to a new veterans study. The study, based on analysis of medical record data from about 50,000 veterans who had no history of opioid use or depression and were subsequently prescribed opioid painkillers, found that patients who started and remained on opioids for 180 days or longer were at a 53% greater risk of developing a new episode of depression. Veterans using opioids for 90-180 days were at a 25% increased risk, compared with patients who never took opioids for longer than 1-89 days.


Repeat Colonoscopy Recommendations Usually Meet Guidelines
ANN ARBOR, MI – Recommendations for when surveillance colonoscopy should be repeated in average-risk patients with one to two small polyps are consistent with guideline recommendations in about 90% of cases, according to a new study. Study authors, who suggested that the frequency of recommending earlier repeat colonoscopy would come under greater scrutiny with enactment of the Affordable Care Act, emphasized that guideline recommendations should be followed in most, but not all, patients. More

Brenda L. Mooney
Editorial Director, U.S. Medicine
[email protected]
39 York Street
Lambertville, NJ  08530

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