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Cancer

VA Research Offers Reassurance on Safety of TKIs for Kidney Cancer

The U.S. Food and Drug Administration approval of several tyrosine kinase inhibitors (TKIs) over the last decade has substantially improved outcomes for patients with metastatic renal cell carcinoma.

Cancer

California Statistics Indicate Kidney Cancer Rates Might Be Declining Overall

After years of apparently rising rates of kidney cancer, the incidence of early-stage disease seems to be declining, at least in California.

Current Issue

Social Support Critical for Military Mental Health

The Marine Resiliency Study-II examined changes in symptomatology across a deployment cycle to Afghanistan. Results were published recently in the Journal of Psychiatric Research.1

Department of Veterans Affairs (VA)

Paliperidone Palmitate Helps Some Schizophrenia Patients

Even though nearly half of all patients diagnosed with schizophrenia have a history of substance abuse (SA), data on treatment of schizophrenia with paliperidone palmitate (PP) among patients with comorbid SA have been limited.

Department of Veterans Affairs (VA)

How Do VA PCPs Respond to Insomnia Complaints?

Veterans have even higher rates of insomnia than other adults in the United States, and many seek treatment from their primary care physicians.

Department of Veterans Affairs (VA)

In-Person Cognitive Therapy Better for Insomnia

Internet-delivered cognitive behavioral therapy appears to be an effective alternative to regular in-person meetings with a therapist for military personnel with insomnia, but it still is only about half as effective as traditional methods.

Department of Veterans Affairs (VA)

VSOs Are Helping to Speed Veteran Claim Processing

An initiative that promises faster processing of certain claims has now been made available at all VA regional offices, the agency announced last month.

Clinical Topics Home

Characteristics of Clinicians Most Likely to Prescribe Testosterone at VA

Testosterone prescribing at the VHA has followed national trends and increased substantially over the last decade.

Department of Veterans Affairs (VA)

VA Leads Nation in Addressing Healthcare Disparities

Shifting demographics and commitment to creating an integrated network that combines community providers and VA facilities has propelled the agency into a leadership position in addressing the healthcare disparities that continue to cost lives and drive up medical expenses.

Department of Veterans Affairs (VA)

VA’s ‘Homegrown’ Mailing Processes Raise Drug Diversion Concerns

Citing unreliable mail data and even the potential for drug diversion, lawmakers admonished VA to do a better job overseeing its mail system.

August 2017

Is Aspirin Really a Wonder Drug for Cardiovascular Prevention?

Since the mid-1980s, aspirin has been used as a preventive drug for cardiovascular disease. In fact, the U.S. Preventive Services Task Force (USPSTF) says that about 40% of American adults over 50 currently take a daily aspirin to prevent heart attacks or strokes.

Agencies Home

VA Makes Public List of Adverse Actions Against Employees

With persistent questions of accountability and transparency dogging VA in recent years, the agency became the first federal agency to post public information on disciplinary actions taken against employees.

Department of Veterans Affairs (VA)

House Legislation Seeks to Modernize Veterans Appeals Process

A bill passed by the House of Representatives with strong bipartisan support will modernize the veterans’ appeals process, supporters maintained.

Department of Veterans Affairs (VA)

Phoenix VA Partners With CVS MinuteClinic to Provide In-Pharmacy Healthcare

When CVS Health became an authorized provider under the Veterans Choice Program, several VAMCs considered using the company’s retail medical clinic, MinuteClinic, to help relieve long waits and offer routine medical services nearer to veterans’ homes.

Agencies Home

Spinal Manipulation Modestly Effective for Low-Back Pain

Spinal manipulative therapy (SMT) is a treatment option for acute low-back pain, but randomized clinical trials (RCTs) and meta-analyses have reported different conclusions about its effectiveness, according to a new study.

Cancer

VA Colorectal Cancer Data Similar to Overall U.S.

Colorectal cancer data from the VA often is underrepresented in U.S. cancer reporting, according to a new study seeking to remedy that.

Clinical Topics Home

Most Common GI Scope Adverse Events at VHA

How common are adverse events related to gastrointestinal (GI) scope and tube placement procedures at the VHA?

Cancer

USU: Younger Colon Cancer Patients Appear Overtreated

While young and middle-aged patients are much more likely to receive postoperative chemotherapy than older patients, they don't appear to survive any longer from colon cancer, a new study reported.

Battlefield Medicine

Award-Winning Army PA Seeks to Improve Battlefield Emergency Care

Maj. Jonathan Monti, DSc, PA-C, says he does not believe in haphazardly adding new technology to the already-overwhelming amount of gear carried by those providing medical care on the battlefield.

Department of Veterans Affairs (VA)

Little Warning of CKD Progression in Veterans Using Proton Pump Inhibitors

While renal symptoms are a known side effect of proton pump inhibitors, the assumption always has been that the drugs could be discontinued before any lasting damage was done.

Department of Veterans Affairs (VA)

VHA Compares Well to Other Health Systems for Patient Safety, Care Quality

Beginning last fall, VHA’s hospitals were included on the Hospital Compare website maintained by the Centers for Medicare and Medicaid (CMS), allowing direct comparison with other, nonfederal facilities.

Department of Veterans Affairs (VA)

VA Opts for Same EHR System Used by DoD Healthcare

Saying that he was not willing “to put this decision off any longer,” VA Secretary David Shulkin, MD, announced that VA will adopt the same EHR system as DoD, now known as MHS GENESIS.

Department of Veterans Affairs (VA)

Unintended Pregnancy More Likely in Active-Duty Troops

Unintended pregnancy is reportedly to be higher in the military population, according to a new study seeking to determine the rates of unintended pregnancy among active duty servicemembers compared to other military healthcare beneficiaries.

Department of Veterans Affairs (VA)

Study Urges More Use of Long-Acting Reversible Contraception

Long-acting reversible contraception is more effective for pregnancy prevention than shorter-acting contraceptive methods and has the potential to reduce healthcare disparities and costs, yet is generally underused, pointed out a new military study.

Breast Cancer

Breast Cancer Surgery Increasing at VA

Women will make up approximately 10% of the VA healthcare system by 2020 and 15% by 2030, meaning that the need for women’s health services, including breast cancer treatment, will increase.

Department of Veterans Affairs (VA)

VSOs Raise Concerns About Proposed VA Smoking Bans

If a new law is passed, veterans living in facilities such as VA nursing homes would have only 90 days to phase out smoking in their rooms, according to veteran service organizations expressing concern about the proposal.

Agencies Home

Veterans Choice Program Increases Burden on VA Pharmacists

The Veterans Access, Choice and Accountability Act in 2014 allows veterans to receive covered care and prescriptions from non-VA providers in a variety of situations.

Department of Veterans Affairs (VA)

Depression Is 60% More Common in Women Veterans Compared to Men

Recent research uncovered some good news and bad news when it comes to female veterans and depression: Women experience depression at much higher rates than men but also are more likely to receive adequate care and report symptom improvement.

Cancer

TKI Persistence Rates at VHA Over Time

How is chronic myeloid leukemia (CML) treated over an extended period at the VHA, including the use of tyrosine kinase inhibitor (TKI) therapy with imatinib, dasatinib and nilotinib?

Cancer

Lymphoma, Other Cancers Linked to HCV

Hepatitis C virus (HCV) infection is known to cause hepatocellular carcinoma (HCC) and subtypes of non-Hodgkin lymphoma (NHL).

Current Issue

Sickle Cell Trait Skews Hemoglobin A1c Results

Hemoglobin A1c might be underestimating glucose levels in a meaningful percentage of African-American and other patients.

Department of Veterans Affairs (VA)

Veterans’ End-of-Life Preferences Not Well-Communicated to Surrogates

With a substantial number of older patients treated at the VA—more than 2 million World War II and Korean War veterans were among the patient population in 2015—how to manage their end-of-life care is an increasingly critical question.

Department of Veterans Affairs (VA)

VA Defends Crisis Line Amid Criticisms from Congress, Recent Reports

Despite criticism from recent government reports, VA officials insisted last month that the Veterans Crisis Line (VCL) “is the strongest it has been since its inception in 2007.”

Department of Veterans Affairs (VA)

TBI Specialist Seeks to Customize Treatment for Brain-Injured Veterans

For the past eight years, Joel Scholten, MD, has enjoyed both a ground-level, exam-room view of traumatic brain injury (TBI) care in VA, as well as a bird’s-eye view of national policy, and both perspectives reveal the same thing: There are as many appropriate treatment plans for TBI as there are veterans suffering from the injury.

Department of Veterans Affairs (VA)

VA Vows Quick Response to DC VAMC Patient Safety Issues

VA Secretary David Shulkin vowed last month that his agency will “act as rapidly as possible” to hold accountable those responsible for “serious and troubling deficiencies” at the DC VAMC.

Department of Defense (DoD)

Military Physicians Unprepared to Treat Transgender Patients as Deadline Approaches

When the DoD lifted the ban on transgender individuals serving in the armed forces last year, it set an aggressive goal of June 2017 for proficiency in treating personnel with gender dysphoria.

Department of Veterans Affairs (VA)

Outdated Processes Hamper VHA in Hiring Medical Staff

By Sandra Basu WASHINGTON — VHA is hampered by outdated human resources processes, as well as competition from the private sector, when it comes to hiring medical professionals, agency officials told lawmakers. “We are striving... View Article

Agencies Home

VA’s Fails to Follow Own Requirements for New Hire Drug Testing

WASHINGTON — VA is “committed to 100% testing of all final selectees” for its safety-sensitive occupations prior to their appointment, lawmakers were told recently.

April 2017

VA Extends Mental Healthcare to Veterans Not Honorably Discharged

WASHINGTON — In his first appearance before Congress as VA Secretary, David Shulkin, MD, said that “there is no other clinical issue” that concerns him as much as veteran suicides.

April 2017

Pain Continuity, Not Headache Type, Affects Return to Duty

FORT BRAGG, NC — Headaches and how to manage the pain are difficult issues for soldiers who suffered mild traumatic brain injury during the wars in Afghanistan and Iraq and their care providers.

April 2017

Why Opioids Are Discontinued in VHA Patients

PORTLAND, OR—Discontinuation of opioids can be accelerated for several reasons, according to a new study, including lack of information about the long-term effectiveness of opioids for chronic pain, heightened awareness about opioid-related adverse events, closer monitoring of patients for opioid-related aberrant behaviors, and greater restrictions around opioid prescribing.

April 2017

System to Smooth Out VBA Claims Backlog Creates Other Issues

WASHINGTON — Implementation of a new process to distribute disability claims to offices with capacity to process them will benefit veterans, Veterans Benefits Administration (VBA) told lawmakers in an effort to reassure them.

April 2017

Few Veterans with Heart Failure Participate in Cardiac Rehabilitation

SAN FRANCISCO—Despite evidence that cardiac rehabilitation reduces morbidity and mortality, few patients with heart failure undertake it, including veterans who often have difficulty accessing center-based programs.

Addiction

Post-Deployment Factors Influence Gambling Addiction

WEST HAVEN, CT—Gambling disorder and its comorbid diagnoses are observed at higher rates in military veterans than in the general population, but a significant research gap exists regarding the relationships of veterans' life and service experiences to problematic gambling, according to a new study.

Addiction

Alcohol Abuse, PTSD Can Be Treated Simultaneously

DURHAM, NC — Many servicemembers and veterans seeking treatment for alcohol problems have experienced the life-threatening stress of combat, many have post-traumatic stress disorder (PTSD), and many servicemembers and veterans seeking treatment for PTSD also have alcohol or other substance problems.

Addiction

New Soldiers’ Alcohol Abuse Linked to Mental Disorders

LA JOLLA, CA— Problem drinking that predates enlistment into military service might be a contributor to the overall burden of alcohol misuse and mental disorders in the U.S. Armed Forces, but evidence remains somewhat limited.

April 2017

Bill Gives VA Secretary New Powers to Fire, Demote, Suspend Employees

WASHINGTON—A bill that would provide the VA Secretary with enhanced authority to remove, demote, or suspend any VA employee, including senior executive service employees, for performance or misconduct is making its way through Congress.

Agencies Home

VA Might Yet Move to Commercial EHR System

After years of working to modernize its electronic health record internally, a senior IT official indicated last month that a shift to a commercial EHR is the likely path forward for VA.

Department of Veterans Affairs (VA)

Shulkin Sails Through Senate on Promise of VA Changes

David J. Shulkin, MD, stepped into the role of VA secretary last month after receiving unanimous support from the U.S. Senate.

Clinical Topics Home

Guideline-Discordant Imaging In Prostate Cancer

About half of veterans with low-risk prostate cancer receive imaging not called for in clinical guidelines, according to a new study.

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