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2018 Compendium of Federal Medicine

Liver Cancer Continues to Rise, Even as VA Declares Victory Over HCV Infection

In March, then-VA Secretary David Shulkin, MD, announced at the annual Wharton Health Care Business Conference that the VA will have eliminated hepatitis C infections among all patients willing and able to be treated by next spring.

2018 Compendium of Federal Medicine

MS in Gulf War Veterans: Zeroing-In on Types, Disability Levels

While veterans serving in the military during the Gulf War era (GWE) appear to have higher risk for multiple sclerosis and a range of neurological illnesses, little has been documented previously on prevalent types of MS or other clinical features.

2018 Compendium of Federal Medicine

Undertreatment of Metastatic Pancreatic Cancer Treatment, Despite Guidelines

While many other cancers have seen dramatic improvement in outcomes in the past 20 years, pancreatic cancer remains one of the deadliest malignancies, regardless of stage at diagnosis, with an overall five-year survival rate of only 8%, according to the American Cancer Society.

2018 Compendium of Federal Medicine

Amid Concerns, VA Says It Is ‘Turning a Corner’ on Cybersecurity

The management and upkeep of information technology structures has historically been a challenge for federal agencies.

2018 Compendium of Federal Medicine

Evidence of CV Benefit Influences Diabetes Treatment Recommendations

In a significant change, the American Diabetes Association’s 2018 guidelines advocate use of a glucose-lowering agent with proven cardiovascular benefit or mortality reduction in patients with Type 2 diabetes mellitus (T2DM) and co-morbid cardiovascular disease.

2018 Compendium of Federal Medicine

Diabetes Prevalence Higher Among Veterans Than General Population

Overall prevalence of diabetes was 20% for the general U.S. population but nearly 25% for veterans, according to a recent study using data from the National Health and Nutrition Examination Survey (NHANES).

2018 Compendium of Federal Medicine

Continuous Glucose Monitoring Highly Effective But Underused in Diabetes

Recent clinical studies have documented why continuous glucose monitors (CGM) can offer significant benefits to patients diagnosed with diabetes.

2018 Compendium of Federal Medicine

DHA Adds New Weapons in the Military’s War on Obesity in Servicemembers

This spring, DoD took direct steps to counter a significant impediment to mission readiness—excessive weight among servicemembers.

2018 Compendium of Federal Medicine

VA Leads the Way in Medication-Assisted Treatment for Opioid Addiction

According to a report from the national Centers for Disease Control and Prevention, more than 42,000 Americans died from an opioid overdose in 2016—five times higher than only seven years prior—and current CDC data shows little evidence that those numbers are any lower for 2017.

2018 Compendium of Federal Medicine

Among Veterans, Women as Likely as Men to Have Substance Abuse

Childhood adversity increases risk for alcohol and drug disorders for veterans, and, unlike in the civilian population, veteran women are as likely as men to have those types of problems.

2018 Compendium of Federal Medicine

CTCL 6-10 Times More Common in Veterans; Agent Orange a Factor New Therapies Raise Optimism about Treatment

Chances are, if you haven’t trained or practiced at the VA, you haven’t seen cutaneous T-cell lymphoma (CTCL), a form of non-Hodgkin lymphoma.

2018 Compendium of Federal Medicine

New Therapy Options Recently Approved for Hodgkin’s Lymphoma

While the availability of novel therapies is making the future brighter for non-Hodgkin’s lymphoma (NHL) patients, new treatments also are coming on line for Hodgkin’s lymphoma, which is a hematological cancer distinct from NHL.

2017 Compendium of Federal Medicine

Despite Criticism of Federal Medicine, Innovation Thrives at VA, MHS

By Brenda L. Mooney Editorial Director ATLANTA — When it comes to American politics, we certainly live in contentious – if not always interesting – times. One of those hot-button issues is a so-called single-payer... View Article

2017 Compendium of Federal Medicine

New Tools Help Reduce CVD Risk in Veterans with Diabetes

By Annette M. Boyle The search has been on for decades: A medication that can help reduce the risk of cardiovascular disease in Type 2 diabetes patients. Late last year, an existing drug was approved... View Article

2017 Compendium of Federal Medicine

How the Brain, Not Just Lung Function, Affects Patient-Perceived COPD Level

By Brenda L. Mooney Test results are only one part of the calculation on how sick patients are with chronic obstructive pulmonary disease. Psychosocial symptoms also play a big role, so that for some veterans... View Article

2017 Compendium of Federal Medicine

Protein Can Help Identify Which Rashes Are Early Mycosis Fungoides

Chronic rash in a sun-protected area that doesn’t respond to topical treatment likely needs to be evaluated for mycosis fungoides, the most common variant of cutaneous T-cell lymphoma. Now, a new VA study reports that... View Article

2017 Compendium of Federal Medicine

Good Treatment Options Emerging for Less-Common Primary Progressive MS

By Annette M. Boyle While treatment options have continued to expand for patients with the most common type of multiple sclerosis—relapsing-remitting—that has not been the case for those with a less-common variety—primary progressive. That changed... View Article

2017 Compendium of Federal Medicine

Key Associations Urge Clinicians to Inform Patients about SUDUP Risks

NEW YORK – Patients with epilepsy should be told about their uncommon risk of death, especially if they suffer from tonic-clonic seizures, new guidelines state. Controlling those seizures might reduce the risk of sudden unexpected... View Article

2017 Compendium of Federal Medicine

Should Adult Epilepsy Patients Be Told About Unexpected Death Risks?

Elevated Mortality Rates for Veterans Fires Up Debate A shocking report on substantially higher mortality rates for veterans with epilepsy, as well as new guidelines from key disease groups, have reignited debate on a difficult... View Article

2017 Compendium of Federal Medicine

Gene Transfer Improves Function in Heart Failure, Hospitalizations Reduced

Could gene transfer be the answer to reducing hospitalizations for veterans with heart failure? A new trial by VA researchers suggests that’s a good possibility, with a single intracoronary injection of an adenovirus to transfer... View Article

2017 Compendium of Federal Medicine

Non-Teaching VA Clinics More Likely to Prescribe Inappropriate Antibiotics

PROVIDENCE, RI – The VA is working hard to stem the rate of unnecessary and inappropriate antibiotic prescribing in its healthcare system. A new study identifies an area where more work might be required. Researchers... View Article

2017 Compendium of Federal Medicine

DoD Aids Research on Identification of Pathogens in Hours, Not Days

Technology Also Helps Determine Most-Effective Antibiotics By Brenda L. Mooney The DoD’s involvement with the development of new technology to rapidly identify pathogens and appropriate antibiotic therapy has its roots in the Iraq and Afghanistan... View Article

2017 Compendium of Federal Medicine

VA Lung Cancer Screening Pilot Was Valuable but ’Challenging and Complex’

While the benefits of lung cancer screening are undeniable for some former smokers—especially those whose lives were saved because of it—the VA recently learned some important lessons on how to use the technology most efficiently.... View Article

2017 Compendium of Federal Medicine

Smoking History, Obesity Increase Risk for Renal Cell Carcinoma in Veterans

While toxic exposures such as contaminated water at Camp Lejeune increase the likelihood of developing renal cell carcinoma (RCC), veterans have higher risks for the cancer even beyond those unusual events. A history of cigarette... View Article

2017 Compendium of Federal Medicine

Oral Combination Therapies for MS Offer Superior Effectiveness

By Annette M. Boyle The first retrospective comparison of newer oral disease-modifying therapies (DMTs) to injectable DMTs for relapsing-remitting multiple sclerosis (MS) found that, in real-world settings, patients taking two of the oral drugs had... View Article

2017 Compendium of Federal Medicine

Better Anaerobic Fatigue Measures Could Help Improve Quality of Life with MS

By Annette M. Boyle Multiple sclerosis patients often report fatigue, but it isn’t always clear how that condition affects their functionality. New research is seeking to establish clearer definitions and measures of fatigue in an... View Article

2016 Compendium of Federal Medicine

2016 Compendium of Federal Medicine Introduction

“Stop focusing on the negative and look at how many people are helped by the VA.”
In a very contentious political year, when candidates of both parties seem to be trying to make us sick so they can demonstrate how they plan to make us better, optimism can be hard to maintain.

2016 Compendium of Federal Medicine

VA Increases Availability of Spirometry to Improve COPD Diagnosis

The VA treats more than a million patients with chronic obstructive pulmonary disease, so it is little surprise that COPD is the first diagnosis that comes to mind when a veteran presents with breathing difficulties. The problem is that the diagnosis isn’t always correct. To remedy the situation, the VA is making spirometry more widely available across the healthcare system.

2016 Compendium of Federal Medicine

Changing Epilepsy Demographics Spur VHA’s Progress in Diagnosis, Treatment

Traumatic brain injury and post-traumatic stress disorder are among the signature injuries for the nation’s youngest veterans. The legacy of those conditions goes beyond the most obvious, however. TBI and PTSD are being partly blamed for the proliferation of epilepsy and other seizure disorders in VHA patients under 45.

2016 Compendium of Federal Medicine

Research With Epilepsy Patients Seeks Device to Restore Memory

DALLAS — Imagine if a device could restore memory in veterans who suffered a traumatic brain injury (TBI) and subsequently developed epilepsy.

2016 Compendium of Federal Medicine

Million Veteran Program Puts VA at Forefront of Push for Use of Individualized Medicine

WASHINGTON — With more data from more than 400,000 veterans, the VA’s Million Veteran Program (MVP) is expanding further as one of the world’s largest medical databases.

2016 Compendium of Federal Medicine

VA Research Provides New Insights Into the Genetic Basis of Idiopathic Pulmonary Fibrosis

Older veterans have a significantly elevated risk of idiopathic pulmonary fibrosis, likely related to increased exposure to the known risk factors of cigarette smoking and environmental dust. New research is looking at genetic predispositions that might help predict which patients are likely to have progression of the devastating disease. That also could provide new targets for pharmacotherapies.

2016 Compendium of Federal Medicine

MS Patients at VA Face Elevated Risk of Hospitalization, Death From Infections

With all of the difficulties faced by veterans with multiple sclerosis, mobility-related and otherwise, they certainly don’t need anything else to worry about. Yet, new research documents that their risk of developing a serious infection or dying from that infection is significantly higher than patients without the neurological condition.

2016 Compendium of Federal Medicine

Telephone Counseling Helps MS Patients Increase Beneficial Exercise

SEATTLE — While multiple sclerosis patients get some of the same benefits from exercise as everyone else, physical activity also can help them manage many symptoms of their disease.

2016 Compendium of Federal Medicine

Adherence to Guidelines Reduces Risk of Death in Veterans Prescribed Opioids

While both the VA and the DoD have dramatically decreased narcotic prescriptions for chronic pain, a subset of patients, including many wounded warriors, still requires opioid medications to get relief from intractable pain. A new study offers advice on how to do that while reducing the risk of death and addiction.

2016 Compendium of Federal Medicine

More Treatment Options Offer Hope for Veterans With Renal Cell Carcinoma

VA oncologists treating renal cell carcinoma had relatively few tools in their arsenal until fairly recently. During the past decade, the influx of newer treatments has dramatically changed how the kidney cancer is diagnosed and treated, however, and patients are increasingly optimistic about progression-free survival.

2016 Compendium of Federal Medicine

VA Pushed to Recognize Immunization Air Injector, HCV Link

SILVER SPRING, MD — For almost 20 years, veterans and the service organizations that represent them have lobbied Congress and the VA to recognize a link between immunizations received in military service using jet injectors and the high rate of infection with hepatitis C among veterans.

2016 Compendium of Federal Medicine

Expanded Treatment Options Led to Increase in RCC Biopsies

With extremely limited treatment options in the past for renal cell carcinoma, there wasn’t much impetus to employ biopsy at the VA. Knowing more about the tumors wasn’t very usual without good options to help the patients.

2016 Compendium of Federal Medicine

VA Tests Telemedicine in Collaborative Approach to Managing Bipolar Disorder

While therapies based on the biology of bipolar disorder might take years to develop, some veterans are finding help living with and managing their disorder through telemedicine.

2016 Compendium of Federal Medicine

Advances in Soft-Tissue Sarcoma Treatment Benefit Older VA Patients

Veterans with certain types of soft-tissue sarcoma have been eligible for VA compensation and medical treatment for 25 years, due to its link to Agent Orange Exposure. During that time, the cancer has remained rare — and so have significant treatment advances. In 2016, however, new research and drug approvals have opened up better options for STS and its subtypes, such as liposarcoma.

2016 Compendium of Federal Medicine

Biomarker Research Holds Promise to Improve Diagnosis of Bipolar Disorder

Of all psychiatric illnesses, bipolar disorder is the one most strongly associated with veteran suicide, according to VA research.

2016 Compendium of Federal Medicine

Genomic Research Identifies Possible Therapeutic Targets for Cutaneous T-Cell Lymphoma

Presumptively caused by Agent Orange exposure, cutaneous T-cell lymphoma occurs disproportionately among male veterans. Complicating the clinical approach, the disorders comprising CTCL are similar but differ greatly in response to therapy. New genomic research on the rare cancer, however, is holding out promise for better, more-customized treatment.

2016 Compendium of Federal Medicine

Army Medical Center Reduces Alarms to Better Respond to Real Emergencies

High-tech monitoring in an intensive care unit saves lives by letting hospital medical staff know immediately when a patient is in trouble. Managed incorrectly, however, the constant beeping can create “alarm fatigue” and result in medical errors. The answer, according to a nursing team at San Antonio Medical Center, was using the technology appropriately by customizing the alarms for each patient’s situation.

2016 Compendium of Federal Medicine

Bigger Budget, Lower Pricing Enable VA to Now Treat All Veterans with HCV

Even though therapies that achieve sustained virologic response in about 90% of hepatitis C patients have been available for several years, the VA wasn’t able to use them universally and instead had to set treatment priorities because of limited resources. The situation has changed, thanks to increased funding and reduced drug prices, so that all VA patients with HCV now will receive the most-effective treatment.

2016 Compendium of Federal Medicine

Genomics Identify Best Candidates for New Hypercholesterolemia Therapies

Patients with familial hypercholesterolemia post extremely high cholesterol levels, even with lifestyle changes and statin therapy, while other patients must discontinue statin treatment because of side effects or intolerance or inability to achieve the desired effect, even on maximum dosages. A new class of drugs to lower LDL-C, injectable monoclonal antibodies that inhibit the PCSK9 protein, is a significant addition to therapies.

2015 Compendium of Federal Medicine

Introduction

One of my earliest memories is walking with my grandfather down the main street of my hometown in southeast Georgia and stopping to talk to a man with a barrel of paper flowers. After greeting him, Grandpop George reached out and shook his hand. He then put some money in a box on the table and selected a bright red flower. I was thrilled when he handed it to me.

2015 Compendium of Federal Medicine

Handbook, Technological Advances Help VA Improve Pressure Ulcer Care

Spinal Injury Patients Especially at RiskQuality organizations consider serious pressure ulcers to be “Never Events,” for U.S. hospitals, and the VA has made great strides in improving prevention and treatment for the adverse events. Now,... View Article

2015 Compendium of Federal Medicine

VA Tops in Experience With Rare Lymphomas, Looks for More Effective Treatments

As the healthcare system with the most experience treating older men, the VA has special expertise in treating uncommon diseases that plague them, such as peripheral T-cell lymphoma. The current challenge for clinicians is to... View Article

2015 Compendium of Federal Medicine

With Prostate Cancer Diagnosed Younger, Treatment Options Under Fierce Debate

Since the mid-1980s, six times as many men under 55 now are receiving prostate cancer diagnoses, and the younger patients face considerably higher mortality rates. With the stakes even greater, the debate continues on whether... View Article

2015 Compendium of Federal Medicine

VA Leads Efforts to Develop Treatments for Rare Blood Disorders

Hope for Future Treatment of Polycethmia Vera, MyelofibrosisRare blood disorders such as polycethmia vera and myelofibrosis can cause a debilitating series of symptoms for the middle-aged and elderly patients who suffer from them. VA researchers... View Article

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