As combat casualty care improved over time during the wars in Iraq and Afghanistan, the use of nontherapeutic laparotomy (NTL) decreased.
News
Strong Links Found Between Obstructive Respiratory Disease in Veterans, Psychiatric Health Conditions
Veterans with obstructive respiratory disease should receive timely screening and treatment for comorbid psychiatric and medical conditions that frequently accompany the condition, according to a new study.
Current Issue
Persian Gulf War Service Linked to High Rates of Myeloproliferative Neoplasms
A study of almost a half-million veterans has found for the first time a link between environmental exposures during military service and the development of myeloproliferative neoplasms (MPNs).
Essien Pushes Pharmacoequity in VA Healthcare to Combat Disparities
A general internist and health services researcher with the Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP) at the Greater Los Angeles Healthcare System, Utibe Essien, MD, MPH, has devoted his career to defining and then breaking down the systemic problems that lead to healthcare inequity.
Oncology
Hepatocellular Carcinoma Screening Associated With Improved Survival in Patients Cured of HCV Infection
Hepatitis C virus (HCV) is the most common blood-borne pathogen in the United States, with HCV-related cirrhosis being the leading cause of primary liver cancer, or hepatocellular carcinoma (HCC).
Agent Orange Exposure Not Linked to Hepatocellular Carcinoma
U.S. veterans are much more likely to be diagnosed with hepatocellular carcinoma, but at least one toxic exposure during military service doesn’t appear to have much to do with that.
Remote Consent, Testing Used to Identify and Treat Germline Pathogenic Alterations in VA Million Veteran Program Participants
About 10% of men with metastatic prostate cancer show germline pathogenic alterations which can inform precision therapy, surveillance, and cancer prevention for family members, according to a recent study.
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
Leadership Is Service, Not Position
It has been a particularly challenging few weeks for Team Buckenmaier. We recently pulled our floating home (a Lagoon 42 catamaran) for much-needed routine maintenance and bottom work at a local yacht yard. Our 3,000-plus miles in the Atlantic had taken their toll on the boat and its systems.
Review Finds Little Evidence That Massage Therapy Relieves Painful Health Conditions
For individuals seeking relief from painful health conditions, there’s low certainty of evidence that massage therapy will ease their pain, according to a recent review article.
New Algorithm Developed for Urinary Retention Evaluation, Catheterization
A new algorithm could improve care for adult inpatients who need to be evaluated for urinary retention and possible catheterization, according to a recent study.
Does ‘Underserved’ Designation Demoralize Staff at VA Facilities?
For the past several years, VA has been identifying the most underserved facilities in its system and requiring them to create action plans to improve care to their veterans.
Unraveling the Mystery of Long COVID: VA Steps Up for Nation in Crisis
By March 2020, the SARS-COV-2 virus had reached every inhabited continent on the globe, with devastating impact. In response, the U.S. and many other countries entered lockdowns to slow the spread and reduce deaths from the virus.
Innovative Pain Self-Management Program Improved Pain, Depressive Symptoms in HIV Patients
For almost three decades, antiretroviral therapy (ART) has enabled people with HIV to have nearly normal life expectancies. But as many as 85% of them experience chronic pain, due in part to common medical comorbidities and the side effects of life-saving treatments.
Microvascular Complications of Type 2 Diabetes Drop When PTSD Resolves in Veterans
Post-traumatic stress disorder (PTSD) has a range of adverse effects in veterans, and about 7% are affected at some point in their lifetimes. A recent study puts a spotlight on an unexpected co-morbidity—worsening Type 2 diabetes (T2D) outcomes.
Alternative Prostate Cancer Screening Guidelines for U.S. Black Men
In the United States, Black men are at highest risk for being diagnosed with and dying from prostate cancer.
Review Authors Urge More Genetic Testing of BRCA for Male Cancer Patients
Even though half of all carriers of inherited cancer-predisposing variants in BRCA1 and BRCA2 are male, the implications for their health tend to be under-recognized compared to females, according to a new study.
Prescription Medications Affect Survival Rates in Metastatic Prostate Cancer
How do prescription medications affect overall survival in metastatic hormone-sensitive prostate cancer?
Another Reason to Reduce PPI Use? Usage Linked to Susceptibility for Respiratory Infections
One of the most commonly used medication classes worldwide, proton pump inhibitors (PPIs) are effective for treating acid-related stomach disorders, such as ulcers, heartburn or acid reflux.
VA EHR Rollout at Lovell Federal Healthcare Center Better Than Previous Sites, But Legislators Say Some Issues Persist
About six months ago, the James A. Lovell Federal Healthcare Center became the sixth VA site to switch to the Oracle-Cerner electronic health record (EHR).
Hepatocellular Carcinoma Screening Associated With Improved Survival in Patients Cured of HCV Infection
Hepatitis C virus (HCV) is the most common blood-borne pathogen in the United States, with HCV-related cirrhosis being the leading cause of primary liver cancer, or hepatocellular carcinoma (HCC).
Study: Propofol Use Should Be Minimized in Children With ALL
A study involving military researchers has raised concerns about the use of certain types of anesthesia in children with acute lymphocytic leukemia (ALL)
Circumstances Linked to Bleeding Risk With Chronic Liver Disease Diagnosis
A recent study looked at risk factors for non-variceal bleeding within the first year after diagnosis of chronic liver disease in veterans.
Multiple Myeloma Patients Have Longer Survival With Military Healthcare
MHS beneficiaries with multiple myeloma (MM) had improved overall survival compared to MM patients from the U.S. general population, according to a new report.
Gastrointestinal Symptoms Frequently Diagnosed in Deployed Gulf War Veterans
Deployed Gulf War veterans frequently developed several gastrointestinal symptoms, including irritable bowel syndrome, dyspepsia, diarrhea, bloating and constipation, and those often persisted long after returning home, according to a new study.
Study: Eating Processed, Red Meat Raises the Risk of Type 2 Diabetes
Consuming meat, especially processed and red meat, is a risk factor for the development of type 2 diabetes, according to a new study involving VA researchers.
Misdiagnosis of Community-Acquired Pneumonia Occurs More Than Half the Time at VA Hospitals
Pneumonia diagnoses change more often than not at VA hospitals, either because a veteran initially thought to have the infection is diagnosed with something else or because the community-acquired pneumonia diagnosis was missed when the patient entered the hospital.
Removing Race From Lung-Function Equations Shifts Disease Classifications
In 2023, the American Thoracic Society recommended race-neutral interpretation of lung function and requested the investigation of “consequences for the yet-unquantified number of individuals with results near decision-making thresholds.”
Anti-TNF Agents Associated With Kidney Function Decline in IBD Patients
The introduction of biologic therapies, such as antitumor necrosis factor (TNF) agents, has revolutionized the management of inflammatory bowel disease (IBD)—a group of diseases characterized by chronic inflammation of the gastrointestinal tract.
Use of Non-therapeutic Laparotomy Decreased in Recent Wars but Remain Essential Battlefield Trauma-Care Tool
As combat casualty care improved over time during the wars in Iraq and Afghanistan, the use of nontherapeutic laparotomy (NTL) decreased.
Strong Links Found Between Obstructive Respiratory Disease in Veterans, Psychiatric Health Conditions
Veterans with obstructive respiratory disease should receive timely screening and treatment for comorbid psychiatric and medical conditions that frequently accompany the condition, according to a new study.
VA Projects $2.88 Billion Shortfall for This Fiscal Year; $12 Billion for Next Year
VA is projecting a $2.88 billion budget shortfall for the remainder of fiscal year 2024 and another $12 billion for FY2025. This comes after VA leaders spent this spring assuring Congress that its FY2025 budget request, while lean, would be sufficient to do the job.
Congress member Calls for McDonough Resignation Over Questionable Bonuses
VA Secretary Reminds Committee He Sought Investigation WASHINGTON, DC—A member of the House VA Committee has called on VA Secretary Denis McDonough to resign over the nearly $11 million in bonuses inappropriately paid to senior VA Central Office (VACO) officials....
New Research Finds Service Dogs Beneficial for Veterans With PTSD
The VA covers the veterinary care and the equipment costs of service dogs for veterans with physical disabilities such as blindness or vision impairment, but the use of service dogs for veterans with post-traumatic stress disorder (PTSD) and other mental health issues has remained controversial.
Fewer Deaths After Serious Illness in Veterans Treated With PARC Care Model
After a serious illness, veterans who received medical care via the Post-Acute Recovery Center (PARC) model experienced fewer deaths and more days outside of the hospital compared to those not treated with PARC, according to a recent study.
Critical OIG Report Raises Key Questions About VA’s Community Care Program
A recent VA Office of the Inspector General (OIG) audit has added more fuel to the argument around community care, finding that VA has provided little accountability over the third-party providers tasked with overseeing the department’s community care networks.
VA Seeks ‘Maintenance Budget’ After Record Growth in Enrollment, Hiring
While VA’s proposed budget represents a 10% increase from last year, it includes decreases in key areas like hiring and infrastructure.
Higher Risk of Dementia Found in Veterans With Housing Instability
Veterans who experience housing instability have an elevated risk of developing Alzheimer’s disease or a related dementia compared to those with stable housing, according to a recent study.
GOP Lawmakers Challenge Data That COVID-19 Vaccine Protected Troops
Recent data from DoD seems to confirm what researchers and physicians have been saying for years—that individuals who receive the COVID-19 vaccine are less likely to experience long-term health effects than those who do not.
Leadership Is Service, Not Position
It has been a particularly challenging few weeks for Team Buckenmaier. We recently pulled our floating home (a Lagoon 42 catamaran) for much-needed routine maintenance and bottom work at a local yacht yard. Our 3,000-plus miles in the Atlantic had taken their toll on the boat and its systems.
Review Finds Little Evidence That Massage Therapy Relieves Painful Health Conditions
For individuals seeking relief from painful health conditions, there’s low certainty of evidence that massage therapy will ease their pain, according to a recent review article.
New Algorithm Developed for Urinary Retention Evaluation, Catheterization
A new algorithm could improve care for adult inpatients who need to be evaluated for urinary retention and possible catheterization, according to a recent study.
Does ‘Underserved’ Designation Demoralize Staff at VA Facilities?
For the past several years, VA has been identifying the most underserved facilities in its system and requiring them to create action plans to improve care to their veterans.
Unraveling the Mystery of Long COVID: VA Steps Up for Nation in Crisis
By March 2020, the SARS-COV-2 virus had reached every inhabited continent on the globe, with devastating impact. In response, the U.S. and many other countries entered lockdowns to slow the spread and reduce deaths from the virus.
Innovative Pain Self-Management Program Improved Pain, Depressive Symptoms in HIV Patients
For almost three decades, antiretroviral therapy (ART) has enabled people with HIV to have nearly normal life expectancies. But as many as 85% of them experience chronic pain, due in part to common medical comorbidities and the side effects of life-saving treatments.
Microvascular Complications of Type 2 Diabetes Drop When PTSD Resolves in Veterans
Post-traumatic stress disorder (PTSD) has a range of adverse effects in veterans, and about 7% are affected at some point in their lifetimes. A recent study puts a spotlight on an unexpected co-morbidity—worsening Type 2 diabetes (T2D) outcomes.
Alternative Prostate Cancer Screening Guidelines for U.S. Black Men
In the United States, Black men are at highest risk for being diagnosed with and dying from prostate cancer.
Review Authors Urge More Genetic Testing of BRCA for Male Cancer Patients
Even though half of all carriers of inherited cancer-predisposing variants in BRCA1 and BRCA2 are male, the implications for their health tend to be under-recognized compared to females, according to a new study.
Prescription Medications Affect Survival Rates in Metastatic Prostate Cancer
How do prescription medications affect overall survival in metastatic hormone-sensitive prostate cancer?
Another Reason to Reduce PPI Use? Usage Linked to Susceptibility for Respiratory Infections
One of the most commonly used medication classes worldwide, proton pump inhibitors (PPIs) are effective for treating acid-related stomach disorders, such as ulcers, heartburn or acid reflux.
VA EHR Rollout at Lovell Federal Healthcare Center Better Than Previous Sites, But Legislators Say Some Issues Persist
About six months ago, the James A. Lovell Federal Healthcare Center became the sixth VA site to switch to the Oracle-Cerner electronic health record (EHR).
Hepatocellular Carcinoma Screening Associated With Improved Survival in Patients Cured of HCV Infection
Hepatitis C virus (HCV) is the most common blood-borne pathogen in the United States, with HCV-related cirrhosis being the leading cause of primary liver cancer, or hepatocellular carcinoma (HCC).
Study: Propofol Use Should Be Minimized in Children With ALL
A study involving military researchers has raised concerns about the use of certain types of anesthesia in children with acute lymphocytic leukemia (ALL)
Circumstances Linked to Bleeding Risk With Chronic Liver Disease Diagnosis
A recent study looked at risk factors for non-variceal bleeding within the first year after diagnosis of chronic liver disease in veterans.
Multiple Myeloma Patients Have Longer Survival With Military Healthcare
MHS beneficiaries with multiple myeloma (MM) had improved overall survival compared to MM patients from the U.S. general population, according to a new report.
Gastrointestinal Symptoms Frequently Diagnosed in Deployed Gulf War Veterans
Deployed Gulf War veterans frequently developed several gastrointestinal symptoms, including irritable bowel syndrome, dyspepsia, diarrhea, bloating and constipation, and those often persisted long after returning home, according to a new study.
Study: Eating Processed, Red Meat Raises the Risk of Type 2 Diabetes
Consuming meat, especially processed and red meat, is a risk factor for the development of type 2 diabetes, according to a new study involving VA researchers.
Misdiagnosis of Community-Acquired Pneumonia Occurs More Than Half the Time at VA Hospitals
Pneumonia diagnoses change more often than not at VA hospitals, either because a veteran initially thought to have the infection is diagnosed with something else or because the community-acquired pneumonia diagnosis was missed when the patient entered the hospital.
Removing Race From Lung-Function Equations Shifts Disease Classifications
In 2023, the American Thoracic Society recommended race-neutral interpretation of lung function and requested the investigation of “consequences for the yet-unquantified number of individuals with results near decision-making thresholds.”
Anti-TNF Agents Associated With Kidney Function Decline in IBD Patients
The introduction of biologic therapies, such as antitumor necrosis factor (TNF) agents, has revolutionized the management of inflammatory bowel disease (IBD)—a group of diseases characterized by chronic inflammation of the gastrointestinal tract.
Legislators Question Continued Usefulness of VISN System at VA
The Veterans Integrated Service Networks (VISNs), which group VA’s facilities into 18 interconnected regions, has been a key part of the department’s structure since they were created in the late 1990s. Now, following a series of key oversight failures at VA facilities and years of watchdog agencies reporting frustrating inconsistencies from VISN to VISN, legislators are wondering if this structure is really the best way to oversee VA’s 172 hospitals nationwide.
VHA Closely Follows Clinical Guidelines on Gender-Affirming Hormone Therapy
When initiating gender-affirming hormone therapy (GAHT) at the VHA, clinicians achieved high overall concordance between current GAHT initiation practices and guidelines, particularly for feminizing GAHT, according to a recent study.
OIG: VISN Leaders Had No Awareness of Toxic Work Environment, Cardiac Surgery Delays at the Rocky Mountain Regional VAMC
At the Rocky Mountain Regional VAMC, a toxic work environment caused by a handful of facility leaders resulted in mass resignations by top clinical staff and the closure of its cardiothoracic surgery program, according to a report from the VA Office of the Inspector General (OIG).
COVID-19 More Severe in Veterans With Chronic Lung Diseases
Veterans with chronic lung diseases, particularly idiopathic pulmonary fibrosis (IPF), other interstitial lung diseases (ILD) and chronic obstructive pulmonary disease (COPD), have an increased risk of experiencing more severe 30-day outcomes with COVID-19, according to a recent study.
Are PSA Values Reliable in Transgender Women to Detect Prostate Cancer?
In a VHA population, prostate-specific antigen (PSA) values in more than one-third of transgender women receiving estrogen were found to be undetectable, which indicates that PSA values in transgender women should be interpreted cautiously, according to a recent study.
Using Spironolactone to Treat HFpEG Reduced All-Caused Death
For veterans with heart failure with preserved ejection fraction (HFpEF), spironolactone use reduced all-cause death and demonstrated a favorable trend in reducing hospitalizations, according to a study of a real-world national cohort of patients with HFpEF.
VA Renews Oracle Contract Amid Intense Criticism of EHR Rollout
VA has renewed its contract with Oracle Health to support its electronic health record modernization project. The 11-month extension will place emphasis on not only improving the much-beleaguered EHR, but on holding Oracle accountable when goals are not met.
Novel Psychotherapy Targeting Unresolved Trauma Reduces Chronic Pain in Older Adults Better Than Traditional CBT
Chronic pain in older adults can be significantly reduced using a newly developed psychotherapy called emotional awareness and expression therapy (EAET), which confronts past trauma and stress-related emotions that can exacerbate pain symptoms, according to a new study.
Shared Decision-Making Tool Promotes More Effective Use of Lung Cancer Screening
Research, including a new study of 57,000 U.S. veterans diagnosed with lung cancer, has shown that low-dose computed tomography lung cancer screening (LCS) saves lives.
Tracking Genetic Risk to Better Understand Which Veterans Have Alzheimer’s
Because of overlapping symptom profiles observed in cognitive disorders, psychiatric disorders, and environmental exposures such as head injury, clinicians can find it difficult to detect early signs of Alzheimer’s disease and related dementias (ADRD).
Pathogenic Variants Found in More Nonbladder Urinary Tract Cancer Patients
In an effort to evaluate factors that could affect the likelihood of identifying a clinically actionable germline pathogenic variant (PV), a new study investigated a real-world multicenter cohort of patients with urinary tract cancer (UTC).
Novel Genetic Associations Identified in So-Called Macular Pucker
Symptoms of epiretinal member (MRM), sometimes called macular pucker, can be severe and require surgery. Patients often complain of loss of central vision and/or visual distortion (i.e. metamorphopsia or “wavy vision”).
Agent Orange Exposure Not Linked to Hepatocellular Carcinoma
U.S. veterans are much more likely to be diagnosed with hepatocellular carcinoma, but at least one toxic exposure during military service doesn’t appear to have much to do with that.
GAO: Servicemembers in Need of Mental Health Services Are Falling Through the Cracks as They Transition to VA Care
Two recent investigations by the Government Accountability Office (GAO) have highlighted how seemingly small procedural issues and technical errors can lead to servicemembers and veterans not receiving much-needed mental health services.
Mohs Surgery at NY Harbor VAMC Reduced Reexcision, Rerepair Needs
Mohs micrographic surgery (MMS) is the standard of care for treating certain types of keratinocyte carcinoma (KCs), but it has not been uniformly accessible to veterans treated by the VHA, according to a recent research letter.
Study: High-Frequency Ultrasound Better as Supplementary Tool for Tumor ID
High-frequency ultrasound (HFUS) can safely and efficiently visualize cutaneous tumor characteristics including depth, but how accurate is it?
Changing DoD Drug Policy Could Open Enlistment for Psoriasis, Eczema Patients
Psoriasis and atopic dermatitis are disqualifying for entrance into the military. Both of the chronic, immune-mediated skin disorders can create difficulties wearing body armor and other protective equipment when poorly controlled, limiting a servicemember’s ability to train and deploy worldwide.
Diagnostics, Treatment Options Improve for Non-Clear Cell Renal Cell Carcinoma
When the law, widely known as the PACT Act, was signed into law two years ago this month, kidney cancer became a presumptive condition for VA care for the first time.
Remote Consent, Testing Used to Identify and Treat Germline Pathogenic Alterations in VA Million Veteran Program Participants
About 10% of men with metastatic prostate cancer show germline pathogenic alterations which can inform precision therapy, surveillance, and cancer prevention for family members, according to a recent study.
Atrial Fibrillation Patients Less Likely to Receive Anticoagulant Therapy at VAMCs Serving More Minority Patients
VA patients receive different medical care for atrial fibrillation depending on whether they visit a VAMC serving more minority patients, according to a new study.