In late September, Hurricane Ian, a deadly Category 4 storm, caused widespread damage, flooding, loss of power and evacuations from hospitals and nursing homes across Cuba and the U.S. Southeast, especially Florida and South Carolina.
News
VA Receives First Doses of Vaccine to Help Combat Monkeypox Outbreak
When the World Health Organization declared monkeypox a public health emergency on July 23, there were more than 4,000 reported cases in the United States. By mid-September, the number of reported U.S. cases had surpassed 24,000.
Current Issue
Smokers With Preserved Lung Function Not Helped by Dual Bronchodilators
Long-term smokers often have serious respiratory symptoms, but without airflow obstruction. A new study questioned whether those patients should be treated with drugs used for chronic obstructive pulmonary disease (COPD).
Many Veterans are Hesitant to Seek Help for Sleep Problems, Alcohol Abuse
Military service and trauma have been linked to an increased risk for substance abuse and mental health disorders. Yet research suggests a lack of willingness to seek treatment for these problems keeps many veterans from getting the help they need.
COVID-19
COVID-19 Can Lead to Long-term Neurologic Disorders; Even Veterans With Mild Illness Could Be Affected
Patients face an increased risk of long-term neurologic conditions after suffering from COVID-19, including stroke, cognition and memory disorders, nervous system disorders, mental health disorders and more, according to a study examining the long-term effects of COVID-19.
Pandemic Didn’t Delay Colonoscopies for Veterans With ‘Red Flag’ Symptoms
Concerns have been raised over the past few years that, because of the COVID-19 pandemic, VHA patients with “red flag signs or symptoms” of colorectal cancer (CRC) did not receive prompt colonoscopy workups.
Second COVID Booster Significantly Protected Nursing Home Residents
Among nearly 10,000 nursing home residents in the United States included in a recent VA-led study, second mRNA COVID-19 vaccine booster doses provided significant additional protection over first booster doses against severe COVID-19 outcomes, even though the Omicron variants were emerging.
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
His place shall never be with those cold and timid souls who neither know victory nor defeat
President Roosevelt’s quote is long, but worth every word. I have a soft spot in my heart for Teddy, since he is my favorite president and my great-grandfather, Anton Buckenmaier, was a Rough Rider. I have been aware of these sage words from our 26th president for most of my career. They have served as an inspiration and guide for critical decisions I have made concerning the direction of my professional pursuits. I would never be so vain as to suggest I could improve Teddy’s profound eloquence in his quote. Then again, I have often summed up the meaning of his words (to appease my goldfish-like memory) when I have had a resident cornered and lecturing. My crass and unpoetic summary of his masterful paragraph: There are those that do and those that don’t.
VA Works to Comply With Expansion of Eligibility Under New PACT Act
Now that the first major provisions of the PACT Act went into effect at the beginning of last month, what happens next?
Pharmacist Email Alerts Don’t Reduce Opioid, Benzodiazepines Prescribing
Email alerts sent from pharmacists to practitioners who prescribe opioids and benzodiazepines fail to reduce concurrent prescribing of these medications, which can put patients at risk of overdose, according to a new study.
Demographics of Hypertrophic Cardiomyopathy Patients Appear to Be Changing
The typical hypertrophic cardiomyopathy patient appears to have changed somewhat, according to a new study, which pointed out that “clinicians are encountering a phenotype of hypertrophic cardiomyopathy evolving from the disease recognized several years ago.”
What Affects Compliance with Thyroid Nodule Surveillance?
Is thyroid nodule surveillance compliance affected by patient demographics or plan type? That was the question addressed in the recent retrospective case series from 2010 to 2018.
Higher Subclinical Papillary Thyroid Cancer Rates Not Found in Middle Age
How does age affect underlying subclinical papillary thyroid cancer (PTC)? A meta-analysis of autopsy studies investigated how subclinical PTC prevalence changes over the lifetime.
Should All Thyroid Incidentalomas Be Evaluated?
It is not unusual for a clinician to identify thyroid incidentalomas on non-thyroid dedicated imaging studies. However, discovered, clinical guidelines recommend evaluation of all thyroid incidentalomas to risk-stratify for cancer.
VHA Data: Migraine Is a Commonly Treated Condition Among Veterans
Migraine is a commonly treated condition at the Veteran’s Health Administration (VHA), with more than half-million veterans being diagnosed during a 12-year study period, according to a recent study.
COVID-19 Can Lead to Long-term Neurologic Disorders; Even Veterans With Mild Illness Could Be Affected
Patients face an increased risk of long-term neurologic conditions after suffering from COVID-19, including stroke, cognition and memory disorders, nervous system disorders, mental health disorders and more, according to a study examining the long-term effects of COVID-19.
Military Study: Biomarkers Can Identify Risk for TBI-Related Dementia
Several studies have found a link between traumatic brain injury (TBI) and an increased likelihood of late-life dementia. The mechanisms driving the relationship have remained elusive, however.
Model Helps Predict Mortality Prognosis for AD, Dementia Patients
Dementia is a leading cause of morbidity and mortality worldwide and is associated with increased mortality risk.
Glitazones Decrease Risk of Alzheimer’s, Other Dementia in Veterans’ Study
The risk of dementia, including Alzheimer’s disease, appeared to be reduced in veterans prescribed an older class of type 2 diabetes drugs, glitazones.
Dietician Mary Julius Champions VA’s Virtual Diabetes Education Program
When Mary Julius was diagnosed with Type 1 diabetes in 1974, the world was a very different place. There were only approximately 4.5 million Americans who had been diagnosed with diabetes.
DoD and VA Update Guideline for Management of Major Depressive Disorder
Expansion of interventional psychiatry and updated algorithms to help guide physicians in making choices about therapies for depression are among important updates included in the newly revised 2022 VA-DoD Clinical Practice Guideline for Management of Major Depressive Disorder.
Association Found Between Battlefield TBI, Subsequent Cardiovascular Disease
Traumatic brain injury (TBI) was common among U.S. servicemembers deployed to Iraq and Afghanistan, with up to 20% sustaining at least one TBI. Although the survival rate for such injury was high, research has suggested TBI is associated with a wide variety of adverse effects, including dementia, epilepsy and mental health conditions.
Hepatitis C Drugs Show Promise in Reducing PTSD Symptoms in Veterans
Direct-acting antivirals used in the treatment of the hepatitis C virus might improve symptoms of post-traumatic stress disorder (PTSD), potentially offering a new therapeutic option for a prevalent disease with few approved medications, according to a new study.
VA Program Successfully Reduces Post-Operative Opioid Prescriptions
Drug overdose is the leading cause of injury-related death in the United States. For many, initial exposure to opioids occurs in the hospital following surgery, and current studies show that up to 75% of post-operative patients have unused opioid pills after discharge.
VA Ceases All New EHR Activities Until At Least Next Summer
All upcoming deployments of VA’s new electronic healthcare record system will be halted until at least June 2023, the agency announced. This is in response to continuing issues with the system at its pilot site in Spokane, WA, as well as the handful of sites that followed.
Community Care Approaches Half of All VA-Funded Medical Services
The VA is approaching a point where one-half of all care paid for by the healthcare system will be delivered through community providers. Outside care accounted for 44% of all VA health services last year, it said.
Overall Prescriptions Are Low at VHA for CVD, CKD Protective Diabetes Drugs
Even though novel therapies for type 2 diabetes have been proven to reduce the risk of cardiovascular disease and chronic kidney disease progression, VHA prescription rates remain low.
Grants Could Help Lower Suicides Among Native American Veterans
VA recently announced that it has awarded $52 million in grants to 80 community-based organizations to deliver or coordinate suicide prevention programs and services for veterans and their family members.
Hurricanes, Sea Level Rise Endanger Hospitals on Atlantic, Gulf Coasts
In late September, Hurricane Ian, a deadly Category 4 storm, caused widespread damage, flooding, loss of power and evacuations from hospitals and nursing homes across Cuba and the U.S. Southeast, especially Florida and South Carolina.
VA Receives First Doses of Vaccine to Help Combat Monkeypox Outbreak
When the World Health Organization declared monkeypox a public health emergency on July 23, there were more than 4,000 reported cases in the United States. By mid-September, the number of reported U.S. cases had surpassed 24,000.
GAO: Claims Processor Misunderstanding Often Denied Agent Orange Benefits to Which Vietnam Vets Were Entitled
VA claims processors have consistently failed to understand the department’s own regulations when it comes to Vietnam veterans presenting with certain Agent Orange-related conditions, prematurely denying benefits for thousands, according to a Government Accountability Office (GAO) report.
VA Partners With American Kidney Fund, Business to Tackle CKD
Several new partnerships are positioning the VA to offer more extensive services, educational material and testing for the one in six veterans estimated to have chronic kidney disease.
VA OIG: Lack of Oversight Found in DO’s Sexual Abuse at Beckley VAMC
This is just the latest finding by the OIG that places blame for a recent criminal case on lack of VA oversight.
Pharmacogenomic Testing Had Positive Results for Major Depression Patients
Pharmacogenomic testing can help clinicians avoid prescribing antidepressant medications that might have undesirable outcomes.
GAO Report Spotlights Medical Supply Issues at VA Healthcare Facilities
Each report the Government Accountability Office (GAO) submits to VA detailing weaknesses in the department comes attached with recommendations for solving the problems.
Senate Changes Spread Out PACT Act Implementation Over Years
When Honoring Our Promise to Address Comprehensive Toxics (PACT) Act passed the House in March, it was expected to be a very hard sell in the Senate.
VA Pauses Further EHR Expansion Because of Patient Care Issues
The VA has paused any further expansion of its new electronic health record (EHR) in reaction to an early draft of a VA Office of the Inspector General (OIG) report.
VHA National Telestroke Program Uses Technology to Improves Acute Stroke Care
Prompt access to specialized care is critical to limiting the damage caused by a stroke.
His place shall never be with those cold and timid souls who neither know victory nor defeat
President Roosevelt’s quote is long, but worth every word. I have a soft spot in my heart for Teddy, since he is my favorite president and my great-grandfather, Anton Buckenmaier, was a Rough Rider. I have been aware of these sage words from our 26th president for most of my career. They have served as an inspiration and guide for critical decisions I have made concerning the direction of my professional pursuits. I would never be so vain as to suggest I could improve Teddy’s profound eloquence in his quote. Then again, I have often summed up the meaning of his words (to appease my goldfish-like memory) when I have had a resident cornered and lecturing. My crass and unpoetic summary of his masterful paragraph: There are those that do and those that don’t.
VA Works to Comply With Expansion of Eligibility Under New PACT Act
Now that the first major provisions of the PACT Act went into effect at the beginning of last month, what happens next?
Pharmacist Email Alerts Don’t Reduce Opioid, Benzodiazepines Prescribing
Email alerts sent from pharmacists to practitioners who prescribe opioids and benzodiazepines fail to reduce concurrent prescribing of these medications, which can put patients at risk of overdose, according to a new study.
Demographics of Hypertrophic Cardiomyopathy Patients Appear to Be Changing
The typical hypertrophic cardiomyopathy patient appears to have changed somewhat, according to a new study, which pointed out that “clinicians are encountering a phenotype of hypertrophic cardiomyopathy evolving from the disease recognized several years ago.”
What Affects Compliance with Thyroid Nodule Surveillance?
Is thyroid nodule surveillance compliance affected by patient demographics or plan type? That was the question addressed in the recent retrospective case series from 2010 to 2018.
Higher Subclinical Papillary Thyroid Cancer Rates Not Found in Middle Age
How does age affect underlying subclinical papillary thyroid cancer (PTC)? A meta-analysis of autopsy studies investigated how subclinical PTC prevalence changes over the lifetime.
Should All Thyroid Incidentalomas Be Evaluated?
It is not unusual for a clinician to identify thyroid incidentalomas on non-thyroid dedicated imaging studies. However, discovered, clinical guidelines recommend evaluation of all thyroid incidentalomas to risk-stratify for cancer.
VHA Data: Migraine Is a Commonly Treated Condition Among Veterans
Migraine is a commonly treated condition at the Veteran’s Health Administration (VHA), with more than half-million veterans being diagnosed during a 12-year study period, according to a recent study.
COVID-19 Can Lead to Long-term Neurologic Disorders; Even Veterans With Mild Illness Could Be Affected
Patients face an increased risk of long-term neurologic conditions after suffering from COVID-19, including stroke, cognition and memory disorders, nervous system disorders, mental health disorders and more, according to a study examining the long-term effects of COVID-19.
Military Study: Biomarkers Can Identify Risk for TBI-Related Dementia
Several studies have found a link between traumatic brain injury (TBI) and an increased likelihood of late-life dementia. The mechanisms driving the relationship have remained elusive, however.
Model Helps Predict Mortality Prognosis for AD, Dementia Patients
Dementia is a leading cause of morbidity and mortality worldwide and is associated with increased mortality risk.
Glitazones Decrease Risk of Alzheimer’s, Other Dementia in Veterans’ Study
The risk of dementia, including Alzheimer’s disease, appeared to be reduced in veterans prescribed an older class of type 2 diabetes drugs, glitazones.
Dietician Mary Julius Champions VA’s Virtual Diabetes Education Program
When Mary Julius was diagnosed with Type 1 diabetes in 1974, the world was a very different place. There were only approximately 4.5 million Americans who had been diagnosed with diabetes.
DoD and VA Update Guideline for Management of Major Depressive Disorder
Expansion of interventional psychiatry and updated algorithms to help guide physicians in making choices about therapies for depression are among important updates included in the newly revised 2022 VA-DoD Clinical Practice Guideline for Management of Major Depressive Disorder.
Association Found Between Battlefield TBI, Subsequent Cardiovascular Disease
Traumatic brain injury (TBI) was common among U.S. servicemembers deployed to Iraq and Afghanistan, with up to 20% sustaining at least one TBI. Although the survival rate for such injury was high, research has suggested TBI is associated with a wide variety of adverse effects, including dementia, epilepsy and mental health conditions.
Hepatitis C Drugs Show Promise in Reducing PTSD Symptoms in Veterans
Direct-acting antivirals used in the treatment of the hepatitis C virus might improve symptoms of post-traumatic stress disorder (PTSD), potentially offering a new therapeutic option for a prevalent disease with few approved medications, according to a new study.
VA Program Successfully Reduces Post-Operative Opioid Prescriptions
Drug overdose is the leading cause of injury-related death in the United States. For many, initial exposure to opioids occurs in the hospital following surgery, and current studies show that up to 75% of post-operative patients have unused opioid pills after discharge.
VA Ceases All New EHR Activities Until At Least Next Summer
All upcoming deployments of VA’s new electronic healthcare record system will be halted until at least June 2023, the agency announced. This is in response to continuing issues with the system at its pilot site in Spokane, WA, as well as the handful of sites that followed.
Community Care Approaches Half of All VA-Funded Medical Services
The VA is approaching a point where one-half of all care paid for by the healthcare system will be delivered through community providers. Outside care accounted for 44% of all VA health services last year, it said.
Overall Prescriptions Are Low at VHA for CVD, CKD Protective Diabetes Drugs
Even though novel therapies for type 2 diabetes have been proven to reduce the risk of cardiovascular disease and chronic kidney disease progression, VHA prescription rates remain low.
Grants Could Help Lower Suicides Among Native American Veterans
VA recently announced that it has awarded $52 million in grants to 80 community-based organizations to deliver or coordinate suicide prevention programs and services for veterans and their family members.
VA Patients Not Told About Risks of COVID-19 Drug Remdesivir Under EUA
VA failed to provide many COVID-19 patients with all the required information when prescribing them remdesivir, according to a recent VA Office of the Inspector General (OIG) report.
Intimate Partner Violence More Common With Veterans, Military Personnel
VA should be doing more to identify and support victims of intimate partner violence (IPV), according to a recent VA Office of the Inspector General (OIG) report that also maintained that programs already in place are inconsistently implemented.
Selection of Supply Chain Management Will Be Test of VA’s New Acquisition Framework to Assure Agency Gets Value for Its Money
As VA moves forward with its long-delayed search for a supply chain management system, the department plans to use the process as a de-facto trial of its new acquisitions’ framework–a system designed to ensure the department uses its money effectively when it comes to major projects.
Healthcare Providers Urged to Increase Firearm Safety Counseling With Veterans
Most, 70%, of suicides among U.S. veterans are due to firearm injury. Yet, according to a new study, not enough veterans are taking advantage of the opportunity to discuss firearm safety with their healthcare providers.
Nonprofit Group: VA Undercounted Thousands of Veteran Suicides
The same week that VA announced a decrease in the national veteran suicide rate, early results from an independent study suggested that the department has been drastically undercounting the total number of veteran suicides for years.
GAO: VA Hasn’t Addressed Core Issues in Standardized Purchasing
For the past decade, VA has struggled to implement a standardized framework for how it purchases goods and services.
Republican Legislators Express Strong Opposition to VA Offering Abortion Services
VA officials believe that the overturning of Roe v. Wade in June and the subsequent enforcement of abortion bans in several states creates a clear danger to the health of women veterans.
Veterans Receiving Cancer Diagnoses Have Increased Suicide Risks
Research has shown that a cancer diagnosis is associated with an increased risk of suicide, which might be attributed in part to factors such as interpersonal struggles, hopelessness, physical pain and strain, financial distress and relationship changes.
New Tool Estimates Age-Specific Prostate Cancer Risk
A multi-ancestry polygenic risk score (PRS) that stratifies prostate cancer risk across populations has been developed. In a recent study, the developers validated the performance of the PRS in the multi-ancestry Million Veteran Program and additional independent studies.
Survival Rates Better for Prostate Cancer With Radical Prostatectomy
Clinicians haven’t had information on the optimal upfront treatment modality for patients with nonmetastatic Gleason Score 9 and 10 prostate cancer (GS 9-10 PCa).
Second Cancer More Common With Radiotherapy for Prostate Cancer
When men are diagnosed with localized prostate cancer, they are often faced with a difficult decision.
PACT Act: Hundreds of Thousands of Veterans Newly Eligible for VA Care
As of the first day this month, the VA expanded and extended eligibility for VA healthcare for specific veterans of the Gulf Wars and post-9/11 era.
High Prescribing of Antibiotics, Opioids Linked In Medical, Dental Providers
Medical and dental providers who are high prescribers of antibiotics are also likely to be high prescribers of opioids, according to a new study.
PTSD Appears to Accelerate Multiple Sclerosis Progression for Veterans
An unfortunate confluence of events puts a significant number of veterans at higher risk of both multiple sclerosis and post-traumatic stress disorder (PSTSD). Agent Orange and other exposures make multiple sclerosis (MS) a presumptive condition for those who have served, while combat experience, higher rates of sexual assault and other factors increase the likelihood of PTSD among veterans.
HIV-Positive Veterans Have Higher Risk of Head and Neck Cancer
Thanks to the use of combination antiretroviral therapy, life expectancy is greater than it has ever been for people living with HIV/AIDS. But with that increase in life expectancy comes an increase in the number of non-AIDS-defining cancers.
Study Finds Significant Regional Variations in Hepatocellular Carcinoma Treatment and Survival Rates Within Nationwide VA Healthcare System
Veteran populations have five times the incidence of hepatocellular carcinoma (HCC)—the most common primary malignancy of the liver, which occurs largely in patients with underlying chronic liver disease—compared to the general population
Glargine, Liraglutide More Effective for Reaching, Maintaining T2D Targets
Clinicians treating Type 2 diabetes have an arsenal of medications to help lower glucose levels in patients with uncontrolled blood sugar. The key question regards which work best to lower glucose levels and keep them low.
Diabetes Genetic Risk Score Linked to Dementia in Some Veterans
Using the VA’s Million Veteran Program data, a new study has determined that a diabetes genetic risk score is associated with all-cause dementia and clinically diagnosed vascular dementia in veterans.
Rural T2D Patients Improved With Remote VA Care
How did a novel approach to provide diabetes specialty team care to rural veterans with Type 2 diabetes (T2DM) affect clinical outcomes and processes of care?
T2D Drugs Didn’t Differ in Preventing CV Complications
Not many studies have looked at the comparative effectiveness of commonly used glucose-lowering medications, when added to metformin, on preventing microvascular and cardiovascular disease outcomes in Type 2 diabetes.