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.
News
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.
Current Issue
Genetic Sequencing Study Is ‘Step in the Right Direction’ Toward Improving Equity in VA Prostate Cancer Trials and Treatment
Prostate cancer affects an estimated 1 in 8 men at some point during their lives, with black men affected at almost double the rate of whites.
Increase in Military Deployment Raised Chronic Pain Threat for Servicewomen
The prevalence of chronic pain is documented to be several times higher in U.S. veterans than the general population. Efforts to deal with that unrelenting issue have led to myriad problems, including elevated rates of substance abuse.
Oncology
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.
Closing in on More Than a Half Century of Cancer Breakthroughs, VA Continues Pioneering Work in Oncology
The VA has been at the forefront of cancer research in the United States. Starting with the establishment of its first tumor research laboratory in 1932 and groundbreaking work in the 1950s on the association between smoking and respiratory tract cancers, the agency has repeatedly changed the course of oncology.
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
The Report Of My Death Was An Exaggeration
It has been a challenging week for me in my interactions with American institutions. I had a primary care appointment for my annual checkup and to manage my ongoing respiratory issues related to burn pit exposure. I fancy myself savvy in how the healthcare system works (and how it does not), so I used the Johns Hopkins MyChart system to request my routine blood work before my visit. This electronic medical record and communication system performed flawlessly, and my labs were ordered a week before my appointment. I was feeling rather smug concerning my patient prowess after reviewing my results and having the opportunity to inquire about some abnormal values via MyChart. The day arrived for my clinical visit, and I wanted to double-check the appointment time, so I logged on to my trusted electronic medical record. MyChart informed me that my account had been disabled.
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.
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.
Opposing Trends for Accidental Death Rates in Returning Soldiers
A longitudinal cohort study, published in the Annals of Epidemiology, determined if risk for accidental death overall, or the most common types of accidental deaths, varied over time in relation to when a soldier returned from a combat deployment.
The Report Of My Death Was An Exaggeration
It has been a challenging week for me in my interactions with American institutions. I had a primary care appointment for my annual checkup and to manage my ongoing respiratory issues related to burn pit exposure. I fancy myself savvy in how the healthcare system works (and how it does not), so I used the Johns Hopkins MyChart system to request my routine blood work before my visit. This electronic medical record and communication system performed flawlessly, and my labs were ordered a week before my appointment. I was feeling rather smug concerning my patient prowess after reviewing my results and having the opportunity to inquire about some abnormal values via MyChart. The day arrived for my clinical visit, and I wanted to double-check the appointment time, so I logged on to my trusted electronic medical record. MyChart informed me that my account had been disabled.
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.
Revised Guidelines Give Recommendations Concerning Use of Newer Pharmacological Treatments for Type 2 Diabetes
The newest medications for Type 2 diabetes have benefits beyond controlling blood sugar. Evidence suggests they also reduce mortality and the risk of cardiac events.
Closing in on More Than a Half Century of Cancer Breakthroughs, VA Continues Pioneering Work in Oncology
The VA has been at the forefront of cancer research in the United States. Starting with the establishment of its first tumor research laboratory in 1932 and groundbreaking work in the 1950s on the association between smoking and respiratory tract cancers, the agency has repeatedly changed the course of oncology.
Highlights of the VA’s Contributions to Cancer Research
In the more than 90 years since the VA established its first tumor research laboratory at the Hines, Ill., VA hospital, the agency has published some of the most instrumental studies in cancer in the U.S.
Is VA Avoiding Reporting Requirements in Supply Chain Modernization?
Lawmakers on both sides of the aisle are upset at VA for delays in providing Congress with information about its ongoing Supply Chain Modernization (SCM) project.
Huge Financial Impact From Lapses in, Misuse of VA Prime Vendor Program
A recent audit of VA’s Medical Surgical Prime Vendor Program (MSPV) found that lack of oversight of the system, which is meant to save VA money by better leveraging the department’s buying power, is costing VA hundreds of millions a year.
COVID-19 Complications Continue to Arise Three Years After Infection
The long-term effects of COVID-19 might last longer and manifest themselves later than was previously thought, according to a new study that followed patients for three years after their initial illness.
Recurrent Hyperkalemia Found to Be Higher in Black, Hispanic Veterans
In U.S. veterans with incident hyperkalemia, the risk of recurrent hyperkalemia within one year is higher in Black and Hispanic patients, according to a recent study.
Supplements Marketed to Military Contain Dangerous, Illegal Substances
Dietary supplements for weight loss are widely promoted online and through social media, with many claiming to have the added benefits of building lean muscle and enhancing energy and performance.
Real-World VA Study Shows Substantial Mortality Benefit From Lung Cancer Screening
Veterans who underwent VHA lung cancer screening were more likely to be diagnosed at an earlier stage and had higher cure rates than those who were not screened, according to a new observational study.
Exposure to Agent Orange Associated With Increased Prostate Cancer Risk
In veterans who were on active duty during the Vietnam War era, exposure to Agent Orange was associated with a small increase in the risk of developing prostate cancer, but not metastatic prostate cancer or fatal prostate cancer, according to a recent study.
Prospective Memory Deficits Explained in Multiple Sclerosis Patients
Patients with multiple sclerosis (MS) have been found to have prospective memory (PM) deficits. A new study sought to better understand how and why that occurs.
Veterans With MS Face Disparities in VA Smoking-Cessation Treatment
Even though smoking is a risk factor for multiple sclerosis (MS) development, symptom burden, decreased medication efficacy and increased disease-related mortality, veterans with the disease continue to smoke at critically high rates, according to a new study.
Why Does Epstein-Barr Lead to Multiple Sclerosis in Some Patients?
Only a small proportion of patients infected with the Epstein-Barr virus (EBV) develop multiple sclerosis (MS). A new military study sought to determine why that is and what the underlying mechanisms are.
In a Turnaround, Nearly All VA Hospitals Require Personnel to Get Flu Shots
In 2017, almost no healthcare personnel at VA hospitals reported in a survey that they had received mandatory influenza vaccinations. By 2021, almost all VA respondents said they had.
Processing of ICE Medical Claims by VA Sparks Controversy in Congress
The U.S. House of Representatives has approved an amendment to H.R. 8580, the Military Construction and Veterans Affairs, and Related Agencies Appropriations Act to prohibit the VA from processing claims for the Immigration and Customs Enforcement (ICE) Health Service Corps at the Department of Homeland Security.
Sacubitril/Valsartan Not Linked to Higher Dementia Rates in HF Patients
Could using the drug combination sacubitril/valsartan, an angiotensin receptor/neprilysin inhibitor, in heart failure patients increase their risk of cognitive impairment?
Influenza Associated With Coronary, Cerebrovascular Events in Older Veterans
Influenza is a significant contributor to coronary and cerebrovascular events in U.S. veterans and exacerbates underlying conditions, according to a new study.
Kidney Disease Defined by KDIGO Guidelines Riskier for Veterans With HF
Is chronic kidney disease (CKD) diagnosed based on a single estimated glomerular filtration rate measurement significantly different from that diagnosed using the Kidney Disease: Improving Global Outcomes (KDIGO) guideline?
Guideline Discordant Care Leads to Lower NSCLC Survival in AI/AN
American Indian/Alaska Native (AI/AN) patients have lower overall survival rates from non-small cell lung cancer (NSCLC), and at least part of the reason is that they are less likely to receive guideline-concordant care, according to a new study.
Mutant HRAS-Driven BC Tumors More Linked to Skeletal Muscle Dysfunction
The quality of life for many breast cancer patients is affected by skeletal muscle dysfunction, which is estimated to appear in about 39% of cases.