2019 issues

August 2019

MHS Pharmacies Prescribed 6,200 Naloxone Kits Under New Directive

FALLS CHURCH, VA—In June 2018, Defense Health Agency Director Raquel Bono, MD, directed all MHS pharmacies to dispense the opioid reversal agent naloxone to eligible beneficiaries and those who request it without requiring a prescription.... View Article

August 2019

Trying to Determine What Leads to Tobacco Cessation in Vets

MINNEAPOLIS—Incidental pulmonary nodules are commonly found on routine chest imaging, but not enough is known about smoking behaviors among patients with IPNs or characteristics of patient-clinician communication that may contribute to these behaviors. A study... View Article

August 2019

Benzodiazepines Prescribed Long-Term for COPD/PTSD

SEATTLE—Symptoms of insomnia and anxiety are common among patients with chronic obstructive pulmonary disease, and that is especially the case among patients with comorbid mental health disorders such as posttraumatic stress disorder, according to a... View Article

August 2019

Decompensated Diabetes More Common in Certain Racial, Age Groups

ATLANTA—Which diabetes patients are most likely to have decompensated diabetes, defined as diabetic ketoacidosis and hyperosmolar hyperglycemic state? A study published in Cureus sought to determine that across age, gender and racial groups of hospitalized... View Article

August 2019

Tight Glycemic Control Increases Fracture Risk in Veterans with Diabetes

DURHAM, NC — Diabetes mellitus among older men has been associated with increased bone mineral density but paradoxically increased fracture risk, according to a study in the Journal of Bone and Mineral Research.1 The mechanisms... View Article

August 2019

Metformin Reduces Dementia Risk in Black Veterans With T2D

ST. LOUIS—Use of metformin for Type 2 diabetes significantly reduces the risk of dementia among African American male veterans older than 50, according to a large observational cohort study. The study published in the Annals... View Article

August 2019

VA-led Study Finds U.S. MS Prevalence Is Double Previous Estimates

WASHINGTON—Researchers and policy makers estimated that 300,000 to 400,000 people in the U.S. had multiple sclerosis in 2010, but new data indicates that number grossly undercounted the number of people affected by the neurological disease.... View Article

August 2019

New Biomarker for MS Discovered; Could Replace MRI for Detection

BALTIMORE—A University of Maryland research team has discovered a biomarker that can determine whether a patients has multiple sclerosis or is relapsing, thanks to VA funding. Now two VA organizations focused on technology transfer are... View Article

August 2019

New Guidelines Recommend TNFi Biologics as Initial Psoriatic Arthritis Treatment

BIRMINGHAM, AL For the first time, new guidelines have recommended the use of tumor necrosis factor inhibitor biologics as initial therapy for psoriatic arthritis. While current Group for Research and Assessment of Psoriasis and Psoriatic... View Article

August 2019

Political Issues Related to VA’s Limited Approval of Esketamine for Depression

WASHINGTON—A VA panel this summer opted not to add the new depression medication esketamine, Spravato, to the department’s formulary in the usual way. This came despite strong support from President Donald Trump and an effort... View Article

August 2019

VA: Blue Water Veterans Must Wait Until 2020 for Claims to Be Processed

Vietnam Vets on Ships Won Fight for Presumptive Agent Orange Status WASHINGTON—Blue Water Navy veterans who want to file disability claims related to Agent Orange exposure will have to wait until next year to have... View Article

August 2019

Whistleblowers Report Ongoing Harassment for Revealing VA Malfeasance

WASHINGTON—In 2014, Katherine Mitchell, MD, was one of a handful of employees at the Phoenix VAMC who blew the whistle on hospital leadership for keeping a separate, secret list of veterans seeking healthcare—a numerical sleight-of-hand... View Article

August 2019

Army Doctor’s Unique Training Helps Improve Battlefield Medicine

SAN ANTONIO— Col. Andrew Cap, the division chief of Acute Combat Casualty Research at the Army Institute of Surgical Research, admits that he’s the last person you want to ask for advice on how to... View Article

August 2019

VA Study Shows Benefit of PCSK9 Inhibitors After Maximizing Other Therapies

HOUSTON—Veterans who have experienced acute coronary syndrome within the past year face a substantial risk of a repeat event. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors significantly reduce that risk, but determining who would benefit... View Article

August 2019

Tests Show No Lung Changes for Recent Veterans

SAN ANTONIO—Significant airborne hazards were reported during military conflicts in southwest Asia, including geologic dusts, burn pit emissions, chemical exposures, and increased rates of smoking. Yet, despite significant concerns about the respiratory health of deployed... View Article

August 2019

Following Guidelines Reduced Mortality in Veterans at High Risk of Recurrent Stroke

Only 15.3% of Eligible Patients Received All Interventions INDIANAPOLIS—Meticulously following clinical guidelines in VA patients who suffered transient ischemic attack or nonsevere ischemic stroke reduced by nearly one-third their risk of death within a year,... View Article

August 2019

Ensuring Community Providers Meet Veteran Suicide Prevention Standards

WASHINGTON—As leaders from across multiple federal agencies begin work on a roadmap to combat veteran suicide, they are searching for ways to turn existing efforts in towns, cities, counties and neighborhoods across the country into... View Article

August 2019

Debate Continues on Esketamine Efficacy and Safety for Depression Treatment

VA Panel Puts Limits on Use of Drug PHILADELPHIA—Is esketamine a revolutionary treatment for depression or just another moderately effective adjunctive medication with some potentially serious risks? The VA’s Medical Advisory Panel leaned toward the... View Article

August 2019

“13. The delivery of good medical care is to do as much nothing as possible.” “Laws of the House of God,” —Samuel Shem

I have been a part of U.S. Medicine and this column for several years now. I am occasionally asked where my ideas come from for the editorials I produce. Many ideas, of course, are pulled... View Article

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