As the number of first-line treatments for Waldenström Macroglobulinemia increased, older adults experienced marked improvements in survival Among older patients, median progression-free survival improved from 28.3 months in the early era to 63.3 months in the modern era, according to a new study. Younger patients, on the other hand, showed almost no improvement in median progression-free survival between eras, the authors pointed out.
Retention Rates Remain Low for Substance Use Disorder Programs
A common explanation for the high dropout rate and failure of a substance use disorder program is that patients fear symptoms of opioid withdrawal. A new study suggested that is for good reason, especially since patients who are exposed to full opioid agonists chronically are recommended to already be experiencing moderate withdrawal symptoms before they can get drugs to alleviate the symptoms. That’s why the FDA has approved new alternatives, including auricular stimulators, to help patients through the difficult withdrawal symptoms.
COVID-19 Infection Increased Suicide Attempts in Some Younger Veterans With Schizophrenic, Schizoaffective Disorder
Authors of a new study strongly urged that patients with schizophrenia or schizoaffective disorder who have a history of suicide attempt and are younger than 59 or obese, should be monitored closely during the COVID-19 pandemic. They warned of the possibility of symptom exacerbation in those patients when they have severe COVID-19 since postmortem examination of brains in that cohort have revealed infection-related impaired brain neurotransmission.
Low Muscle Mass Along with High Tumor IL-6 Expression Strongly Associated with Mortality in Renal Cancer
The combination of low muscle mass and high tumor IL-6 expression predicts early death in patients with clear cell renal cell carcinoma, according to a new study. As with some other malignancies, cachexia is a major cause of mortality in ccRCC, the authors warned, noting that the combination of low muscle mass and high tumor IL-6 expression should raise alarms.
Treatment Options Expand for Older Veterans With Castration-Resistant PCa
In most recurrent prostate cancer patients, androgen-deprivation therapy works for a while. Eventually, however, most men end up developing castration-resistant prostate cancer. Now, expanding treatment options are especially benefitting older men in that situation, who often didn’t fare well with chemotherapy.
VA Pharmacists Take On Even More Critical Roles Because of Pandemic
For years, pharmacists working at the VA, as well as the DoD, have had broader scope of practice than those in the community. The COVID-19 pandemic expanded it even more, with VA pharmacists playing essential roles in identifying, treating and prevention SARS-C0V-2.
The Fungus Really Is Among Us: Its Role in Airway Disease, Nasal Polyps
What is the role of fungus in allergic airway diseases? VA researchers found that many conditions, including chronic rhinosinusitis (CRS), allergic fungal rhinosinusitis, asthma, allergic bronchopulmonary mycosis/aspergillosis, and cystic fibrosis (CF have a shared immunological signature. In some cases, nasal polyps can occur.
A Rare Cancer Prompts Sleuthing at the VA; New Options for MDS
VA researchers solved a mystery involving younger veterans who developed unusual and deadly cancers. They determined that patients currently using certain drugs, thiopurines, had triple the risk of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) on an adjusted basis compared to those never exposed. The risks resolved with discontinuation.
Smoking Cessation Success Rate Low Even in Veterans With Lung Cancer
With a range of smoking cessation program, the VA is having some success reducing the percentage of veterans who use tobacco. Still, data show that veterans find it hard to quit, even when they have been diagnosed with lung cancer and continued smoking affects their overall survival.
Early Colonoscopy in Veterans With IBD Lowers Overall Mortality
Well-timed colonoscopy appears to improve overall survival in inflammatory bowel disease patients, but many VA patients aren’t getting screened regularly. A new study supported current VA practice guidelines that recommend colonoscopy intervals from one year to three years among patients with IBD who have extensive colitis or left-sided colitis.
Risk Factors Change for HCC With More Effective Hepatitis C Treatment
Risk factors for hepatocellular carcinoma have undergone dramatic changesin recent years. Metabolic conditions such as obesity and diabetes, as well as associated nonalcoholic fatty liver disease, now sit at the top of the list. Alcohol use disorders also are on the increase, fueling alcoholic liver disease and alcoholic cirrhosis. At the same time, however, with more effective treatment and prevention, hepatitis C and hepatitis B infections have decreased in prevalence.
VA Researchers Look at Role of Estrogen, Menopause In Elevated Rates of Glaucoma in Women
Women represented less than 10% of U.S. veterans in 2017, according to the National Center for Veterans Analysis and Statistics, but the number of women veterans receiving VHA care has increased by 22.1%, from 423,642 in 2014 to 517,241 in 2018 and is predicted to burgeon even more in the future. That’s why studies such as one examining the role of estrogen and menopause in glaucoma are so important to the VA.
Diabetes Patients With CKD Use More Insulin, Even Though Combination Raises Risk of Severe Hypoglycemia
Conventional wisdom has suggested that insulin requirements go down with advanced chronic kidney disease in Type 2 diabetes patients. That does not always appear to be the case, however. A recent study found that patients with both T2D and CKD are at much higher risk of severe hypoglycemia with insulin use.
In-hospital Continuous Glucose Monitoring Protects Patients, HCPs
Hyperglycemia and diabetes are common in hospitalized patients. Managing that amid the restrictions of the COVID-19 pandemic, including the more recent staff shortages, has been extremely difficult at the VA and elsewhere. Increased use of continuous glucose monitoring has helped the situation.
Genetic Changes Increase Likelihood of Poor COVID-19 Outcomes in Chronic Lung Diseases; Environmental Exposures, Lifestyle Put Veterans at Higher Risk
Because they are molecularly susceptible to SARS-CoV-2, patients with chronic lung diseases appear to be primed for worse outcomes after infection, through the dysregulation of genes related to viral replication and the innate immune response in epithelial cells, and basal differences in inflammatory cell gene expression programs, according to a new study. The authors cautioned that patients with idiopathic pulmonary fibrosis are most at risk but the greater danger also affects those with chronic obstructive pulmonary disease and interstitial lung disease.
Bipolar Disorder Often Misdiagnosed as Major Depression, Leading to Improper Treatment
Nearly 70% of bipolar patients are initially misdiagnosed and a third or more still haven’t gotten an appropriate diagnosis a decade later. Making the situation even more troubling is that many bipolar patients are being treated for major depressive disorder and receiving antidepressants alone – therapy that is suspected of actually destabilizing mood.
Did Military Toxic Exposures Increase Risk of AML, MDS in Veterans?
The debate continues a half-century after Agent Orange use ended over whether exposure to the herbicide in Vietnam and elsewhere contributed to the development of acute myeloid leukemia and myelodysplastic syndromes. A recent article from Yale researchers raised the issue anew.
Co-Morbid Conditions Make Veterans’ Alcohol Use Disorder Even Riskier
While alcohol use disorder is common among U.S. veterans, it often doesn’t stand alone. Instead, AUD is frequently found as a co-morbid condition with other psychiatric diagnoses or post-traumatic stress disorder. The combinations make the condition riskier and harder to treat.