All World War II veterans now are eligible for no-cost VA healthcare, medical services and nursing home care, the VA announced shortly before Veterans Day.
News
VA Will Fund Medical Residencies in Underserved Areas Across the United States
In an effort to improve healthcare access for veterans in rural, trial and underserved areas across the United States, the VA is creating a new pilot program for graduate medical education.
Current Issue
McDonough: VA Can Only Be So Competitive in Physician Salaries
For many high-demand medical professions, VA will likely never be able to fully compete with the private sector, regardless of the breadth of benefits the department can offer, according to VA Secretary Denis McDonough.
VA Caught in Middle Over Scope-of-Practice Disputes Involving Physicians, Others
VA is working to establish a set of national credentials for more than 50 healthcare occupations, allowing the department to transfer care workers more easily from state to state.
Oncology
Very Elderly Patients Fare Much Worse When Treated for DLBCL
Diffuse large B-cell lymphoma (DLBCL) becomes much more difficult to treat in older patients, according to a new study suggesting that more adults of advanced age be included in clinical trials for new agents.
Despite Disparities, Making a Difference for Veterans With Relapsed DLBCL
DURHAM, NC—Recent Food and Drug Administration approvals of chimeric antigen receptor (CAR) T cell therapies and novel immunotherapies have helped...
More Diverse Dataset Raises Questions about MGUS Risk Models
Patients with monoclonal gammopathy of undetermined significance (MGUS) have been thought to have a less than 1% chance of progressing to multiple myeloma as long as their M-protein levels are below 1.5 g/dL.
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
A great leader takes people where they don’t necessarily want to go but ought to be
I was saddened to learn of the passing of first lady Rosalynn Carter. She and President Jimmy Carter were a leading political team during a particularly turbulent time in America. Although the Carter presidency was marred by the energy crisis of 1979 and the Iran hostage crisis, which likely limited Carter to one presidential term, the husband-wife team had a remarkable list of accomplishments during their four years at the White House. Carter made some difficult and unpopular decisions during his presidency. He pardoned all Vietnam War draft dodgers, returned the Panama Canal, established the Departments of Energy and Education and shepherded, arguably, the most significant talks regarding Middle East peace through the Camp David Accords.
With High Awareness of Long COVID, Researchers Put Spotlight on Long Flu
Clinicians are well aware of long COVID, the enduring health conditions caused by the SARS-CoV-2 virus’ ability to attack multiple organ systems.
Oral Antiviral Drug Paxlovid Reduced Only Some Post-COVID-19 Conditions
Nirmatrelvir-ritonavir, an oral antiviral drug used to treat COVID-19, only appears to reduce some post-COVID-19 conditions, such as combined thromboembolic events, according to a recent study.
War on Terror Created High Rates of Ocular Trauma in U.S. Servicemembers
The rate of combat ocular trauma in Operations Iraqi Freedom and Enduring Freedom exceeded that of any past U.S. conflict. A new study looked at the long-term effects of the devastating battlefield injuries.
Homeless Veterans More Likely to Receive Risky Benzodiazepine Prescriptions
Despite an elevated risk of mental illness and substance use disorder in most homeless populations, a scarcity of research exists on the use of psychiatric medications and understanding of prescribing practices among providers for these populations.
Multilevel Intervention Aligns Colorectal Cancer-Screening Use With Benefit
Each year, the VA diagnoses some 4,000 new cases of colorectal cancer (CRC) in veterans. Colorectal cancer screening can help detect cancer early, when it is most treatable. But the benefits of screening in older adults varies by individual, according to a new study.
Legislators Raise Concerns About Lack of Background Checks at VA
VA apparently lacks the personnel needed to complete timely background checks on all new staff, resulting in employees going to work at VA hospitals without ever being fully vetted, according to a legislator.
Knowing Seasonality of Wartime Wound Infections Can Aid Effective Treatment
Battlefield-related wound infections complicate recovery from combat casualties. A new study described what pathogens are more likely to cause morbidity at what times of the year to help better manage the infections.
New Factbook Reveals Veteran Trends, Including Mental Health, Labor Market
U.S. military veterans are declining as a percentage of the population and are, on average, older, more likely to be male and less racially or ethnically diverse than the overall nonveteran population, reports a new factbook that sheds light on demographics, mental health and labor market outcomes.
Surgery Is Better Treatment for Primary Aldosteronism
Even though primary aldosteronism (PA) is one of the most common causes of secondary hypertension, the comparative outcomes of targeted treatment often are unclear.
Consensus Documents Answers Some Questions on Carotid Stenosis
Many national/international guidelines provide recommendations on management of patients with asymptomatic (AsxCS) and symptomatic (SxCS) carotid stenosis. Several questions remain unanswered, however, according to a new report.
SMART2 CABG Risk Score Performs Well in Racially Diverse VA Cohort
A new study tested the potential of the Secondary Manifestations of Arterial Disease (SMART2) risk score for use in patients undergoing coronary artery bypass grafting (CABG).
Fate of VA’s Whistleblower Protection Office Under Legislative Discussion
Should VA’s Office of Accountability and Whistleblower Protection (OAWP) be given more authority in order to better conduct investigations and track enforcement recommendations, or should it be done away with entirely?
Psychedelics to Treat PTSD Now Getting Bipartisan Congressional Support
After decades of being considered fringe science by lawmakers, research into psychedelics for the treatment of post-traumatic stress disorder (PTSD) is finding bipartisan support in Congress.
VA’s Research Portfolio Suffers From Lack of Focus, Critics Maintain
VA’s research portfolio has slowly but steadily grown larger year after year. Nearly every major piece of legislation impacting VA includes provisions requiring the department to conduct research, whether it be on toxic exposure, mental health, suicide or other high-profile issues affecting veterans’ health.
Thyroid Cancer More Common Among Transgender Female Veterans
Transgender female veterans appear to have a high prevalence of thyroid cancer, according to a recent study that might be the first to demonstrate such a disparity in that cohort.
COVID-19 Cases Were Undercounted Early in Active-Duty Servicemembers
The number of reported COVID-19 cases in active-duty U.S. military members was considerably lower than true cases during the first 18 months of the COVID-19 pandemic, according to a recent study, which used severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence data to reveal the gap
MHS Patients Receive Earlier Cancer Diagnoses Than General U.S. Population
Cancer patients treated within the MHS generally receive their diagnoses earlier than members of the general U.S. population covered by employee-provided insurance, Medicaid or without insurance.
Apixaban Suggested as Better OAC for Frail Older Adults With AF
Past research has suggested that elderly veterans who are frail are less likely to be prescribed oral anticoagulants for atrial fibrillation (AF). A recent study suggested a possible way to mitigate some of those challenges.
Usability Testing to Identify Deficiencies, Improve Efficiency in EHR Transition
For healthcare systems changing over from one electronic health record (EHR) system to another—such as the VA’s transition from its legacy EHR system to Oracle Cerner EHR modernization program—the transition poses many challenges, including an impact on medication safety.
A Review of Long-Acting Injectable Antiretroviral Therapy
Barriers to maintaining viral suppression remain a challenge to ending the HIV epidemic. Among those are medication adherence.
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.
VA Adds Nine Rare Cancers to Presumed Service-Connected Disabilities
Nine new rare respiratory cancers are now on the VA’s list of presumed service-connected disabilities for certain veterans exposed to fine particulate matter during military service.
Severe Staffing Shortages Continue to Plague VA Healthcare System
The VA healthcare system currently is grappling with about 50,000 vacancies, mostly among doctors, nurses, social workers and physician aides. In addition, the turnover rate among nurses is the highest the department has experienced since 2005.
Biden Underscores Commitment to Veterans Who Had Toxic Exposures
During the State of the Union address, President Joe Biden shined a light, as he has many times in the past, on the effects of toxic exposure, declaring that he would continue to make it a priority of his administration.
Is VA Doing Enough for Veteran Survivors Seeking Deserved Benefits?
Part of VA’s mission is to care for the widows and orphans of servicemembers and veterans, but some legislators have expressed concern that survivors are getting short shrift, especially when the veteran dies long after their initial service rather than in combat.
VA Announces Ambitious Plan to Improve Staff Recruitment, Retention
VA recently unveiled a 10-step human infrastructure plan designed to strengthen the department’s ability to recruit and retain staff.
A great leader takes people where they don’t necessarily want to go but ought to be
I was saddened to learn of the passing of first lady Rosalynn Carter. She and President Jimmy Carter were a leading political team during a particularly turbulent time in America. Although the Carter presidency was marred by the energy crisis of 1979 and the Iran hostage crisis, which likely limited Carter to one presidential term, the husband-wife team had a remarkable list of accomplishments during their four years at the White House. Carter made some difficult and unpopular decisions during his presidency. He pardoned all Vietnam War draft dodgers, returned the Panama Canal, established the Departments of Energy and Education and shepherded, arguably, the most significant talks regarding Middle East peace through the Camp David Accords.
New Journal Article Decries Lack of Recognition for Military Medicine
A new Special Communication in JAMA Network Open decried that military medicine’s contribution to healthcare advances often are overlooked and that not enough communication occurs between civilian and military clinicians.
No Increase in Cancer Identified With Use of Ranitidine Vs. Other H2RAs
In 2020, the U.S. Food and Drug Administration asked manufacturers to remove from the market all products containing ranitidine, a histamine-2 receptor antagonist (H2RA) that has been widely used to treat gastroesophageal reflux disease and peptic ulcer disease.
Too Few VA Anal Cancer Exams in HIV Patients
Because human immunodeficiency virus (HIV) patients are at high risk for anal cancer, screenings are recommended annually for U.S. veterans with HIV.
Uterine Cancer Mortality Increased Sharply in Some Groups
Since the beginning of the 21st century, uterine cancer mortality has increased, especially among Black and Hispanic women, according to a new study.
Pandemic Declines in Cancer Diagnoses Persisted for Two Years
Early in the COVID-19 pandemic, significant declines in cancer diagnoses occurred. But what happened from the end of 2020, the first year, and after widespread vaccination occurred?
Military Health Mammography Lapses During Pandemic Spotlights Disparities
Breast cancer screening within the Military Health System (MHS) plummeted by 74% in the early COVID-19 pandemic period and 22% in the late pandemic period, compared with the prepandemic period.
Frailty in Older Veterans Increases Their Risk for Long COVID Symptoms
Older veterans diagnosed with frailty are at much greater risk of developing long COVID after acute infection with SARS-CoV-2, according to a new study. Making that especially significant is that so many older VHA patients, including those living in the community, meet the criteria for frailty.
VA Researchers Spotlight Racial, Ethnic Disparities in Liver Cancer Care
Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, is the fastest-growing cause of cancer-related death in the United States. But a new study points out that the burden of the often deadly cancer is not spread equally.
Trial of Fluticasone Furoate Didn’t Show Benefits for COVID-19 Outpatients
Inhaled glucocorticoids do not appear to be effective in shortening the time to symptom resolution or preventing hospitalization or death among outpatients with mild-to-moderate COVID-19, according to a recent study.
Liver Cancer Risk Low for Veterans Who Clear HCV Without Treatment
The risk of developing hepatocellular carcinoma, the most common type of liver cancer, is low for veterans who spontaneously clear hepatitis C virus (HCV) infection.
No Excess Late Mortality for Veterans Who Survived COVID-19
The devastating toll of acute COVID-19 infections on human lives is well documented. Yet a pressing question remains: Do survivors of acute COVID-19 face a higher risk of mortality in the aftermath of their infection and, if so, for how long does this risk persist?
Heat-Related Illness Among Veterans Showing Nationwide Rise
Environmental heat can adversely affect health, resulting in heightened healthcare demands, disability and even mortality. The combination of particular medical conditions with the ongoing global temperature increase may exacerbate susceptibility to heat-related ailments.
Genetic Risk Factors Lead to Potential Therapeutic Targets for Heart Failure
Heart failure affects nearly 6.2 million adults in the United States and disproportionately impacts veterans. The long-term prognosis of heart failure is poor, with a five-year mortality rate of 50%, raising the demand for new therapeutic opportunities.
Deportation Increases Risk of Poor Health for Noncitizen U.S. Veterans
For noncitizen U.S. military servicemembers, deportation can increase the risk of poor physical and mental health outcomes, making this group a vulnerable and often overlooked health disparity population, according to a recent study.
Healthy Older Veterans Not Getting CRC Screening That Could Benefit Them
Even though clinical guidelines recommend that clinicians selectively offer colorectal cancer (CRC) screening to older adults aged 76 to 85 years, taking into account their life expectancy, values, and preferences.
Concern Is Growing About Sharp Increase in Asian American, Native Hawaiian, Pacific Islander Veteran Suicide Rates
Growing suicide rates among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) veterans are of increasing concern, according to a new study.
Army Files Charges Against Anesthesiologist, Alleges Inappropriate Sexual Conduct
Sexual-assault charges have been filed by the Army against Maj. Michael Stockin, MD, an anesthesiologist stationed at the pain clinic at Joint Base Lewis-McChord’s Madigan Army Medical Center.
TBI Triples Suicide Rate Among Veterans vs. General US Population
As suicide deaths have reached shocking highs among American adults as a whole, the rates for U.S. veterans are even higher—57.3% greater than for nonveterans.
With Influx of Patients, VA Loses Ground in Filling Key Healthcare Positions
Despite a recent hiring surge, VA has been losing ground in filling key healthcare positions, with the number of severe shortages rising from this time last year.
Number of VA Patients Prescribed Opioids Has Plummeted in the Last Decade
The number of VHA patients with opioid prescriptions has plummeted by 67% since 2012, primarily because of the agency’s Opioid Safety Initiative (OSI) beginning a decade ago.
Statin, Ezetimibe Therapy Combo Shows Promise for Reducing CVD Risk
Combining two different medications used to lower high cholesterol levels, optimized statin therapy and ezetimibe, appears to be associated with reducing cardiovascular risk in U.S. military veterans with coronary artery disease, according to a new study.
Review Looks at Higher Alzheimer’s Rates Among Blacks in U.S.
Why do Black/African-American (AA) individuals have a higher risk of Alzheimer’s disease (AD) than white non-Hispanic persons of European ancestry (EUR)?
More Flexible Lookback Periods for Dementia Also Useful
Alzheimer’s disease and related dementias (ADRD) often are identified using a list of claims codes and a fixed lookback period of three years of data.
Monogalactosyl Diglyceride Levels Rise With Alzheimer’s Progression
While many clinical studies have reported brain lipidomic abnormalities in Alzheimer’s disease (AD) that affect glycerophospholipids, sphingolipids and fatty acids, no consensus exists about those abnormalities and whether they relate to disease progression.
New Journal Article Decries Lack of Recognition for Military Medicine;
A new Special Communication in JAMA Network Open decried that military medicine’s contribution to healthcare advances often are overlooked and that not enough communication occurs between civilian and military clinicians.
Sarah Krein Researches Whatever Is Necessary to Improve Veterans’ Care
Most VA researchers begin their research career because of a fascination with a certain clinical subject–a niche area usually discovered early in their studies that starts them off on a long, relatively straight, journey. Not for Sarah Krein, PhD, RN, who is interested in many subjects but none so deeply as the methodology of research itself.
Veteran Firearm Owners Support Some Safety Counseling in Clinical Settings
Most U.S. veterans who own firearms believe that clinicians should discuss firearm safety, if the patient or the patient’s family members are at increased risk of firearm injury, according to a recent study.
VA Will Assess Leukemias, Multiple Myeloma as Presumptive Service Conditions
In what could be the first conditions added to the new PACT Act, the VA is conducting a scientific review to determine any relationship between three conditions—acute leukemias, chronic leukemias, and multiple myeloma outside of the head and neck—and toxic exposures for servicemembers who deployed to Iraq, Afghanistan, Somalia, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan, and the entire Southwest Asia theater of operations.
Legislators Raise Concerns About VA Roll Out of New Acquisition System
VA is slowly rolling out its Integrated Financial and Acquisition Management System (iFAMS), which seeks to replace a 40-year-old legacy system and shore up a material weakness that leaves the department unable to accurately track billions in expenditures.
Women Serving in Gulf War Demonstrated Worse Health Outcomes Than Others
Women veterans who deployed to the 1990-1991 Gulf War report poorer health than Gulf War Era veterans who served during that time but didn’t deploy and women in the U.S. general population, according to a recent study.
Flexible Prevention Bundle Appears to Reduce Some Surgical Site Infections
Surgical site infections (SSIs) are associated with significant morbidity and mortality, prolonged length of hospital stay and readmission.
Statins Affect Coronary Artery Calcium Score Used to Determine CVD Risk
A retrospective study involving more than 1,000 U.S. veterans has called into question the use of a coronary artery calcium score (CACS) to assess risk of atherosclerosis.
VAMCs Outperform Community Hospitals Overall in CMS Quality Measures
The first time VA hospitals were included in the Centers for Medicare & Medicaid Services annual Overall Hospital Quality Star Ratings, they aced it.
Rheumatoid Arthritis Raises the Risk of Aortic Stenosis Development
For rheumatoid arthritis patients, cardiovascular disease (CVD) is the most frequent cause of death and leads to much of the excess mortality associated with the condition.
Overestimation of Oxygen Saturation Delayed COVID-19 Care, Despite Race
The overestimation of oxygen saturation by pulse oximetry in patients led to the delay of COVID-19 treatment and potentially increased hospital readmissions, according to a new study.
Real-World Prognostic Data for Radiation Therapy in Localized Prostate Cancer
Accurate information regarding treatment outcomes after radiation therapy for localized prostate cancer is important for shared decision-making.
Diabetes Has Surprising Effect on Prostate Cancer Prognosis
How diabetes affects the prognosis of advanced prostate cancer (PC) is not well documented, according to a new study which sought to provide more information.
Mast Cell Depletion Affects Prostate Cancer Progression
Better understanding of the cellular immune components underlying aggressive prostate cancer, especially among African American (AA) men who are disproportionately affected by the disease compared with white men, could help improve precision medicine treatment strategies, according to a new study.
Agent Orange Appears to Be Prostate Cancer Risk Factor
Agent Orange exposure appears to be an independent risk factor for a prostate cancer (PCa) diagnosis, although it remains unclear how Vietnam veterans exposed to the defoliant fare when it comes to metastasis or mortality.
Lower Risks of Adverse Effects in Older Adults With Moderna COVID-19 Vaccine
Receipt of the Moderna COVID-19 vaccine by older adults was associated with a lower risk of adverse events than the Pfizer-BioNTech version, according to a new study.