Prophylaxis for venous thromboembolism (VTE) is crucial in people who have had traumatic brain injuries (TBIs), due to their heightened risk caused by immobility, inflammation and coagulation system activation.
News
Former U.S. Representative Doug Collins Confirmed as 12th VA Secretary
Following a 77-23 Senate vote confirming him as the 12th VA Secretary earlier this month, Douglas Collins released a message on X.
Current Issue
Large Analysis of Veterans With Diabetes: More Benefits with GLP-1RA, Especially Neurological
While glucagon-like peptide-1 receptor agonists (GLP-1RA) are known to successfully treat diabetes and aid weight loss, they also have other widespread benefits, including for cognitive and behavioral health.
Outgoing VA Secretary McDonough Concerned About Budget, Slow Hiring
In his final press conference, VA Secretary Denis McDonough discussed what he thinks should be the top priority for incoming department leaders.
Oncology
Soft-Tissue Sarcoma Rates Higher in Middle-Aged Servicemembers
While the incidence rates of soft-tissue sarcomas are lower in young U.S. active-duty military servicemen compared with those in the general population, according to a new study, those are higher in middle-aged servicemen, possibly because of greater cumulative exposure to toxins.
Frailty Assessment Can Improve Decision-Making for Older NSCLC Patients
Frailty indices predict overall survival and toxicity among older adults with cancer receiving chemotherapy.
Clotrimazole Shows Promise in Improving NSCLC Survival
Preclinical data has suggested antifungal azole derivatives have antitumor efficacy that might modulate response to immune checkpoint inhibitors (ICIs). A new study evaluated the association of azole drugs with overall survival (OS) in a population of patients with non-small cell lung cancer (NSCLC) treated with ICI within the VHA.
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
You can’t have a healthy civilization without healthy soil. You can’t have junk food and have healthy people.
I identify with the label “foodie.” While I am no help in the kitchen (I can burn water) beyond doing the dishes, I am a joy to cook for because I enthusiastically praise anything prepared to pass down my gullet. As expected, managing my weight and body shape has been a lifelong challenge due to my passion for food.
VA Urged to Avoid Large Monolithic IT Projects, Use a More Modular Approach
Legislators, agency watchdogs and VA leaders are in agreement: The department must stop investing in massive, multiyear IT projects whose intention is to solve a technology need in one fell swoop.
VA EHR Rollout Will Resume in 2026 at Several Michigan Sites
VA has announced that it is planning to restart the rollout of its electronic healthcare record modernization project in mid-2026, starting with four facilities in Michigan—Ann Arbor, Detroit, Battle Creek and Saginaw.
Opioid-Use Disorder Prevalence Declined Since 2017, Especially in Black, Hispanic and Younger Veterans
After peaking at 1.16% in 2017, the prevalence of opioid-use disorder (OUD) among VHA patients declined steadily and was 0.97% in 2022, the most recent date for which data is available.
Soft-Tissue Sarcoma Rates Higher in Middle-Aged Servicemembers
While the incidence rates of soft-tissue sarcomas are lower in young U.S. active-duty military servicemen compared with those in the general population, according to a new study, those are higher in middle-aged servicemen, possibly because of greater cumulative exposure to toxins.
Vascular Comorbidities Affect Functionality in Multiple Sclerosis Patients
Do multiple sclerosis patients with a vascular comorbidity such as hypertension, hyperlipidemia, heart disease and diabetes have more issues with functional activities, and how does that relate to disability, depression and fatigue?
Use of Botulinum Toxin for Headaches Under-Researched in Servicemembers, Veterans
A new study spotlighted the trend of using botulinum toxin, including onabotulinum toxinA (OTA), in active military personnel and veterans who have been diagnosed with migraine and post-traumatic headache (PTH). The article in the Journal of Pain Research also sought to describe the efficacy of botulinum toxin administration.
Long-term Opioid Use Can Lead to Neurocognitive Symptoms
Opioid-related harm might be signaled early on by neurocognitive symptoms (NCS).
Concerns Raised About Severe Allergic Reactions in Outdoor Military Personnel
Tick bites in U.S. military personnel are leading to the development of antibodies to alpha-gal, a molecule found in most mammals, and possibly alpha-gal syndrome, a serious, potentially life-threatening allergic reaction.
Record Number of Benefits Claims Relate to Military Sexual Trauma
The end of 2024 saw a record number of servicemembers filing VA benefits claims related to military sexual trauma. According to VA leaders, that is the result of increased outreach by the department.
Differing Definitions of Symptoms Might Delay Migraine Diagnosis
Headaches are an almost universal experience, affecting approximately 96% of people globally at some point in their lives. Migraines, with a lifetime prevalence of 12.9% to 15.2%, consistently rank among the top three leading causes of disability for both men and women.
Memory Recall Differs Across Common Neurological, Psychiatric Conditions
Memory performance is a vital cognitive function crucial for daily life and overall well-being. Impairments in memory are associated with various neurological, neurodevelopmental and neuropsychiatric disorders.
Bipolar Disorder Symptoms Linked to Sleep Disturbance, Cannabis-Use Disorder
In bipolar disorder patients, having cannabis-use disorder and a natural tendency to go to sleep and awaken late are associated with more severe mood symptoms, according to a recent study.
Clotrimazole Shows Promise in Improving NSCLC Survival
Preclinical data has suggested antifungal azole derivatives have antitumor efficacy that might modulate response to immune checkpoint inhibitors (ICIs). A new study evaluated the association of azole drugs with overall survival (OS) in a population of patients with non-small cell lung cancer (NSCLC) treated with ICI within the VHA.
Multiple Comorbidities Affect NSCLC Survival in Older Veterans
Most advanced non-small cell lung cancer (NSCLC) patients are older adults, and they often have multiple other comorbidities (multimorbidity) when initiating treatment. A new study sought to learn more about the nature and impact of multimorbidity, especially since aging patients are often excluded from clinical trials.
More Benefit From Intensive BP Control in Veterans With CKD Than Original SPRINT Participants
The Systolic Blood Pressure Intervention Trial (SPRINT) found benefits of intensive vs. standard blood pressure (BP) control. But do those findings generalize to adults with chronic kidney disease (CKD)?
First-Line PTSD Therapies Lower Veteran Suicide Risk, but Fewer Than 9% Receive Them
Suicide prevention is the top clinical priority of the VA. Given the higher prevalence of PTSD among veterans and its strong association with veteran suicide risk, it is essential to evaluate whether and how the treatments veterans receive for PTSD through the VA are influencing that risk.
Payer Shift From Medicare Meant Extra $2 Billion VA Emergency Care Costs
At least $2 billion of VA spending for community emergency department care in 2021 was due to a payer shift from Medicare, according to a recent research letter.
VA’s Pivotal Trial Transformed Hypertension Treatment, Clinical Trial Structure
U.S. Medicine’s 60th anniversary profiles to date have featured interviews with researchers who have dramatically changed the practice of federal medicine, but a comment during last month’s interview prompted an exception for Freis.
BMI Is Major—but Not Only— Risk Factor for Metabolic Disease in Veterans
Body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, has been established as a tool to evaluate the risk of obesity-related health conditions and mortality.
Will New Supreme Court Ruling Change Ability of VA Leaders to Interpret New Legislation?
Republicans on the House VA Committee are looking to a recent Supreme Court case as an opportunity to strip the power from VA when it comes to interpreting how to enact legislation.
Chemoprophylaxis Is Likely Safe if Started 72 Hours After TBI, but Evidence Lacking for Earlier Use
Prophylaxis for venous thromboembolism (VTE) is crucial in people who have had traumatic brain injuries (TBIs), due to their heightened risk caused by immobility, inflammation and coagulation system activation.
Former U.S. Representative Doug Collins Confirmed as 12th VA Secretary
Following a 77-23 Senate vote confirming him as the 12th VA Secretary earlier this month, Douglas Collins released a message on X.
For the First Time in More Than 50 Years, VA Funds Research on Psychedelic-Assisted Therapy for PTSD, AUD
For the first time in more than 50 years, the VA will fund a study on psychedelic-assisted therapy for post-traumatic stress disorder and alcohol-use disorder among veterans.
Military Health System Multiple Myeloma Patients Survive Longer
Military Health System (MHS) beneficiaries with multiple myeloma have longer 5- and 10-year survival rates compared to multiple myeloma patients from the U.S. general population, according to a recent study.
Congress Doesn’t Address VA’s PACT Act-Related $12 Billion Shortfall
Before going on recess through mid-November, Congress passed a continuing resolution to keep the federal government funded through Dec. 20, 2024. That resolution, however, did not address the $12 billion shortfall in VHA’s FY 2025 budget,
Continued Issues, Absent Research in Breast Cancer Care for Women Veterans
Breast cancer remains a significant health concern, particularly among women veterans, who face unique challenges within the Veterans Affairs (VA) healthcare system.
Judge Requires VA to Build More Housing for Homeless in West Los Angeles
Last month, a federal judge provided an overwhelming victory to veterans who filed a class-action lawsuit against VA that sought to force the department to build more housing for homeless veterans on its West Los Angeles Medical Center campus.
Use of Non-therapeutic Laparotomy Decreased in Recent Wars but Remain Essential Battlefield Trauma-Care Tool
As combat casualty care improved over time during the wars in Iraq and Afghanistan, the use of nontherapeutic laparotomy (NTL) decreased.
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.
You can’t have a healthy civilization without healthy soil. You can’t have junk food and have healthy people.
I identify with the label “foodie.” While I am no help in the kitchen (I can burn water) beyond doing the dishes, I am a joy to cook for because I enthusiastically praise anything prepared to pass down my gullet. As expected, managing my weight and body shape has been a lifelong challenge due to my passion for food.
VA Urged to Avoid Large Monolithic IT Projects, Use a More Modular Approach
Legislators, agency watchdogs and VA leaders are in agreement: The department must stop investing in massive, multiyear IT projects whose intention is to solve a technology need in one fell swoop.
VA EHR Rollout Will Resume in 2026 at Several Michigan Sites
VA has announced that it is planning to restart the rollout of its electronic healthcare record modernization project in mid-2026, starting with four facilities in Michigan—Ann Arbor, Detroit, Battle Creek and Saginaw.
Opioid-Use Disorder Prevalence Declined Since 2017, Especially in Black, Hispanic and Younger Veterans
After peaking at 1.16% in 2017, the prevalence of opioid-use disorder (OUD) among VHA patients declined steadily and was 0.97% in 2022, the most recent date for which data is available.
Soft-Tissue Sarcoma Rates Higher in Middle-Aged Servicemembers
While the incidence rates of soft-tissue sarcomas are lower in young U.S. active-duty military servicemen compared with those in the general population, according to a new study, those are higher in middle-aged servicemen, possibly because of greater cumulative exposure to toxins.
Vascular Comorbidities Affect Functionality in Multiple Sclerosis Patients
Do multiple sclerosis patients with a vascular comorbidity such as hypertension, hyperlipidemia, heart disease and diabetes have more issues with functional activities, and how does that relate to disability, depression and fatigue?
Use of Botulinum Toxin for Headaches Under-Researched in Servicemembers, Veterans
A new study spotlighted the trend of using botulinum toxin, including onabotulinum toxinA (OTA), in active military personnel and veterans who have been diagnosed with migraine and post-traumatic headache (PTH). The article in the Journal of Pain Research also sought to describe the efficacy of botulinum toxin administration.
Long-term Opioid Use Can Lead to Neurocognitive Symptoms
Opioid-related harm might be signaled early on by neurocognitive symptoms (NCS).
Concerns Raised About Severe Allergic Reactions in Outdoor Military Personnel
Tick bites in U.S. military personnel are leading to the development of antibodies to alpha-gal, a molecule found in most mammals, and possibly alpha-gal syndrome, a serious, potentially life-threatening allergic reaction.
Record Number of Benefits Claims Relate to Military Sexual Trauma
The end of 2024 saw a record number of servicemembers filing VA benefits claims related to military sexual trauma. According to VA leaders, that is the result of increased outreach by the department.
Differing Definitions of Symptoms Might Delay Migraine Diagnosis
Headaches are an almost universal experience, affecting approximately 96% of people globally at some point in their lives. Migraines, with a lifetime prevalence of 12.9% to 15.2%, consistently rank among the top three leading causes of disability for both men and women.
Memory Recall Differs Across Common Neurological, Psychiatric Conditions
Memory performance is a vital cognitive function crucial for daily life and overall well-being. Impairments in memory are associated with various neurological, neurodevelopmental and neuropsychiatric disorders.
Bipolar Disorder Symptoms Linked to Sleep Disturbance, Cannabis-Use Disorder
In bipolar disorder patients, having cannabis-use disorder and a natural tendency to go to sleep and awaken late are associated with more severe mood symptoms, according to a recent study.
Clotrimazole Shows Promise in Improving NSCLC Survival
Preclinical data has suggested antifungal azole derivatives have antitumor efficacy that might modulate response to immune checkpoint inhibitors (ICIs). A new study evaluated the association of azole drugs with overall survival (OS) in a population of patients with non-small cell lung cancer (NSCLC) treated with ICI within the VHA.
Multiple Comorbidities Affect NSCLC Survival in Older Veterans
Most advanced non-small cell lung cancer (NSCLC) patients are older adults, and they often have multiple other comorbidities (multimorbidity) when initiating treatment. A new study sought to learn more about the nature and impact of multimorbidity, especially since aging patients are often excluded from clinical trials.
More Benefit From Intensive BP Control in Veterans With CKD Than Original SPRINT Participants
The Systolic Blood Pressure Intervention Trial (SPRINT) found benefits of intensive vs. standard blood pressure (BP) control. But do those findings generalize to adults with chronic kidney disease (CKD)?
First-Line PTSD Therapies Lower Veteran Suicide Risk, but Fewer Than 9% Receive Them
Suicide prevention is the top clinical priority of the VA. Given the higher prevalence of PTSD among veterans and its strong association with veteran suicide risk, it is essential to evaluate whether and how the treatments veterans receive for PTSD through the VA are influencing that risk.
Payer Shift From Medicare Meant Extra $2 Billion VA Emergency Care Costs
At least $2 billion of VA spending for community emergency department care in 2021 was due to a payer shift from Medicare, according to a recent research letter.
VA’s Pivotal Trial Transformed Hypertension Treatment, Clinical Trial Structure
U.S. Medicine’s 60th anniversary profiles to date have featured interviews with researchers who have dramatically changed the practice of federal medicine, but a comment during last month’s interview prompted an exception for Freis.
BMI Is Major—but Not Only— Risk Factor for Metabolic Disease in Veterans
Body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, has been established as a tool to evaluate the risk of obesity-related health conditions and mortality.
Will New Supreme Court Ruling Change Ability of VA Leaders to Interpret New Legislation?
Republicans on the House VA Committee are looking to a recent Supreme Court case as an opportunity to strip the power from VA when it comes to interpreting how to enact legislation.
Melatonin Appears to Have Some Effect Enhancing Flu Vaccine
Noting that vaccine immunogenicity is affected by a variety of factors, melatonin has been reported to affect immune responses to vaccines and infection, according to a new study.
Past COVID-19 Infection Increases Frailty in Older Veterans
COVID-19 survivors appear to be at greater risk for new medical conditions. A new study sought to determine if previous infection with the SARS-CoV-2 virus is associated with a change in frailty among older U.S. veterans.
Older White Veterans Most Likely to Get Flu Vaccines
How do race, ethnicity, sex and rurality affect influenza vaccination adherence in a VHA cohort?
‘Prescription Rules’ Could Lengthen Survival in mCRPC
If detected and treated at an early stage, prostate cancer is often curable. That is not the case, however, with an advanced stage such as metastatic castration-resistant prostate cancer (mCRPC), which has a high risk of mortality.
How General Obesity Affects Prostate Cancer
How does general obesity affect prostate cancer? Thus far, inconsistent evidence has been found for the association between general obesity and prostate cancer among men in the United States.
No Problems Found With Concurrent Spironolactone, Abiraterone Administration
The most common cancer in men in the United States, prostate cancer has low survival rates once metastasized.
What Happened When VA Formulary Transitioned to Different Inhalers?
The VA’s experience provided valuable information on what is likely to occur when a formulary changes for environmental reasons, according to a new report.
Inclusive Genetic Tools Needed to Evaluate Primary Open-Angle Glaucoma Risk
Primary open-angle glaucoma (POAG), the most common type of glaucoma, develops gradually and is often asymptomatic in its early stages.
VA/DoD Guideline Update Reflects Newest Therapies for Headaches
Expanded recommendations for treatment, preventive therapies and nonpharmacologic therapies are among noteworthy changes in the recently updated VA and Department of Defense (DoD) Clinical Practice Guideline for the Management of Headache.
As-Needed Blood Pressure Medication Linked to Adverse Outcomes in VA Hospitals
In hospitalized veterans, use of at least one as-needed blood pressure medication was associated with higher risk of acute kidney injury and rapid drop in blood pressure, as well as increased risk of stroke, heart attack or death, according to a recent study.
VA Hospitals Went from Worse Than Community Facilities in 2017 to Outperforming Them in 2021
With the debate heating up about how much VA care should be shifted to the community, a new study found that VA hospitals changed in a 5-year period from 2017 to 2021 from providing worse experiences for Black and poor-health patients to outperforming community hospitals for those and all other patient subgroups examined.
Congressional Republicans Seek to Further Expand VA’s Use of Community Care
Republican legislators are looking to expand VA’s use of community care further with the coming Congress.
VA’s Landmark Study Shifted Paradigm for Managing Diabetes
MEMPHIS, TN — As part of our ongoing series...
VA Accused of Not Keeping Up with a More Active Amputee Patient Population
While VA has long considered itself a provider of world-class prosthetics care, younger veterans are reporting that the department has yet to adapt to a more active patient population.
Prediction of Patient Outcomes After Severe Traumatic Brain Injury
Serum cytokines, neuronal proteins and clinical data can be used to predict vasospasm and early mortality in patients with severe traumatic brain injury, according to a recent study.
VARA Registry Seeks to Improve the Lives of Veterans With Rheumatoid Arthritis
New findings concerning the risk of interstitial lung disease in rheumatoid arthritis (RA) and how body composition and metabolic dysregulation are tied to RA and inflammation were among the highlights of research presented at the 20th Annual Fall Meeting of the VA Rheumatoid Arthritis (VARA) Registry held in September.
Higher CVD Events in Older Adults Undergoing Chemotherapy, With Certain Cancers
Cardiovascular disease (CVD) is a greater risk for cancer survivors because of either their malignancy or its treatment.
Sexual Orientation Affects Prevalence of Atherosclerotic CVD in Veterans
Sexual orientation appears to have some unexplained effect on cardiovascular health, according to a new study.
Prescribing of Antihypertensives Not Always Guideline Concordant at VHA
While more than half of U.S. veterans diagnosed with hypertension with a pretreatment systolic BP ≥160 mm Hg were started on antihypertensive monotherapy, disparities existed between guideline-recommended first-line treatments and the actual regimens initiated, according to a new study.
Higher Psychosocial Well-Being at Time of Trauma Reduces PTSD Risk
Victims of traumatic events with higher well-being in three areas—vocational well-being, financial well-being and social well-being—are less likely to experience post-traumatic stress disorder (PTSD), according to a recent study.
