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2011 Compendium of Federal Medicine
The charm of history and its enigmatic lesson consist in the fact that, from age to age, nothing changes and yet everything is completely different. —Aldous Huxley
Looking at the lineup in the 2011 Compendium of Federal Medicine, I’m struck by how much medicine, especially federal medicine, has embraced the challenges and benefits of the 21st century while grappling with some of the same issues that plagued healers in the 19th century—and long before.
Often Misdiagnosed as Alzheimer's Disease, Chronic Traumatic Encephalopathy Could Play a Role in Veterans' Dementia
Patients with chronic traumatic encephalopathy are sometimes diagnosed as suffering from Alzheimer’s disease and other dementias until post-mortem brain examination proves otherwise. CTE, a preventable form of dementia believed to be caused by repetitive mild head injuries, has been identified in former boxers and football players. Now researchers are turning their attention to former soldiers with mild head injuries to determine whether CTE could cause future dementia development.
Despite Success in Managing Warfarin Usage, VA's Anticoagulation Units' Role Likely to Change With New Drugs
The VA's pharmacist-led anticoagulation units use diligent monitoring and constant overview of patient compliance to keep Warfarin patients’ International Normalized Ratio at a safe level. Despite that success, their future role may be in question because of a new class of medications that doesn’t require routine laboratory monitoring as well as a move toward home-monitoring for Warfarin.
Where There's Smoke: DoD Investigates Causes of Deployment-Related Pulmonary Symptoms Reported by Troops
Dramatic media coverage has helped raise concerns about pulmonary disease in troops deployed in Iraq and Afghanistan. Although servicemembers have reported increased symptoms, long-term damage from exposure to particulate matter has not been clinically verified. Now, the United States Army Medical Department and other DoD agencies are embarking on a number of investigations into deployment-related lung disease and exposures.
Crohn's disease is difficult to diagnose and complex to treat. For clinicians, the goal is to help their patients, who often are young, to achieve remission and enjoy a better quality of life. Continuing controversies over treatment guidelines can make that challenging.
How Long Before Early Adoption of Insulin Becomes Rule Instead of Exception for Difficult to Control Type 2 Diabetes?
New research suggests that early adoption of insulin can improve long-term outcomes in type 2 diabetes patients. Most practice guidelines, including the VA/DoD guideline, which was updated last summer, still call for oral medication, primarily metformin, as first-line treatment. Insulin currently is reserved for early-stage patients with contraindications or difficult-to-control symptoms, but the introduction of basal insulins, which allow patients to more safety and easily initiate insulin, could mean changes in practice in the near future.
With 90% of U.S. Influenza Deaths in Elderly, New High Dose Vaccine Seeks Lower Mortality, Morbidity Rates
The elderly suffer disproportionately from seasonal influenza, with nearly 90% of all deaths occurring in those older than 65. One explanation is that the standard flu vaccine does not increase antibody levels for older recipients at the same rate as younger recipients. To address that issue, a high-dose flu vaccine was introduced for use in the 2010-2011 influenza season in an effort to decrease the rate of serious illness and/or mortality.
Once called the “disease of kings” because of its association with consumption of rich food and alcohol, gout actually affects far more than royalty. Three million Americans suffer from the painful affliction, and the VHA treats a disproportionate share of those, since gout is more common in older men and post-menopausal women, especially those who use alcohol. Still, quality indicators for treating gout have been available less than 10 years and only more recently has the VA begun looking at how those best practices could be applied in its system.
The high rate of mental health conditions not only can make it difficult for HCV-infected veterans to manage their own illnesses. Those psychiatric issues also can be barriers to interferon treatment and liver transplants. In response, VA resource centers are employing a multi-disciplinary approach to HCV disease management.
Lack of treatment adherence is one of the biggest difficulties for health providers trying to manage HIV patients. Now, a new computerized assessment tool being rolled out by the VHA helps identify patients who are not taking their drugs as well as reasons for noncompliance.
Most Popular Stories
- Many Healthcare Providers Lose VA Retention Bonuses
- Federal Medicine Organizational Meetings — Tarred with the Same Brush?
- Despite Formulary, High-Cost Diabetes Drug Use Varies Widely Across VA Facilities
- Report Says Administration Faces Hard Choices For Veterans Programs
- Physician Overcomes TBI to Return to Active-Duty Medicine
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