Old soldiers never die,
Never die, never die,
Old soldiers never die
They just fade away.

From an old Army ballad made famous in a speech by Gen. Douglas MacArthur.
That song was sung proudly by troops at the turn of the last century; it was believed to have originated in Britain around 1900 and adapted into an American version during World War I.

When is a cancer patient too old to benefit from a surgical procedure? An answer to that question has been hard to find. Now, researchers from the Minneapolis VAMC are providing data and guidelines to help physicians and surgeons determine optimal treatments for colon and lung cancers.

Rosacea’s etiology remains a mystery, even as promising new treatments and interventions are employed. Now, new VA-led studies are providing clues to what causes rosacea and what can cure it.

Rural veterans with hepatitis C (HCV) could live hours from a medical center that provides specialty treatment for the disease. Through the VA Connecticut Healthcare System’s telemedicine initiative, however, specialists are training primary-care practitioners to deliver high quality HCV care close to home for patients.

Intrauterine devices (IUDs) are safe, effective and convenient but remain underused in the United States. That also is true in the military, where storage limitations and difficulties with compliance argue for better birth-control options.

Traumatic brain injury (TBI) accounts for 22% of total casualties in the current conflicts and 59% of the injuries where servicemembers are exposed to blasts. That makes research on the relationship between TBI and dementia later in life especially critical for the future of the VHA.

Early adoption of insulin therapy for diabetes can stop or delay progression of the disease and help avoid complications. But change has been slow, even at VA, where more than a million veterans get treatment for the disease. A VA pharmacist offers advice to clinicians on how to initiate earlier insulin treatment.

Prevention Is the Goal
During the past three years, the VA has more than doubled the number of veterans in care who have been tested for HIV and linked those who are positive to HIV specialists. Newer programs focus on preventing transmission through aggressive treatment and prophylaxis, with mixed results.

Controversy continues about when and for whom prostate-specific antigen (PSA) screening makes sense. PSA testing often is on lists of “excessive” medical procedures, but primary-care physicians are uncomfortable doing no screening for the common cancer. Two VA clinicians who have researched extensively in the area offer practical advice.

A project to measure performance and improve inpatient stroke care at the VA has shown considerable success. Now, the focus has shifted to post-stroke care and the outpatient arena.