Even a few decades ago, it would have been difficult to predict the central role women now play in the defense of our country or the complexities of providing for their unique health-care needs, as described in this issue’s articles about menstrual suppression and menopause. More than 208,000 women are on active duty in the U.S. Army, Navy, Marine Corps and Air Force, representing 14.6% of total military personnel.

HIV was unrecognized as recently as the Vietnam War era, yet VHA now is the largest provider of HIV care in the United States, having treated nearly 64,000 HIV-positive patients. Read in this issue how VHA is using technology to increase medication adherence.

In another complication unanticipated a decade or so ago, federal health-care professionals must navigate a proliferation of mental-health issues to provide care. Those include everything from the relationship between traumatic brain injury and dementia conditions, such as Alzheimer’s disease, to the intricate relationship of PTSD to other disease states to the treatment of mentally-ill veterans with complex co-morbidities such as hepatitis C virus. Many of those issues are covered here in the 2011 Compendium of Federal Medicine as well as in the monthly issues of U.S. Medicine.

At the same time, military medicine continues to struggle with some of the same problems it faced centuries ago, as described in several articles here. Malaria, that old nemesis, continues to endanger troops as researchers search for an effective vaccine. On the VA front, researchers are trying to find better methods to prevent deadly influenza outbreaks in the elderly and revamp treatment of gout, a disease known to ancient Egyptians, Greeks and Romans.

Medical researchers have every reason to be optimistic about their eventual success. The 21st century already has seen rapid advances in the understanding of disease processes and in the development of advanced diagnostic techniques and/or novel new therapies for many conditions such as Alzheimer’s disease, multiple sclerosis, Crohn’s disease, lung cancer, coagulation disorders and diabetes, which are covered in this publication.

Among the most significant advances are new methods of managing pain. Opioids have been in use since at least the Civil War but create significant side-effects, especially in patients recovering from wounds. Be sure to review this issue’s article discussing military medicine’s advanced understanding of the mechanisms of pain, novel technologies and a commitment to consistent pain management.

Unintended consequences, of course, are always a danger in significant technological advances, which are components of at least two articles. The increase in the painful condition herpes zoster may be related to the high rate of vaccination against chicken pox in children, which may have reduced natural immunity in older people. Also, plastics and other innovative materials that have improved modern warfare can produce dangerous toxins in burn pits, as discussed in the article about pulmonary symptoms reported by deployed troops.

Yet, the commitment to move forward remains. As co-authors Cols. Chester C. Buckenmaier III and Kevin T. Galloway write in the pain article in this issue, “The goals are lofty, the task is difficult, but the effort will enhance wounded warrior care, which is reason enough to move out.”

On a personal note, after a long career in journalism and more than 20 years of medical publishing experience, I am honored to be the editorial director of U.S. Medicine and am constantly awed by the dedication and professionalism shown by federal health-care providers. I trust you find the material presented in the Compendium both thought-provoking and useful in your practice. U.S. Medicine is committed to be a strong voice for federal medicine and welcomes any recommendations or comments. Please don’t hesitate to contact me with any comments on this publication or U.S. Medicine.

Brenda L. Mooney, Editorial Director, U.S. Medicine