Childhood Trauma May Influence PTSD More Than War Experience AARHUS, DENMARK - Traumatic experiences in childhood, not wartime experiences, may have greater influence on which deployed servicemembers develop post-traumatic stress disorder (PTSD). That’s according to a new study from a team of Danish and American researchers seeking to understand why some servicemembers develop PTSD, while others don’t. Their study was published this month in the journal Psychological Science. More
IG Report Points to Lack of Responsiveness by Iowa City VAMC Management WASHINGTON - While medical care has not been compromised in the Iowa City VA Healthcare System, a “pervasive lack of support for staff problem-solving” could threaten patient safety, a recent investigation concluded. The findings were part of a VA Inspector General’s report examining allegations about quality of care in the Iowa City VA Healthcare System and whether the concerns of employees there had been “largely ignored” by the leadership. More
Focus On: Diabetes
Robert A. Vigersky, MD
Soldiers with Diabetes Increase Disease Management Challenges BETHESDA, MD - The Army is retaining an increasing number of personnel with diabetes, and, despite directives to the contrary, these soldiers may be deployed to active war zones where typically recommended methods for managing the disease might create more problems than they solve. Managing diabetes in theater might involve challenges unknown to stateside servicemembers. Meters for monitoring blood sugar are not validated in extreme conditions, such as desert summers, and insulin might become denatured and inactivated in high heat. More
WASHINGTON - For the more than one million VHA patients who have diabetes, peer support and shared medical appointments offer an efficient, surprisingly effective, way to deliver care and improve disease management. The shared medical appointment (SMA) is a multidisciplinary team approach that, at the VA, typically includes a physician, diabetes nurse, health psychologist, dietician and clinical pharmacist. In addition, the team draws on the expertise of patients, who must deal with practical management of the disease and often have solutions clinicians have not considered. More
Obesity Specialty Update
Obesity Appears to Affect Response to MRSA Antibiotics SAN FRANCISCO - While non-obese patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia respond to both of the antibiotics vancomycin and linezolid, obese patients are best treated with linezolid, according to a VA researcher. A retrospective analysis compared outcomes with the two drugs in a VA population admitted with MRSA pneumonia between January 2002 and September 2010. When investigators looked at discharge from hospital or intensive care by Day 14 without death, treatment change, readmission, ICU admission or intubation, they found that obese patients did notably better on linezolid. More
Duodenal Switch May Be More Effective Surgical Procedure FORT LEWIS, WA - Is the duodenal-switch (DS) procedure better than the commonly-used gastric bypass (GB) in prompting weight loss and control of coexisting conditions, especially for the super-obese? An Army study published recently in the Archives of Surgery suggests it might be, but caution clinicians about some significant risks. The study found that DS patients experienced significantly greater BMI reductions than GB patients at all follow-up periods. More
Cardiology Specialty Update
Veterans' CPAP Compliance Linked to Medication Adherence ATLANTA - A study of veterans who were prescribed Continuous Positive Airway Pressure (CPAP) therapy after having a stroke or transient ischemic attack (TIA) found that their compliance with the treatment had a significant association with how regularly they also took cardiovascular medications. Study subjects were part of the VA’s “Go To Sleep” study, which included hypertensive veterans with a history of stroke or TIA who lacked a previous diagnosis of sleep apnea. Selection criteria included new diagnosis of sleep apnea, having a home CPAP device, and receiving lipid-lowering, anti-hypertensive, or non-aspirin anti-platelet agents from the VA pharmacy.More
Depression Increases Peripheral Artery Disease Risk SAN FRANCISCO - Depression increases the risk of peripheral artery disease (PAD), according to researchers who recommend that clinicians pay more attention to mental-health issues in patients with the disease. The study from researchers at the San Francisco VA Medical Center and the University of California, San Francisco, was published online earlier this year by the Journal of the American Heart Association. Modifiable risk factors such as smoking and reduced physical activity explained some of the PAD risk, according to the authors, who called for further research to determine cause and effect. More
Brenda L. Mooney Editorial Director, U.S. Medicine mooney@usmedicine.com 39 York Street Lambertville, NJ 08530
