More than a half-century after the United States escalated involvement in the Vietnam War by sending significant combat troops, veterans still face significant psychological and physical health challenges related to their employment.
News
Updated VA/DOD Stroke Rehabilitation Guidelines Enhance Patient Care
Revised treatment algorithms, 24 new recommendations and an expanded literature review on complementary and integrative health (CIH) approaches
Current Issue
Impulse Oscillometry Not Recommended for First-Line Airway Obstruction Evaluation After Deployment
When evaluating airway obstruction in military personnel after deployment, impulse oscillometry (IOS) may serve as an additional diagnosis tool, but it can’t replace the reliability of the standard spirometric evaluation, according to a recent study.
Rural Veterans Have Less Access to Crucial COPD Therapies Post-Discharge
Chronic obstructive pulmonary disease, a group of progressive and complex conditions that affect the lungs, require a comprehensive treatment approach.
Oncology
A Range of Factors Put Veterans at Higher Colorectal Cancer Risk
Colorectal cancer (CRC) remains a major health threat in the United States, ranking as the fourth most common cancer among men and women combined.
VA Offers Pathway through First-Line Treatment Options for mCRC
The VA diagnoses approximately 4,000 new CRC cases annually. More than half of people with CRC either have metastatic disease at diagnosis or will develop it
The Importance of Hyperselection in Treating Metastatic CRC
Recent research in metastatic colorectal cancer (mCRC) demonstrates that personalized therapy outperforms broad approaches to treatment of this challenging malignancy in federal medicine and elsewhere.
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
‘Tip of the spear’
Throughout my military career, I would hear the phrase ‘tip of the spear’ to describe units or leaders who were first to the fight. The metaphor refers to the business end of one of the oldest weapons of warfare, the spear. As Madeline Miller in “The Song of Achilles” says, “You can use a spear as a walking stick, but that will not change its nature.” Everyone understands what the spear represents and what it is for. As military medical physicians, we often discuss our role as the “soft side of the spear.” We were not at the pointy end, but we certainly supported the effective implementation and application of force embodied by the spear tip.
Peer Support Program Benefited Well-Being of Women Veterans, Decreased PTSD, Depression
Women veterans who participated in a peer-led, social support group showed improvements in well-being outcomes, including a greater sense of belonging, higher quality of life and decreased post-traumatic stress disorder (PTSD) and depression, according to a recent study.
Non-VA Services Reveal Hidden Biases in VA Hospital Performance Metrics
As the veteran population ages and healthcare options expand, it might be beneficial for the VHA to reassess how it evaluates hospital performance, a new study suggested.
2023-to-2024 XBB.1.5 COVID-19 Vaccines Weren’t Effective Over Long Term
Serious concerns were raised in a new VA study about the effectiveness of COVID-19 vaccines targeting the XBB.1.5 Omicron variant, which were introduced in September 2023.
Aligning Total Joint Arthroplasty Outcomes With Patient Expectations
Patient-reported outcome measures are increasingly integrated into quality assessments following total joint arthroplasty (TJA), but patient perceptions of quality paired with the phase of surgical care has not been described, according to a new report.
High Plantar Fasciopathy Rates in U.S. Military
U. S. armed forces have high rates of ankle and foot injuries and mean medical and personnel costs for the DoD.
Veterans’ White-Matter Volume Affected by Physical Activity Level
Trauma exposure affects cardiovascular, cerebral and mental health, causing declines.
PTSD in Veterans With HIV Leads to More Antiretroviral Therapy Nonadherence
In veterans with HIV, having post-traumatic stress disorder (PTSD) increased the likelihood of being nonadherent with their HIV treatment and requiring modification to their HIV treatment, according to a recent study.
VA Committee Hears About Challenges Getting Community Mental Healthcare
The Republican focus on further expanding VA-funded community care has been fueled, in part, by reports from veterans and service organizations detailing the hurdles they have had to go through to obtain care for themselves or their clients.
CVD, CKD Combine to Increase Surgical Mortality
What are the interactive effects of cardiovascular disease (CVD) and chronic kidney disease (CKD) on long-term mortality following major operations?
How Different Heart Failure Types Are Affected by CKD
Chronic kidney disease (CKD) is defined by the KDIGO (Kidney Disease: Improving Global Outcomes) guideline as abnormal kidney structure or function, present for more than 3 months, with implications for health.
Decreasing Renal Function Affects PAD Treatment
What is the impact of the severity of chronic kidney disease (CKD) on mortality and major adverse limb events (MALE) after endovascular revascularization of the superficial femoral artery (SFA)?
Happiness Levels in U.S. Military Veterans Similar to General Population
Overall, U.S. military veterans report happiness levels that are only slightly lower than the general population, despite potentially traumatic experiences during deployment.
Factors Linked to Major CVD Events in Veteran Postmenopausal Women
In contrast to the civilian population, certain indicators of socioeconomic status, such as education, occupation, household income and neighborhood socioeconomic status, aren’t significantly linked to major cardiovascular disease events in postmenopausal women veterans, according to a recent study.
Deputy VA Secretary Nominees Faces Hard Questions on Firings
At his confirmation hearing, President Donald Trump’s nominee for deputy VA secretary, Paul Lawrence, PhD, promised he would look into recent firings at VA
A Quarter of U.S. Veterans Older Than 60 Have Been Diagnosed with CVD
One in 4 U.S. veterans age 60 and older have reported being diagnosed with cardiovascular disease at some point, which has potential implications for their physical and mental health, according to a recent study.
Critics: Some of the $2 Billion in Contracts VA Cut Were Essential for Veteran Care
VA Secretary Doug Collins announced in a video in late February that VA had cut $2 billion in cuts to contracts thus far. While he said the funds would be redirected to veterans’ health care and benefits, critics claimed the cuts will do the opposite.
VA Study Underscores the Urgent Need for Clear Guidelines on Treating Chronic Pain
A new VA-led study underscored the urgent need for clear guidelines on how best to treat chronic pain, especially when it comes to prescribing opioid pain medications.
SGLT2i Use Linked to Higher Risk of Amputations in Diabetes Patients
More than 30 million U.S. adults—including approximately 25% of veterans—have diabetes, putting them at increased risk of heart disease.
Legislators Push for Better Oversight of VA Community Care Providers
As promised, the new Republican-led Congress began the legislative year by focusing heavily on community care in VA, with a glut of hearings targeting different aspects of the issue.
VA Experts Push for Consistency, Innovation in Bladder Cancer Care
Bladder cancer, recently designated as a presumptive condition for Gulf War and Post-9/11 veterans, per the PACT Act, is the third most prevalent noncutaneous cancer among veterans, following prostate and lung cancer.
More Than 50 Years Later, Vietnam War Still Affects Veteran Health
More than a half-century after the United States escalated involvement in the Vietnam War by sending significant combat troops, veterans still face significant psychological and physical health challenges related to their employment.
Updated VA/DOD Stroke Rehabilitation Guidelines Enhance Patient Care
Revised treatment algorithms, 24 new recommendations and an expanded literature review on complementary and integrative health (CIH) approaches
More than 1,000 Firings at VA Are Just the Beginning of ‘Generational Change’
President Donald Trump began his second term with a flurry of executive orders that have resulted in the firing of thousands of employees, including many at VA, with the promise of deeper cuts to come.
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.
‘Tip of the spear’
Throughout my military career, I would hear the phrase ‘tip of the spear’ to describe units or leaders who were first to the fight. The metaphor refers to the business end of one of the oldest weapons of warfare, the spear. As Madeline Miller in “The Song of Achilles” says, “You can use a spear as a walking stick, but that will not change its nature.” Everyone understands what the spear represents and what it is for. As military medical physicians, we often discuss our role as the “soft side of the spear.” We were not at the pointy end, but we certainly supported the effective implementation and application of force embodied by the spear tip.
Peer Support Program Benefited Well-Being of Women Veterans, Decreased PTSD, Depression
Women veterans who participated in a peer-led, social support group showed improvements in well-being outcomes, including a greater sense of belonging, higher quality of life and decreased post-traumatic stress disorder (PTSD) and depression, according to a recent study.
Non-VA Services Reveal Hidden Biases in VA Hospital Performance Metrics
As the veteran population ages and healthcare options expand, it might be beneficial for the VHA to reassess how it evaluates hospital performance, a new study suggested.
2023-to-2024 XBB.1.5 COVID-19 Vaccines Weren’t Effective Over Long Term
Serious concerns were raised in a new VA study about the effectiveness of COVID-19 vaccines targeting the XBB.1.5 Omicron variant, which were introduced in September 2023.
Aligning Total Joint Arthroplasty Outcomes With Patient Expectations
Patient-reported outcome measures are increasingly integrated into quality assessments following total joint arthroplasty (TJA), but patient perceptions of quality paired with the phase of surgical care has not been described, according to a new report.
High Plantar Fasciopathy Rates in U.S. Military
U. S. armed forces have high rates of ankle and foot injuries and mean medical and personnel costs for the DoD.
Veterans’ White-Matter Volume Affected by Physical Activity Level
Trauma exposure affects cardiovascular, cerebral and mental health, causing declines.
PTSD in Veterans With HIV Leads to More Antiretroviral Therapy Nonadherence
In veterans with HIV, having post-traumatic stress disorder (PTSD) increased the likelihood of being nonadherent with their HIV treatment and requiring modification to their HIV treatment, according to a recent study.
VA Committee Hears About Challenges Getting Community Mental Healthcare
The Republican focus on further expanding VA-funded community care has been fueled, in part, by reports from veterans and service organizations detailing the hurdles they have had to go through to obtain care for themselves or their clients.
CVD, CKD Combine to Increase Surgical Mortality
What are the interactive effects of cardiovascular disease (CVD) and chronic kidney disease (CKD) on long-term mortality following major operations?
How Different Heart Failure Types Are Affected by CKD
Chronic kidney disease (CKD) is defined by the KDIGO (Kidney Disease: Improving Global Outcomes) guideline as abnormal kidney structure or function, present for more than 3 months, with implications for health.
Decreasing Renal Function Affects PAD Treatment
What is the impact of the severity of chronic kidney disease (CKD) on mortality and major adverse limb events (MALE) after endovascular revascularization of the superficial femoral artery (SFA)?
Happiness Levels in U.S. Military Veterans Similar to General Population
Overall, U.S. military veterans report happiness levels that are only slightly lower than the general population, despite potentially traumatic experiences during deployment.
Factors Linked to Major CVD Events in Veteran Postmenopausal Women
In contrast to the civilian population, certain indicators of socioeconomic status, such as education, occupation, household income and neighborhood socioeconomic status, aren’t significantly linked to major cardiovascular disease events in postmenopausal women veterans, according to a recent study.
Deputy VA Secretary Nominees Faces Hard Questions on Firings
At his confirmation hearing, President Donald Trump’s nominee for deputy VA secretary, Paul Lawrence, PhD, promised he would look into recent firings at VA
A Quarter of U.S. Veterans Older Than 60 Have Been Diagnosed with CVD
One in 4 U.S. veterans age 60 and older have reported being diagnosed with cardiovascular disease at some point, which has potential implications for their physical and mental health, according to a recent study.
Critics: Some of the $2 Billion in Contracts VA Cut Were Essential for Veteran Care
VA Secretary Doug Collins announced in a video in late February that VA had cut $2 billion in cuts to contracts thus far. While he said the funds would be redirected to veterans’ health care and benefits, critics claimed the cuts will do the opposite.
VA Study Underscores the Urgent Need for Clear Guidelines on Treating Chronic Pain
A new VA-led study underscored the urgent need for clear guidelines on how best to treat chronic pain, especially when it comes to prescribing opioid pain medications.
SGLT2i Use Linked to Higher Risk of Amputations in Diabetes Patients
More than 30 million U.S. adults—including approximately 25% of veterans—have diabetes, putting them at increased risk of heart disease.
Legislators Push for Better Oversight of VA Community Care Providers
As promised, the new Republican-led Congress began the legislative year by focusing heavily on community care in VA, with a glut of hearings targeting different aspects of the issue.
VA Experts Push for Consistency, Innovation in Bladder Cancer Care
Bladder cancer, recently designated as a presumptive condition for Gulf War and Post-9/11 veterans, per the PACT Act, is the third most prevalent noncutaneous cancer among veterans, following prostate and lung cancer.
Oral, Intravenous Antibiotics, Both Effective in Treating Fracture-Related Infection
Both oral and intravenous antibiotics are effective after fracture-related infection (FRI), a serious complication following fracture fixation surgery, according to a recent study.
GOP Legislators Push Bill to Expedite Firing Authority for VA Employees
Republican legislators are again seeking to provide the VA secretary with expedited firing authority for VA employees that are deemed “bad actors.”
Martin Focuses on Improving Sleep-Disorder Treatment for Veterans
We spend approximately one-third of our lives asleep, but it’s only been in the last couple of decades that the medical community has begun to understand in detail just how important sleep can be to our lives.
Issues Weren’t That Different in VA 60 Years Ago
With news every day about VA staffing cuts, the cancellation of contracts and, essentially, the way the agency does business, it is interesting to look back to what might seem to us as a simpler time – 60 years ago, when U.S. Medicine began.
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.