b'I N T R O D U C T I O NOld and New in Federal MedicineBy Brenda L. Mooney, Editorial DirectorThankstocutting-edgeeffortschallengingdermatologicconditions,fast-spreading to use targeted testing and strictinfectiousdiseases,cancerscausedbytoxicexpo-guideline-adherence,thecareofsures and the wide-ranging consequences of battle-patients with serious illnesses isfield traumatic brain injuries.arguablybetterthaneverattheThe annual Compendium of Federal Medicine seeks VAandmilitaryhealthcaresys- to provide new and useful information about the range tems. For cancer, that means theof conditions faced by federal healthcare providers. use of both tumor testing for somatic mutations andCritical to our mission is to keep in mind that veterans germlinetestingforhereditarymutationstofindandmilitaryservicemembersarentalwaystypical treatment to improve survival.patients; because of their service, they have faced sit-Those efforts, combined with universal healthcareuations and conditions that can adversely affect their offered by both the VA and MHS, mean that impor- health. Their sacrifices go far beyond the risk of being tant advances benefit all patients, regardless of race,wounded or killed in battle.religion or ethnicitysomething that is not alwaysIt is especially gratifying when our writers can share the case in private healthcare. information that goes against the conventional wis-Much of this would have been beyond imagina- dom and can contribute to a change in practice to tion 60 years ago when U.S. Medicine printed itsimprove care. Among the many examples of that in first issue. While a vigorous research program wasthe 2024 Compendium are:being initiated at the VA, most veterans received the counterintuitive findings that frail veterans only inpatient treatment there and were often dis- had better survival when treated with more-chargedontheirownforchronicillnesses,suchintensive multiple myeloma therapy; asdiabetes,thatmighthavecreatedorexacer-while extremely rare, activated phosphoinositide bated acute illness. (That quickly changed as some3-kinase delta (PI3K) syndrome (APDS), might of the research paid off and the realization grewbe slightly more common than thought now that that, despite Vietnam War veterans, the average VAgenetic testing is available; patient was an old man with a range of comorbidi-that tackling the emotional systems of diabetes ties that required management.) distress improves outcomes; andMeanwhile, the Vietnam War was a game-changer that gout really isnt the disease of kings, for military medicine and its ability to save lives on theaffecting only the affluent, but plagues all battlefield because of rapid casualty evacuation, thesocioeconomic classes, with veterans being availability of whole blood and other improvements.especially vulnerable.Yet, as advanced as federal medicine has become, Because of articles such as there, it is our hope itstillfacessomeoftheworldsoldestmedicalthatyoufindthe2024CompendiumofFederal foes, many of them more common in servicemem- Medicine interesting and informative in the year of bers and veterans than civilians. Those include gout,U.S. Medicines 60th anniversary.Kristin Mendola Alex DinardoVice President, Sales Art Directormendola@usmedicine.comBrenda L. Mooney 203-761-0202 Annette M. Boyle Editorial Director Kristine Bergenheim Chief Medical Writermooney@usmedicine.com Art and Production Stephen SpotswoodJames F. Breuning production@usmedicine.comWashington CorrespondentPublisher Melody English Eden Jackson Landow breuning@usmedicine.com Advertising CoordinatorCopy Editor609-397-5522 advertising@usmedicine.com 1'