House Panel to Probe VA Mistakes

House panel to analyze VA medical gaffes 05/30/09. A congressional panel will question Department of Veterans Affairs officials about mistakes that put patients at risk of possible exposure to HIV and other infectious body fluids at three VA hospitals. The VA recommended more than 10,000 former VA patients in Miami, Murfreesboro, Tenn., and Augusta, Ga., get follow-up blood checks. Five have tested positive for HIV and 43 have tested positive for hepatitis, according to an update on the VA Web site Friday. Washington Times

Veterans' Use of VA & Non-VA Care for Depression

Dual use of VA and non-VA services among primary care patients with depression. 05/29/09. Almost half of depressed primary care patients used non-VA care, with most of their non-VA use for physical rather than emotional health problems. Care management strategies for depressed patients should include communication and coordination with non-VA providers. Journal of General Internal Medicine via PubMed

Vets With HIV Less Likely to Receive Needed Lipid Lowering Therapy

The association between the receipt of lipid lowering therapy and HIV status among veterans who met NCEP/ATP III criteria for the receipt of lipid lowering medication. 05/29/09. Among those who met NCEP/ATP III criteria for lipid lowering therapy, HIV-infected veterans, particularly those with high HIV viral loads and HCV co-infection, were significantly less likely to receive lipid lowering therapy. This may be a modifiable mediator of cardiovascular disease among HIV-infected individuals. Journal of General Internal Medicine via PubMed

Study: Obese, Highly Fit Vets With Lowest Mortality Risk

Fitness and fatness as mortality predictors in healthy older men: the veterans exercise testing study. 05/29/09. In this cohort of elderly male veterans, we observed independent and joint inverse relations of BMI and CRF to mortality. This warrants further investigation of fitness, fatness, and mortality interactions in older persons. Free full text. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences via PubMed

Agent Orange & Aggressive Prostate Cancer

Exposure to Agent Orange is a significant predictor of prostate-specific antigen (PSA)-based recurrence and a rapid PSA doubling time after radical prostatectomy. 05/29/09.Patients with AO exposure and treated with RP were more likely to be black, present with lower risk features, have an increased risk of biochemical progression, and shorter PSADT after recurrence. When stratified by race, the association between AO exposure and poor outcomes was present in both races. These findings suggest that among selected men who choose RP, AO exposure might be associated with more aggressive prostate cancer. BJU International via PubMed

VAOIG Audit of Consolidated Mail Outpatient Pharmacies

Audit of VA Consolidated Mail Outpatient Pharmacy Inventory Accountability 05/28/09. The Office of Inspector General conducted an audit to determine whether VA CMOPs effectively and efficiently accounted for non controlled pharmaceutical inventories and to determine whether the CMOPs managed and safeguarded non controlled pharmaceutical inventories at risk for diversion. The Charleston and Dallas CMOPs established physical security controls to prevent the unauthorized physical removal of pharmaceuticals from CMOPs. However, inventory management controls used to account for and prevent diversion of non controlled pharmaceuticals could be further improved. Specifically, the Charleston and Dallas CMOPs did not: (1) conduct physical counts of their entire wall to wall inventory, as required; (2) consistently estimated inventory quantities of open products during their annual wall to wall physical inventory; (3) effectively control and monitor adjustments made to their pharmaceutical inventory; (4) secure, track and monitor non controlled pharmaceuticals held for return credit, as required; (5) ensure segregation of critical system functions; (6) control and monitor the prime vendor’s (Econolink) system access. In addition, QMSI software, which controls the majority of the CMOPs production system, does not always adequately track the dispensing of pharmaceuticals. The Under Secretary for Health concurred with all six of our recommendations and has already implemented two of the six recommendations. The Under Secretary’s planned actions for the remaining four recommendations are acceptable. Finally, we consider all review issues to be resolved and will follow up on the implementation of planned improvement actions. VAOIG

General Anxiety Disorder, Major Depressive Episode & Mortality in Vietnam Veterans

Generalized anxiety disorder, major depressive disorder, and their comorbidity as predictors of all-cause and cardiovascular mortality: the Vietnam experience study. 05/28/09. OBJECTIVE: To examine whether the 1-year prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and their comorbidity were associated with subsequent all-cause and cardiovascular disease (CVD) mortality during 15 years in Vietnam veterans. Psychosom Med. via PubMed

PTSD Affects Interoceptive Responses

Initial Evidence of a Failure to Activate Right Anterior Insula During Affective Set Shifting in Posttraumatic Stress Disorder 05/28/09. These findings may suggest that although individuals with PTSD are cognitively aware of the impending shift in interoceptive state, they fail to appropriately activate neural circuitry involved in modulating interoceptive responses. Psychosom Med. via PubMed

Personality Traits & Longevity: Vietnam Experience Study Cohort

Emotionally stable, intelligent men live longer: the Vietnam experience study cohort 05/28/09. The effects of high neuroticism, low cognitive ability, and their interaction predict mortality. Cognitive ability effects are mediated by health, income, and education. Psychosom Med. via PubMed

Combat Exposure & PTSD

PTSD prevalence, associated exposures, and functional health outcomes in a large, population-based military cohort. 05/27/09. Posttraumatic stress disorder (PTSD) results from experiencing or witnessing traumatic, life-threatening events including combat-related experiences. The purpose of this study was to investigate the prevalence of PTSD symptoms and diagnosis, self-reported exposures, and functional health in a large cross-section of the U.S. military. Public Health Rep.

Psychological Risks Associated With Combat Exposure

Combat Exposure Raises PTSD, Smoking, Alcohol Abuse Risks 05/27/09. The latest research results from a large randomized study on the long-term health effects of thousands of service members show that while deployers generally are very healthy, there are increased risks for smoking, heavy drinking, and PTSD symptoms among subgroups exposed to combat during deployment. Military Health System

Counseling Veteran Students Website

Web Site Helps College Counselors Aid Vets 05/27/09. The Department of Veterans Affairs has launched a new Web site to strengthen the connection between college and university mental health professionals and veterans of the Iraq and Afghanistan conflicts studying on their campuses. The Web site, http://www.mentalhealth.va.gov/College, features recommended training for college and university counselors, with online modules including “Operation SAVE” for suicide prevention, “PTSD 101” and “Helping Students Who Drink Too Much.” It also will feature a resource list that will be updated regularly. DefenseLink

Advanced Prostheitc Arm

VA Announces Study of Advanced Prosthetic Arm 05/27/09. The Department of Veterans Affairs has announced a three-year study of an advanced artificial arm that easily allows those with severe limb loss to pick up a key or hold a pencil. “This arm is a high-tech example of how VA researchers are continually modernizing the materials, design and clinical use of artificial limbs to meet veterans’ lifestyle and medical needs,” said Dr. Joel Kupersmith, VA’s physician and chief research and development officer. DefenseLink