Federal practitioner : for the health care professionals of the VA, DoD, and PHS最新文献

{"title":"The Veteran's Canon Under Fire.","authors":"Cynthia M A Geppert","doi":"10.12788/fp.0528","DOIUrl":"https://doi.org/10.12788/fp.0528","url":null,"abstract":"","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 11","pages":"356-357"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevating the Importance of Asthma Care in the United States.","authors":"Gary C Steven, Neil Skolnik, Mike Devano, Wendy L Wright, Maureen George","doi":"10.12788/fp.0531","DOIUrl":"10.12788/fp.0531","url":null,"abstract":"","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 Suppl 6","pages":"S13-S22"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypercortisolism Is More Common Than You Think-Here's How to Find It.","authors":"Pamela Kushner, David R Brown, Robert S Busch","doi":"10.12788/fp.0532","DOIUrl":"10.12788/fp.0532","url":null,"abstract":"","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 Suppl 6","pages":"S23-S28"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving COPD Management at Transitions of Care.","authors":"Alan Kaplan","doi":"10.12788/fp.0533","DOIUrl":"10.12788/fp.0533","url":null,"abstract":"","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 Suppl 6","pages":"S29-S34"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Finerenone in Optimizing Cardiovascular-Kidney-Metabolic Health: Everything PCPs Should Know.","authors":"Eugene E Wright, Richard B Frady, Chigozie Uko","doi":"10.12788/fp.0535","DOIUrl":"10.12788/fp.0535","url":null,"abstract":"","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 Suppl 6","pages":"S41-S46"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact and Recovery of VHA Epilepsy Care Services During the COVID-19 Pandemic.","authors":"Zulfi Haneef, Erin Sullivan-Baca, Rizwana Rehman, Alan Towne, Ann C Van Cott, Aatif Husain","doi":"10.12788/fp.0488","DOIUrl":"10.12788/fp.0488","url":null,"abstract":"<p><strong>Background: </strong>The Epilepsy Centers of Excellence (ECoE) is a network of facilities within the Veterans Health Administration that evaluates and treats veterans with epilepsy and seizure disorders. This article outlines how the COVID-19 pandemic impacted ECoE services and recovery.</p><p><strong>Methods: </strong>Directors of 17 ECoEs were surveyed 4 times between May 2020 and July 2022 on 5 domains: functioning of outpatient epilepsy clinics, outpatient electroencephalogram, epilepsy monitoring unit, anticipated permanent operational changes, and utility of national and local recommendations. Data on the spread of COVID-19 and administrative workload data were compared with the availability of epilepsy services.</p><p><strong>Results: </strong>There was an increase in in-person outpatient visits from May 2020 (1 of 13 sites) to June 2022 (all 16 sites). Similar increases were also observed for outpatient electroencephalogram from 4 of 13 sites and subsequently all 16 sites, and for epilepsy monitoring unit from 1 of 12 sites to 11 of 16 sites. The spread of COVID-19 did not correlate with the availability of services. Respondents predicted telehealth would be a permanent change.</p><p><strong>Conclusions: </strong>Comprehensive ECoEs within the Veterans Health Administration increased services during the COVID-19 pandemic without demonstrating an association to the disease's spread.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 11","pages":"370-375"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Glucose Monitoring vs Fingerstick Monitoring for Hemoglobin A_1c Control in Veterans.","authors":"Kelsey Floerchinger, Kelley Oehlke, Scott Bebensee, Austin Hansen, Kelsey Oye","doi":"10.12788/fp.0525","DOIUrl":"10.12788/fp.0525","url":null,"abstract":"<p><strong>Background: </strong>Patients with diabetes have traditionally been required to use fingerstick testing to self-monitor their glucose levels. However, continuous glucose monitors (CGMs) collect glucose readings throughout the day and display daily trends, which allow clinicians to individualize treatment to achieve hemoglobin A_1c (HbA_1c) goals and simplify medication regimens. While studies have shown that CGMs improve HbA_1c levels compared to fingerstick testing, this research has focused on type 1 diabetes and excluded veterans and patients on insulin therapy.</p><p><strong>Methods: </strong>This retrospective chart review used a crossover, self-controlled design conducted at the Veterans Affairs Sioux Falls Health Care System. Veterans with an active CGM prescription were included. The primary endpoint compared the change in HbA_1c before and after initiation of a CGM.</p><p><strong>Results: </strong>The mean baseline HbA_1c for the 150 veterans included in this study was 8.6%. The change in HbA_1c before CGM use was 0.003 and change in HbA_1c after CGM use was -0.971. The primary endpoint of difference in HbA_1c associated with CGM use was -0.969 (<i>P</i> = .0001). The overall mean change in total daily doses of insulin was -22 units. Subgroup analysis of change in HbA_1c after CGM use by prescriber type was -0.97 for endocrinology, -0.7 for pharmacy, and -1.23 for primary care practitioners. The overall average HbA_1c post-CGM use was similar across all prescriber types at 7.64%.</p><p><strong>Conclusions: </strong>This study found veterans with type 2 diabetes and on insulin therapy demonstrated a significant reduction in HbA_1c with CGM use compared with their baseline fingerstick monitoring. Use of a CGM may be beneficial in patients who require a reduction in HbA_1c by allowing more precise adjustments to medications to optimize therapy.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 Suppl 5","pages":"S1-S5"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection and Diagnosis of Early Symptomatic Alzheimer's Disease in Primary Care.","authors":"Dani Cabral, Thomas O Obisesan","doi":"10.12788/fp.0530","DOIUrl":"10.12788/fp.0530","url":null,"abstract":"","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 Suppl 6","pages":"S7-S12"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Alirocumab Monotherapy vs Ezetimibe Plus Statin Therapy on LDL-C Lowering in Veterans With History of ASCVD.","authors":"Han Nguyen, Brandon Hubert, Courtney Rogen, Rose Anderson","doi":"10.12788/fp.0522","DOIUrl":"10.12788/fp.0522","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend a low-density lipoprotein cholesterol (LDL-C) goal of < 70 mg/dL for patients with very high-risk atherosclerotic cardiovascular disease (ASCVD). While alirocumab monotherapy and ezetimibe plus statin therapy have both shown efficacy in independently reducing LDL-C, a direct comparison has not been conducted.</p><p><strong>Methods: </strong>A retrospective chart review at the Veterans Affairs Sioux Falls Health Care System compared 20 patients with a history of ASCVD events who received alirocumab monotherapy to 60 patients receiving ezetimibe plus statin therapy. The primary endpoint was incidence of reaching the < 70 mg/dL LDL-C goal after 4 to 12 weeks, 13 to 24 weeks, and 25 to 52 weeks.</p><p><strong>Results: </strong>Fourteen patients (70%) in the alirocumab monotherapy group reached the LDL-C goal (< 70 mg/dL) compared with 34 patients (57%) in the ezetimibe plus statin group (<i>P</i> = .29). In both groups, the goal was most frequently achieved in 25 to 52 weeks.</p><p><strong>Conclusions: </strong>In a small population of veterans with ASCVD, there was no significant difference between the 2 treatment groups in LDL-C reduction or in several secondary endpoints, including percentage change in high-density lipoprotein and triglycerides, ASCVD events, and adverse events leading to treatment discontinuation. However, a statistically significant difference in percentage reduction in LDL-C and total cholesterol was found favoring alirocumab monotherapy.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 11","pages":"376-381"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Patient-Centric COPD Management.","authors":"Barbara P Yawn","doi":"10.12788/fp.0534","DOIUrl":"10.12788/fp.0534","url":null,"abstract":"","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 Suppl 6","pages":"S35-S40"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}