The Health Status of Gulf War Veterans: Lessons Learned from the Department of Veterans Affairs Health Registry

Murphy, Frances M.; Kang, Han K.; Dalager, Nancy A.; Lee, Ki Young; Allen, Robert E.; Mather, Susan H.; Kizer, Kenneth W.

doi:10.1093/milmed/164.5.327

Cited by 74 publications

(45 citation statements)

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“…DOD and VA PGW registries' most frequently diagnosed medical conditions include musculoskeletal pain at rates of 25 percent and connective tissue diseases at rates of 36 percent. A survey of 15,000 PGW Veterans found prevalence rates for headaches at 54 percent, joint pain at 45 percent, back pain at 44 percent, muscle pain at 33 percent, and abdominal pain at 23 percent [23][24][25]. Combat Veterans have high rates of pain that also occur with comorbid disorders and are often associated with worse outcomes.…”

Section: Intersection Of Ptsd and Painmentioning

confidence: 99%

Review of posttraumatic stress disorder and chronic pain: The path to integrated care

Gibson¹

2012

JRRD

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Abstract-With the large number of Veterans experiencing posttraumatic stress disorder (PTSD) and chronic pain, the purpose of this article is to review the prevalence of PTSD and chronic pain, the theoretical models that explain the maintenance of both conditions, and the challenges faced by providers and families who care for these patients. The Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress with special attention to chronic pain is presented. Limited scientific evidence supports specific care and treatment of PTSD and chronic pain, and this challenges providers to investigate and research potential treatment options. Integrated care models designed for working with these patients are reviewed, including a focus on the techniques and strategies to address not only PTSD and chronic pain, but other conditions, including substance dependence and depression. A specific focus on headaches, back pain, and neuropathic pain follows, including treatment recommendations such as pharmacological, psychotherapeutic, and complementary approaches, given the high rates of these pain complaints for Veterans in PTSD clinical programs. Integrated care is presented as a viable solution and approach that challenges clinicians and researchers to develop innovative, scientifically based therapeutics and treatments to enhance the recovery and quality of life for Veterans with PTSD and chronic pain.

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Section: Intersection Of Ptsd and Painmentioning

confidence: 99%

Review of posttraumatic stress disorder and chronic pain: The path to integrated care

Gibson¹

2012

JRRD

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“…In research studies and the systematic clinical examination of Ͼ 100,000 U.S., British, and Canadian veterans, common fungal skin infections have been the most frequently diagnosed infectious disease. [70][71][72] In addition, no pattern of infectious diseases has emerged among patients with chronic unexplained symptoms, who have been hypothesized to have a unique ''Gulf War syndrome.'' Nor has a characteristic physical sign or laboratory test abnormality been observed that would indicate a chronic infectious process, including a unique skin rash, lymphadenopathy, hepatosplenomegaly, transaminase elevations, or hematological abnormalities.…”

Section: Resultsmentioning

confidence: 99%

“…Nor has a characteristic physical sign or laboratory test abnormality been observed that would indicate a chronic infectious process, including a unique skin rash, lymphadenopathy, hepatosplenomegaly, transaminase elevations, or hematological abnormalities. [70][71][72] The finding in several surveys that most veterans did not develop unexplained symptoms until several months after returning home further suggests that an infectious disease acquired in the Gulf is not a cause of chronic health problems. 20,70 Although it is unlikely that infectious diseases endemic to the Arabian Gulf or traditional BW agents could cause longterm health effects and remain undetected over a 10-year period, latent leishmania infection could progress to clinical disease among some veterans.…”

Section: Resultsmentioning

confidence: 99%

Endemic infectious diseases and biological warfare during the Gulf War: a decade of analysis and final concerns.

Hyams¹,

Riddle²,

Trump³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. Infectious diseases were one of the first health threats confronted by Coalition troops deployed to the Arabian desert in August 1990. On the basis of experiences in World War II, the major endemic infectious disease risks were thought to be sandfly fever, cutaneous leishmaniasis, diarrheal disease, and malaria. Although there was active surveillance, no case of sandfly fever and few other endemic infectious diseases were identified among over 500,000 U.S., British, and Canadian ground troops. In addition, there was no diagnosis of biological warfare (BW) exposure, and BW agents were not detected in clinical, environmental, or veterinary samples. The most common infectious disease problems were those associated with crowding (acute upper respiratory infections) and reduced levels of sanitation (travelers-type diarrhea). Only one endemic infectious disease has been confirmed as causing chronic health problems: visceral Leishmania tropica infection (viscerotropic leishmaniasis). However, this protozoan infection was diagnosed in only 12 U.S. veterans, and no new cases have been identified during the last 8 years. Infectious diseases were not a serious problem for Gulf War troops because of extensive preventive medicine efforts and favorable weather and geographic factors. Moreover, it is unlikely that an endemic infectious disease or a BW agent could cause chronic health problems and remain undetected over a 10-year period.

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“…The objective of the VA Registry was to provide clinical examinations, including both laboratory tests and physician referrals, to further evaluate symptoms reported by veterans during their initial physical examinations. 1, 32,33,45 The Comprehensive Clinical Evaluation Program (DoD Registry) initiated by the DoD on June 7, 1994, was also a voluntary registry offered to Gulf War veterans and their families who remained on active duty, retired from career service, became civilian DoD employees, or served full-time in the Reserves or National Guard. The objective of the DoD Registry was to provide systematic clinical evaluations for the diagnosis and treatment of medical conditions occurring subsequent to service in the Gulf War theater.…”

Section: Gulf War Health Registry Datamentioning

confidence: 99%

The Postwar Hospitalization Experience of Gulf War Veterans Participating in U.S. Health Registries

Smith

Jimenez²,

Smith³

et al. 2004

Journal of Occupational and Environmental Medicine

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In response to concerns that Gulf War veterans were experiencing increased morbidity resulting from wartime exposures in the Gulf War, the Department of Veterans Affairs and the Department of Defense (DoD) initiated clinical registries to provide systematic health evaluations for self-referred Gulf War veterans. The authors used Cox's proportional hazard modeling with data from all DoD hospitals to estimate the probability of hospitalization resulting from any cause, resulting from diagnosis in a major diagnostic category, and resulting from a specific diagnosis of interest. After adjusting for other risk factors, registry participants were 1.43 times more likely to have a postwar hospitalization than registry nonparticipants (95% confidence interval, 1.40-1.46). These findings support the hypothesis that registry participants were more likely to experience postwar morbidity than veterans who chose not to enroll in the health registries.

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The Health Status of Gulf War Veterans: Lessons Learned from the Department of Veterans Affairs Health Registry

Cited by 74 publications

References 0 publications

Review of posttraumatic stress disorder and chronic pain: The path to integrated care

Review of posttraumatic stress disorder and chronic pain: The path to integrated care

Endemic infectious diseases and biological warfare during the Gulf War: a decade of analysis and final concerns.

The Postwar Hospitalization Experience of Gulf War Veterans Participating in U.S. Health Registries

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