ReportWire

Tag: Wolters Kluwer Health: Lippincott

  • Black Patients More Likely to Perceive Racial Bias From Orthopaedic Surgeons

    Black Patients More Likely to Perceive Racial Bias From Orthopaedic Surgeons

    Newswise — October 9, 2023 – Black patients report more difficulties relating to their orthopaedic surgeon and are more likely to perceive bias from their surgeon, as compared with White patients, reports a study in The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

    “Black patients were six times more likely to report difficulty relating to their surgeon and 14 times more likely to report perceived racial bias compared with their White counterparts,” according to the survey study by Marsalis Brown, MD, of University Hospitals – Cleveland Medical Center, and colleagues. The research also shows race- and gender-related differences in patient preferences for orthopaedic surgeons with specific characteristics.

    Survey shows racial differences in patient experiences

    The study evaluated patients’ experiences, perceptions, and preferences related to diversity in orthopaedic surgery. The survey included 349 patients seen at orthopaedic clinics within the authors’ health system. About 80% of respondents were White and 18% were Black; only about three percent were Hispanic.

    The results showed differences in patient experiences between racial groups. Black patients were more likely to report difficulties relating to their orthopaedic surgeon, as compared with White patients: 11.48% versus 2.29%. Black patients were also much more likely to perceive racial bias from their surgeon: 5.17% versus 0.37%.

    Patients perceived low levels of diversity within orthopaedic surgery (average rating of 2.5 out of 10) with only a small difference between Black and White patients (2.10 versus 2.57). Black patients ranked race as a more important factor to consider when selecting a surgeon: average rating 3.49 compared with 1.45 for White patients.

    Women report more difficulty relating to their orthopaedic surgeon

    Women were about five times more likely to report difficulty relating to their surgeon. Although male and female patients had similar perceptions of diversity in orthopaedic surgery, women placed more importance on their surgeon’s gender.

    The study also found some differences according to patient income and education, with more-educated patients perceiving lower diversity among surgeons. That perception is consistent with the slow rate of change in representation of racial and ethnic minorities and women in orthopaedic surgery, which lags behind other surgical specialties.

    The findings are especially important in light of recent studies, which have shown that diversity leads to higher patient satisfaction, greater adherence to recommended treatment, and improvement in the patient-physician relationship. “Despite the ongoing education reforms to encourage increased diversity during trainee selection, the impact of such efforts is yet to manifest as changes in patient perceptions in current practice settings,” Dr. Brown and coauthors write. They discuss the critical need for reforms early in medical education, including early exposure to orthopaedic surgery, improving access to mentors, and steps to improve retention through each educational level.

    Read Article [ Patient Preferences and Perceptions of Provider Diversity in Orthopaedic Surgery ]

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    ###

    About The Journal of Bone & Joint Surgery

    The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.

    About Wolters Kluwer

    Wolters Kluwer (EURONEXT: WKL) is a global leader in professional information, software solutions, and services for the healthcare, tax and accounting, financial and corporate compliance, legal and regulatory, and corporate performance and ESG sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

     Wolters Kluwer reported 2022 annual revenues of €5.5 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,900 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    For more information, visit www.wolterskluwer.com, follow us on LinkedIn, Twitter, Facebook, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Medical Care publishes article collection on integrating evidence-based programs into clinical practice

    Medical Care publishes article collection on integrating evidence-based programs into clinical practice

    Newswise — September 8, 2023 — As part of its partnership with the Patient-Centered Outcomes Research Institute (PCORI), Medical Care has published its first PCORI-sponsored article collection, which provides specific information about the costs that healthcare systems can expect to incur in promoting the uptake of specific evidence-based programs. Medical Care, https://journals.lww.com/lww-medicalcare/pages/default.aspxthe official journal of the Medical Care Section of the American Public Health Association, is published in the Lippincott portfolio by Wolters Kluwer. 

    In the September issue, five project teams that received Implementation Award funding from PCORI describe their approaches and methods for determining the costs of implementing programs into routine clinical practice, and they report their cost findings. 

    “Having cost information available during the decision-making process—before implementation occurs—has been found to be particularly important so that leaders can consider financial implications and weigh trade-offs before investing in implementing an evidence-based practice change,” Valerie Lehman, MHA, program officer for dissemination and implementation at PCORI, and colleagues note in an introductory editorial. “Yet information about the cost of implementation is not often available.” 

    Accounting for context-specific considerations when assessing costs of implementation is crucial 

    One paper in the collections reports on a team that assessed the costs of implementing Connect to Health, an evidence-based pediatric weight management program, into three healthcare systems that care for pediatric populations with a disproportionately high prevalence of obesity: Denver Health; Prisma Health in Greenville, South Carolina; and Massachusetts General Hospital in Boston. 

    Natalie Smith, PhD and Douglas E. Levy, PhD, investigators at the Mongan Institute Health Policy Research Center at Mass General, together with colleagues, used time-driven activity-based costing methods. Specifically, each of the three sites developed a process map and a detailed report of all implementation actions taken, aligned with major implementation requirements (e.g., electronic health record integration) or strategies (e.g., providing clinician training). For each action, sites identified the personnel involved and estimated the time they spent, and the research team then estimated the total costs of implementation and broke down the costs for major categories of implementation activities. 

    Process maps showed the program integrated easily into well-child visits. Overall implementation costs ranged from $77,103 to $142,721, with setting up the technological aspects of the program being a major driver of costs. Other drivers included training, engaging stakeholders, and audit and feedback activities, but there was variability across healthcare systems based on how they chose to implement the program and expend resources. 

    Site-specific data can be useful to other healthcare centers 

    “Beyond just the technological aspects of the program, our findings provide valuable information for future adoption and implementation decisions as they clearly delineate what kinds of costs sites should expect, the personnel involved in various implementation actions, and how costs were distributed across pre-implementation and implementation,” Dr. Smith and her co-authors say. “Disaggregating costs across different categories allows future sites to better plan for what to expect in implementation, even if the exact dollar amounts will likely be different than what was observed in the three research sites.” 

    Ms. Lehman and the other editorialists add that all five papers “provide more information to healthcare decision-makers on the actual observed costs associated with implementing evidence-based practices. Each team was able to capture the specific types of personnel, as well as the detailed tasks and activities, involved in implementation, essentially laying out clear pathways for future sites considering whether and how to put these evidence-based practices into place.” 

    Read Article [Costs to Implement a Pediatric Weight Management Program Across 3 Distinct Contexts]

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth. 

    ### 

    About Medical Care 

    Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments related to the research, planning, organization, financing, provision, and evaluation of health services. 

    About The American Public Health Association 

    The American Public Health Association is the only organization that combines a 150-year perspective, a broad-based member community, and the ability to influence policy to improve the public’s health. The Member Care section advocates for strengthening the social, economic, and environmental conditions that preserve and enhance health as well as a medical care system that assures high-quality care, accessible preventive medicine, and cultural sensitivity for all. 

    About Wolters Kluwer  

    Wolters Kluwer (EURONEXT: WKL) is a global leader in professional information, software solutions, and services for the healthcare, tax and accounting, financial and corporate compliance, legal and regulatory, and corporate performance and ESG sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services. Wolters Kluwer reported 2022 annual revenues of €5.5 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,900 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. 

    Wolters Kluwer Health: Lippincott

    Source link

  • Yelp Reviews of Plastic Surgeons – What Factors Affect Positive and Negative Ratings?

    Yelp Reviews of Plastic Surgeons – What Factors Affect Positive and Negative Ratings?

    Newswise — July 27, 2023 – How many stars would you give your plastic surgeon? An analysis of Yelp reviews identifies a wide range of surgeon-and practice-related factors that influence whether plastic surgery patients leave positive or negative reviews, reports the September issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). The journal is published in the Lippincott portfolio by Wolters Kluwer.

    “Our study also identifies some sources of bias that may affect patients’ perceptions of their care – although the plastic surgeon’s gender or race doesn’t appear to affect the overall quality ratings,” comments senior author Brent R. DeGeorge, MD, PhD, of University of Virginia, Charlottesville.

    Multiple factors affect five-star versus one-star ratings

    The researchers analyzed 5,210 Yelp reviews of plastic surgery provider practices from 49 cities across the United States. Reviews were coded for the presence of positive and negative themes. Surgeon and practice-related factors associated with positive or negative ratings were identified, including the effects of the physician’s race and gender.

    80% of reviews included in the analysis were five-star reviews, indicating the highest level of patient satisfaction. Another 13.5% were one-star reviews, reflecting the lowest patient satisfaction. Two- to four-star ratings accounted for only about six percent of reviews.

    In positive reviews, the most frequently mentioned surgeon-related factors were the surgical outcomes achieved, the physician’s temperament, the physician’s competency and knowledge, and physician-patient communication.

    “Patients with positive experiences emphasized having results that looked natural and matched the look they had discussed with the physician prior to surgery,” Dr. DeGeorge and colleagues write. “Patients felt most comfortable with physicians who gave thorough explanations of the procedures beforehand, often spending several hours over multiple consultation sessions.”

    Plastic surgeons can learn from online reviews to improve the patient experience

    In adjusted analyses, positive physician factors associated with higher Yelp ratings were surgical outcomes, physical exam/procedures, injectable outcomes, competency and knowledge, and temperament. Negative mentions of the same factors were linked to lower Yelp ratings, along with cost consciousness.

    On analysis of practice-related factors, interactions with office staff and issues related to scheduling significantly affected whether patients left positive or negative reviews. Additional negative practice-related factors included billing/insurance issues and wait times. The study “corroborates the results of past studies, which have found that practice factors such as wait time and courtesy of registration staff were correlated with a patient’s likelihood to highly rate a practice,” according to the authors.

    Yelp ratings were not significantly associated with the physician’s race or gender. While that’s an encouraging finding, the researchers note some differences in both positive and negative factors related to race and gender. “Further research is needed to identify the effect of patient characteristics on their ratings and reviews of providers,” Dr. DeGeorge and colleagues write.

    While noting some limitations of the study – including the inherent subjectivity of online ratings – the researchers believe their analysis lends new insights into the range of physician and practice-related factors influencing patient perceptions of quality of care. Dr. DeGeorge and coauthors conclude: “Plastic surgeons can learn from patient ratings and reviews to develop initiatives to improve the patient experience and learn more about general biases held by patients as the field becomes more diverse.”

    Read [The Ratings Game: Demographic and Practice Factors Affecting Yelp Ratings of Plastic Surgeons]

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    ###

    About Plastic and Reconstructive Surgery

    For over 75 years, Plastic and Reconstructive Surgery® (http://www.prsjournal.com/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair and cosmetic surgery, as well as news on medico-legal issues.

    About ASPS

    The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

    About Wolters Kluwer

    Wolters Kluwer (EURONEXT: WKL) is a global leader in professional information, software solutions, and services for the healthcare, tax and accounting, financial and corporate compliance, legal and regulatory, and corporate performance and ESG sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

    Wolters Kluwer reported 2022 annual revenues of €5.5 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    For more information, visit www.wolterskluwer.com, follow us on LinkedIn, Twitter, Facebook, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Bilateral total knee arthroplasty linked to increased complication rates

    Bilateral total knee arthroplasty linked to increased complication rates

    Newswise — July 7, 2023 – Patients undergoing bilateral total knee arthroplasty (TKA) are at an increased risk of several types of complications, as compared with matched patients undergoing unilateral TKA, reports a study in The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

    “Patients who underwent simultaneous bilateral TKA were at higher risk of experiencing postoperative complications such as pulmonary embolism, stroke, blood loss anemia, and requiring a transfusion,” according to the report by Nathanael D. Heckmann, MD, and colleagues of Keck School of Medicine of USC, Los Angeles.

    Study in matched groups of patients clarifies risks of bilateral TKA

    TKA is a highly effective treatment for patients with advanced osteoarthritis of the knee, decreasing pain and improving function. When both knees are affected, bilateral TKA offers some advantages over sequential unilateral TKA, including less time in the hospital, a single rehabilitation period, and lower overall costs.

    However, some studies have found an increased risk of complications, along with a higher mortality rate, in patients undergoing bilateral TKA. These studies have had important limitations, including a lack of patient matching to account for potential differences between those undergoing  bilateral versus unilateral TKA. To address these issues, Dr. Heckmann and colleagues compared complications and mortality in a large, nationally representative group of patients undergoing bilateral versus unilateral TKA.

    The analysis included more than 21,000 patients undergoing simultaneous bilateral TKA. These were matched for age, sex, race, and comorbidities with a cohort of 126,000 patients undergoing unilateral TKA. After matching, the two groups had an average age of 64 years with similar comorbidities. As all TKAS were performed between 2015 and 2020, the surgical procedures reflected modern orthopaedic practice.

    Stroke, transfusion, and other risks higher following bilateral TKA

    Patients in the simultaneous bilateral TKA group had increased rates of several types of complications compared with those in the unilateral TKA group, pulmonary embolism (0.27% versus 0.13%), stroke (0.13% versus 0.06%), and respiratory failure (0.46% versus 0.34%).

    Patients undergoing bilateral TKA were also at a higher risk of anemia due to blood loss (26.89% versus 14.86%) and were more likely to undergo a blood transfusion (5.23% versus 0.67%). These risks were increased despite the high use of tranexamic acid to reduce blood loss during surgery in both groups.

    Patients undergoing bilateral TKA were also more likely to be readmitted to the hospital within 90 days (2.80% versus 2.05%). There was no significant increase in the risk of in-hospital death (0.05% versus 0.04%).

    After adjusting for confounders, the risks of pulmonary embolism, stroke, and acute blood loss anemia were approximately doubled in the bilateral TKA group, while the risk of blood transfusion was nearly nine times higher. The risk of readmission within 90 days was 35% higher with bilateral compared with unilateral TKA.

    “This study presents the largest matched sample size to date comparing the complications and safety between patients treated with simultaneous bilateral TKA and those treated with unilateral TKA,” Dr. Heckmann and coauthors write. Although there was no significant difference in the rate of in-hospital death, “The risk of mortality following simultaneous bilateral TKA is still a topic of concern.” The researchers emphasize the need for patient counseling and “thorough medical optimization” in patients selected for bilateral TKA.

    Read [Complications and Safety of Simultaneous Bilateral Total Knee Arthroplasty: A Patient Characteristic and Comorbidity-Matched Analysis]

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    ###

    About The Journal of Bone & Joint Surgery

    The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.

    About Wolters Kluwer

    Wolters Kluwer (EURONEXT: WKL) is a global leader in professional information, software solutions, and services for the healthcare, tax and accounting, financial and corporate compliance, legal and regulatory, and corporate performance and ESG sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

     Wolters Kluwer reported 2022 annual revenues of €5.5 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    For more information, visit www.wolterskluwer.com, follow us on LinkedIn, Twitter, Facebook, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Accelerated delivery of transcranial magnetic stimulation is safe and effective

    Accelerated delivery of transcranial magnetic stimulation is safe and effective

    Newswise — May 12, 2023 — Accelerated schedules for repetitive transcranial magnetic stimulation (rTMS) can be offered to patients experiencing treatment-resistant major depressive disorder (MDD), a group of clinician–researchers and neuroscientists have concluded. The group cautions that such treatment should be proposed only after detailed discussion with patients about acceleration being an alternate form of rTMS scheduling, with documentation of informed consent.

    The recommendations are published in a special issue of Harvard Review of Psychiatry (HRP), “Interventional Neuropsychiatry and Neuromodulation: An Emerging Subspecialty in Brain Medicine.” HRP is published in the Lippincott portfolio by Wolters Kluwer.

    Repetitive TMS is a noninvasive therapy in which an electromagnet delivers repeated low-intensity pulses to stimulate the brain. It has been proven safe and effective in numerous clinical trials involving patients whose MDD does not respond to antidepressant medication. Conventionally, rTMS is given once daily 20 to 30 days over four to six weeks. That places great time demands on both patients and clinicians.

    Theta burst stimulation treats MDD

    The next step in development of rTMS is accelerated schedules in which patients undergo two or more sessions per day, each approximately 30 minutes long, separated by one hour or more. Although this change was just as effective in treating depression as once-daily rTMS, it created a different kind of impracticality and clinical inefficiency, according to Leo Chen, MBBS, MPsych, PhD, FRANZCP, of Monash University/Alfred Health in Melbourne, Australia, and colleagues. “These schedules required patients to attend treatment settings for long periods on each treatment day, limiting patient capacity at treatment clinics,” they note.

    The time burden can be alleviated, at least in part, with a novel approach called theta-burst stimulation (TBS). The most commonly used conventional rTMS protocol delivers electromagnetic pulses at a frequency of 10 Hz, whereas TBS refers to three pulses applied at 50 Hz (gamma frequency), repeated at 5 Hz (theta frequency) intervals. Two or more TBS sessions can be delivered within an hour.

    Dr. Chen and his colleagues recently published results from a multicenter randomized, controlled trial in which 10 days of TBS was compared head-to-head with a four week course of conventional rTMS. The two approaches were similar in antidepressant effect and safety. This was the largest study of accelerated TBS in depression to date.

    Standardization needed

    Accelerated delivery doesn’t necessarily mean accelerated response, the authors caution. Some retrospective studies have shown twice-daily rTMS induces antidepressant effects faster than once-daily administration, but the evidence is mixed. One barrier is that studies have varied widely in factors such as the stimulation target, frequency and intensity of stimulation, the duration of breaks between sessions, and the number of pulses applied per session and over a treatment course.

    Importantly, though, “accelerated rTMS’s antidepressant efficacy appears comparable to conventional, once-daily rTMS protocols,” Dr. Chen’s group writes. In addition, “studies show that accelerated rTMS protocols are well-tolerated and not associated with serious adverse effects.”

    “As with all therapies, the efficacy, safety, and tolerability of protocols that deviate from those investigated in clinical trials are unknown and should be cautioned against,” the researchers continue. “The durability and depression relapse patterns following accelerated rTMS remain a recognized knowledge gap.”

    Read [Accelerated Repetitive Transcranial Magnetic Stimulation to Treat Major Depression: The Past, Present, and Future]

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    ###

    About HRP

    Harvard Review of Psychiatry is the authoritative source for scholarly reviews and perspectives on a diverse range of important topics in psychiatry. Founded by the Harvard Medical School Department of Psychiatry, the journal is peer-reviewed and not industry sponsored. It is the property of President and Fellows of Harvard College and is affiliated with all of the Departments of Psychiatry at the Harvard teaching hospitals.

    Articles encompass all major issues in contemporary psychiatry, including (but not limited to) neuroscience, psychopharmacology, psychotherapy, history of psychiatry, and ethics. In addition to scholarly reviews, perspectives articles, and columns, the journal includes a Clinical Challenge section that presents a case followed by discussion and debate from a panel of experts.

    About Wolters Kluwer

    Wolters Kluwer (EURONEXT: WKL) is a global leader in professional information, software solutions, and services for the healthcare, tax and accounting, financial and corporate compliance, legal and regulatory, and corporate performance and ESG sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

    Wolters Kluwer reported 2022 annual revenues of €5.5 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    Wolters Kluwer Health: Lippincott

    Source link

  • Sustained-release chemotherapy gives new option for frail patients with invasive bladder cancer

    Sustained-release chemotherapy gives new option for frail patients with invasive bladder cancer

    Newswise — April 7, 2023 – For patients with advanced bladder cancer who are medically unfit for standard treatment, a new intravesical (inside the bladder) chemotherapy delivery system called TAR-200 is safe and shows initial evidence of effectiveness, reports a study in the May issue of The Journal of Urology®, an Official Journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer.

    TAR-200 is a drug-device combination product that is inserted into the bladder and provides continuous, low-dose, local delivery of chemotherapy. “Our preliminary clinical trial found that TAR-200 was generally safe, well tolerated, and had beneficial effects on bladder cancer outcomes, in a group of patients with limited treatment options,” comments lead author Mark Tyson, MD, MPH, of Mayo Clinic Arizona, Phoenix.

    ‘Critical need’ for new treatment options for MIBC

    Bladder cancer is a common disease in older adults. By the time of diagnosis, about one-fourth of bladder cancers have spread into the muscle layer of the bladder wall. For these muscle-invasive bladder cancers (MIBCs), chemotherapy followed by surgery is the standard treatment.

    However, some patients are considered medically unfit or decline to pursue this treatment, which carries substantial rates of complications and adverse effects. Based on previous studies, 25% to 57% of patients worldwide may not receive any “curative-intent” therapy for MIBC. “This suggests a critical need for alternative therapies that are tolerable and effective in an elderly population,” the researchers write.

    The TAR-200 is a small device implanted into the bladder, where it releases a continuous, low dose of gemcitabine, a standard chemotherapy agent. The goal of treatment is to limit cancer growth or progression while limiting the toxic effects of chemotherapy.

    In the new phase one study, TAR-200 was used in 35 patients with MIBC: 24 men and 11 women, median age 84 years. The patients were deemed medically ineligible for standard surgery (radical cystectomy) and chemotherapy, or opted not to receive this treatment. All patients underwent minimally invasive surgery (transurethral resection of bladder tumor, or TURBT) to remove visible tumor.

    The patients then underwent a simple procedure to place the TAR-200 device, which released gemcitabine over 21 days. At that time, another procedure was performed to remove and replace the device, for a total of four treatments over 84 days.

    Few adverse events, evidence of efficacy with TAR-200

    TAR-200 treatment was safe and well-tolerated, assessments suggested. About one-fourth of patients had problems related to device placement or treatment procedures. About 40% had some kind of treatment-related adverse event, most commonly related to problems with urination. These relatively minor problems were “as expected” in a group of frail elderly patients with MIBC, according to the authors. Just two patients were considered “not tolerant” of TAR-200, requiring device removal.

    Overall, 11 of 35 patients had a complete tumor response to TAR-200, with no evidence of bladder cancer at follow-up. Three more patients had a partial response, for an overall response rate of 40%.  Median overall survival was about 27 months. That compared to a 12 overall survival rate in previous studies of MIBC patients not receiving curative-intent treatment.

    Among 14 patients with lasting responses to TAR-200 treatment, 70.5% remained free from progressive bladder cancer at 12 months after treatment. “Overall, the observed clinical response to TAR-200 was robust and durable in a cohort with very limited curative-intent treatment options,” Dr. Tyson and coauthors conclude.

    The researchers note the small size of their study, the lack of a comparison group, and incomplete assessment of response rates. Dr. Tyson comments, “Despite these limitations, the safety, patient tolerance, and promising preliminary effects of TAR-200 warrant further study as an alternative treatment for MIBC.”

    Read [Safety, Tolerability, and Preliminary Efficacy of TAR-200 in Patients With Muscle-invasive Bladder Cancer Who Refused or Were Unfit for Curative-intent Therapy: A Phase 1 Study]

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    ###

    About The Journal of Urology®

    The Official Journal of the American Urological Association (AUA), and the most widely read and highly cited journal in the field, The Journal of Urology® brings solid coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of urology. This premier journal presents investigative studies on critical areas of research and practice, survey articles providing brief editorial comments on the best and most important urology literature worldwide and practice-oriented reports on significant clinical observations. The Journal of Urology® covers the wide scope of urology, including pediatric urology, urologic cancers, renal transplantation, male infertility, urinary tract stones, female urology and neurourology.

    About the American Urological Association

    Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 23,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health care policy. To learn more about the AUA visit: www.auanet.org

    About Wolters Kluwer

    Wolters Kluwer (EURONEXT: WKL) is a global leader in professional information, software solutions, and services for the healthcare, tax and accounting, financial and corporate compliance, legal and regulatory, and corporate performance and ESG sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

    Wolters Kluwer reported 2022 annual revenues of €5.5 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    For more information, visit www.wolterskluwer.com, follow us on LinkedIn, Twitter, Facebook, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Hearing aids donated to Ukrainian refugees in response to article published in The Hearing Journal

    Hearing aids donated to Ukrainian refugees in response to article published in The Hearing Journal

    Newswise — March 15, 2023 – In response to an article published in the February issue of The Hearing Journal, the audiology and hearing solutions company ReSound donated nearly 120 rechargeable hearing aids to address the hearing health care crisis among Ukrainian refugees in Poland. The Hearing Journal is published in the Lippincott portfolio by Wolters Kluwer.

    The hearing aids were given to the Heart of Hearing team, which is led by King Chung, PhD, CCC-A, professor of audiology at Northern Illinois University in DeKalb, IL and the director of the audiology program there. Over the past 12 years, groups of faculty and students from Northern Illinois University and other universities have traveled to eight countries and provided free hearing services to more than 4,000 people.

    When research drives action

    During Thanksgiving break in 2022, a team from Northern Illinois University and Federal University of Rio Grande do Norte in Brazil traveled to the Jewish Community Centre (JCC) in Kraków, Poland to address the hearing health care needs of Ukrainian refugees. As Dr. Chung explains, “After unsuccessful attempts to obtain rechargeable hearing aids from manufacturers, we brought four pairs of older lab hearing aids with us and planned to fit them to refugees with hearing loss.”

    During the trip, the team conducted otoscope exams, tympanometry, distortion product otoacoustic emissions, and pure-tone audiometry. Among the estimated 150 refugees tested, significant hearing loss was documented: approximately 66 needed hearing aids for the first time. The Hearing Journal covered the trip, and reading Dr. Chung’s description of the unmet needs motivated the donation from ReSound.

    The project is ongoing, and more help is needed

    The team plans subsequent trips to Poland to fit the newly donated hearing aids and provide follow-up services. The Hearing Journal will be writing about this ongoing work throughout 2023, so please watch for updates.

    To make a monetary donation to support the team’s travels, please:

    • Use the Northern Illinois University donation website: https://foundation.myniu.com/give.php and choose “Audiology General”
    • Then send an email to NIU Foundation at [email protected] to specify your name and donation amount for Heart of Hearing for Ukrainian Refugees—it is very important to do both steps

    To donate hearing aids, contact .

    “While the impact of the war is often expressed as the number of casualties in the media, the damage to people’s hearing is not mentioned,” Dr. Chung notes. “Ukrainian refugees are not only displaced by the war, but many are also left with a permanent disability that can negatively affect their communication abilities and cause long-term disability.”

    In addition, Dr. Chung points outs, hearing loss “will likely to be one of the most prevalent noncommunicable disabilities among the people who stayed in Ukraine, because of the continuous and relentless missile attacks. We strive to raise awareness of the great hearing health care needs among the people of Ukraine and . . . hope more people will join our cause to provide hearing and amplification services and devices.”

    Read [Significant Hearing Loss Found in Ukrainian Refugees]

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    ###

    About The Hearing Journal 

    Established in 1947, The Hearing Journal is the leading publication in hearing health care, reaching more than 22,000 hearing healthcare professionals. Each month, the journal provides readers with accurate, timely, and practical information to help them in their practices. Read The Hearing Journal to find out about the latest developments in patient care, technology, practice management, and professional issues. Popular monthly features include Hearing Matters, Journal Club, Clinical Consultation, and Tot 10.

    About Wolters Kluwer

    Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the healthcare; tax and accounting; governance, risk and compliance; and legal and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

    Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    For more information, visit www.wolterskluwer.com, follow us on LinkedIn, Twitter, Facebook, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Surgery for spinal stenosis linked to lower mortality and costs, compared to nonoperative treatment

    Surgery for spinal stenosis linked to lower mortality and costs, compared to nonoperative treatment

    Newswise — January 13, 2023 – For patients with spinal stenosis, operative treatment is associated with a lower risk of death and lower costs over two years, compared with nonoperative treatment, suggests a study in the February issue of The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

    Based on extensive analysis of Medicare data, the study by Raymond Hwang, MD, MEng, MBA, of New England Baptist Hospital and colleagues is one of the first to directly compare the outcomes and costs of operative and nonoperative treatment for patients with spinal stenosis.

    Lower mortality with operative versus nonoperative treatment for spinal stenosis

    Patients with spinal stenosis experience narrowing of the spinal canal and compression of spinal nerves, causing back pain, leg pain, and other symptoms. In some patients, stenosis is related to degenerative spondylolisthesis, referring to “slipped” vertebrae often resulting from spinal degeneration.

    Operative treatment of spinal stenosis can include the use of a laminectomy to decompress the spinal canal, a spinal fusion to stabilize the spine, or a combination of both. Nonoperative treatment can include the use of medications, steroid injections, and physical therapy.

    Spine surgery has been shown to be cost-effective in reducing pain and restoring function. Many patients experience improved quality of life and mobility following surgery – which might promote general health and thus lead to a reduced risk of death. “However, the effect of spine surgery relative to nonsurgical management on these important outcomes has not been well described,” Dr. Hwang and coauthors write.

    The researchers analyzed data on 61,534 Medicare patients with spinal stenosis alone and 83,813 with stenosis and spondylolisthesis. Among these patients, 37% of those with stenosis alone and 52% of those with stenosis and spondylolisthesis were managed operatively; the most common procedures were laminectomy and spinal fusion, respectively. In both groups, the average age was about 73 years.

    Patients undergoing operative versus nonoperative treatment were matched in terms of demographic characteristics and health status (based on Risk Stratification Index). Predicted mortality rates were similar between the operative and nonoperative groups, indicating that the groups were well-matched.

    However, in most comparisons, the actual two-year risk of death was higher in the nonoperative group. For example, among patients with stenosis alone, mortality rates were 3.7% for nonoperative treatment versus 2.5% for laminectomy, as assessed in matched cohorts. For patients with spondylolisthesis, mortality rates were 2.3% for nonoperative treatment versus 1.3% for laminectomy and fusion. In adjusted analyses, the relative risk of death was 28% lower in operatively managed patients.

    Costs vary with diagnosis and type of surgery for spinal stenosis

    Nonoperatively treated patients tended to require more health care, including pain medication, magnetic resonance imaging scans, and physical therapy. Among patients with spinal stenosis and spondylolisthesis, Medicare costs were lower with surgical treatment. For example, the average two-year costs were $47,667 for patients who underwent a laminectomy compared with $68,890 for those who were nonoperatively managed.

    Among patients with stenosis alone, costs were lower in those who underwent laminectomy compared with nonoperative treatment: $34,998 versus $59,071. In contrast, costs were higher in patients who underwent spinal fusion compared with nonoperative treatment: $67,451 versus $60,540.

    Mortality was similar for patients undergoing combined fusion and laminectomy, as compared with either procedure alone. “However,” the researchers write, “laminectomy alone was associated with significantly lower two-year payments when treating stenosis with or without spondylolisthesis.”

    The study provides new evidence linking spine surgery to lower mortality and lower costs among Medicare patients with spinal stenosis. For those without spondylolisthesis, costs are lower with laminectomy and higher with fusion. The researchers point out some limitations of their study, including the possible effects of unrecognized confounding factors.

    These findings may have important implications for clinical practice, especially considering recent increases in the use and costs of lumbar fusion surgery. Based on the observed mortality and cost reductions, “The current study suggests that this trend may be justified within the Medicare population” for well-selected patients, Dr. Hwang and coauthors conclude.

    Read [Surgical Treatment of Single-Level Lumbar Stenosis Is Associated with Lower 2-Year Mortality and Total Cost Compared with Nonsurgical Treatment]

    ###

    About The Journal of Bone & Joint Surgery

    The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.

    About Wolters Kluwer

    Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

    Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Applications to plastic surgery residency programs lag behind significant increase in residency positions

    Applications to plastic surgery residency programs lag behind significant increase in residency positions

    Newswise — December 30, 2022 – Historically plastic surgery has been considered one of most competitive and highly sought after residency programs. While this remains true recent appearing wrinkles may be of concern, according to an article in the January issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). The journal is published in the Lippincott portfolio by Wolters Kluwer.

    “Our data shows that the very significant increase in integrated plastic surgery residency positions seen during our study period has not been mirrored by a similar increase in residency applications,” comments ASPS Member, Surgeon James E. Zins, MD, of The Cleveland Clinic, senior author of the special Plastic Surgery Focus paper. The researchers suggest steps to increase awareness and stimulate interest in plastic surgery careers among the next generation of physicians.

    As available plastic surgery training slots increase, applicant numbers remain unchanged

    To analyze trends in applications to plastic surgery residency programs, Dr. Zins and colleagues analyzed data from the San Francisco Match and National Resident Matching Program from 2010 to 2018. During this time, there was a dramatic shift toward integrated residency programs, in which trainees go through a six-year training period directly out of medical school.

    From 2010 to 2018, the number of integrated plastic surgery residency positions increased by 142%. However, applications to these programs increased by only 14.5%. Overall, the number of applicants per available integrated training slot decreased by about half: from 2.9 applicants per position in 2010 to 1.4 in 2018. “Therefore, the likelihood of acceptance into an integrated program increased from approximately 35% in 2010 to almost 73% in 2018,” Dr. Zins and colleagues write.

    Meanwhile, positions in traditional independent programs, where plastic surgery applicants must complete full training in general surgery or a surgical subspecialty before entering a three-year plastic surgery residency, decreased sharply. Including both integrated and independent positions, the overall number of plastic surgery residency slots increased by 45% during the study period, while the number of applicants decreased by nearly nine percent

    Increasing applications to non-surgical residency programs

    The trends in plastic surgery applications were consistent with other surgical specialties. General surgery, neurosurgery, orthopedic surgery, and otolaryngology saw decreases of 12.5% to 22.5%. At the same time, applications to internal medicine and specific non-surgical residency programs increased significantly. The largest increases were noted for internal medicine, 17%; emergency medicine, 37%; and family medicine, 44%.

    “Historically, plastic surgery has been considered a highly desirable residency and anecdotally attracted some of the best and brightest talent,” according to the authors. So why have application numbers not followed the increase in residency positions? While the reasons are “likely multifactorial,” Dr. Zins and coauthors write, “students receive relatively little exposure to the field during medical school. In addition, some medical schools have no plastic surgery residency programs. Finally, medical student perceptions regarding match competitiveness and stresses may represent significant deterrents.”

    Based on the growing popularity of non-surgical residency positions, “It may well be that lifestyle issues are drawing students away from the surgical subspecialties and towards the less time-demanding specialties,” the researchers add. Recent measures to encourage primary care may also be a contributing factor.

    The future of plastic surgery “will depend in large part on the talent pool,” Dr. Zins and colleagues write. They suggest steps to ensure plastic surgery’s visibility in the medical school curricula and to cultivate opportunities for future plastic surgeons. The researchers conclude: “Reaching out to medical students and highlighting the wide opportunities that plastic surgery offers is perhaps the best approach.”

    Read [Supply and Demand: Resident Applications to Program Positions in Plastic Surgery and Our Sister Specialties]

    ###

    About Plastic and Reconstructive Surgery

    For over 75 years, Plastic and Reconstructive Surgery® (http://www.prsjournal.com/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair and cosmetic surgery, as well as news on medico-legal issues.

    About ASPS

    The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

    About Wolters Kluwer

    Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

    Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Delaying antibiotics for neutropenic fever may not affect survival of cancer inpatients

    Delaying antibiotics for neutropenic fever may not affect survival of cancer inpatients

    Newswise — December 29, 2022 — In cancer patients with neutropenic fever, delaying antibiotic treatment past 60 minutes from the time of fever detection does not reduce the short-term chance of survival, according to a study in the American Journal of Medical Quality. The journal is published in the Lippincott portfolio by Wolters Kluwer.

    Neutropenia—low levels of white blood cells called neutrophils, which fight infection—develops in more than 80% of patients who receive chemotherapy for a blood cancer. It occurs because chemotherapy destroys neutrophils along with tumor cells.

    A fever in a patient with neutropenia is considered a medical emergency, according to Adam Binder, MD, of Thomas Jefferson University Hospital in Philadelphia, and colleagues. The fever signals a severe decrease in neutrophils and therefore a compromised ability of the immune system to ward off infections. Neutropenic fever is defined as a temperature of at least 101°, or a sustained temperature of at least 100.4° for an hour or more.

    The Infectious Disease Society of America and the American Society of Clinical Oncology have both published guidelines for treating outpatients who have neutropenic fever. Both organizations call for administering an intravenous antibiotic within 60 minutes after the fever is detected. The recommendation about antibiotics is also often applied to the treatment of hospital inpatients, but there’s no clear evidence that’s appropriate.

    Comparing inpatients who did or did not receive antibiotics during the recommended treatment window

    Dr. Binder and his colleagues looked back at data on 187 patients at their hospital who had developed neutropenic fever. Their main goal was to see whether delays in antibiotic treatment affected short-term survival.

    Only 14% of patients received antibiotics within 60 minutes of developing neutropenic fever. Their survival rate 6 months later wasn’t significantly better than the survival rate of patients who received antibiotics later than recommended.

    Further analysis identified several factors that had a statistically significant association with the risk of death:

    • Patients with insurance had a 72% lower risk of death than those without insurance
    • Patients with at least one other major medical condition had a 2.7 times greater risk of death than those with blood cancer alone
    • Patients who were treated with antibiotics within 40 minutes actually had a 5.7 greater risk of death than those who didn’t receive antibiotics so quickly

    A possible explanation for the last finding, the researchers say, is that patients who received antibiotics within 40 minutes “had other symptoms that yielded a concerning clinical picture, thus leading to a timelier administration of antibiotics, but ultimately a worse clinical outcome.”

    Guidelines for treatment of outpatients may not apply to hospitalized patients

    Even a delay of more than 4 hours wasn’t long enough to affect survival, Dr. Binder and his colleagues determined. That result is consistent with information from previous studies of inpatients, they say.

    The authors believe existing treatment guidelines are appropriate for patients with neutropenic fever who are treated in a physician’s office or an emergency department, but other factors must be considered for patients who have been admitted to a hospital. “Unlike neutropenic fever patients presenting to the emergency department, where true time to antibiotic administration may often be many hours or even days before arrival, a few hours long [delay] in the hospital may not be sufficiently long enough to cause significant patient harm.”

    Read [Delay in Time to Antibiotics for De Novo Inpatient Neutropenic Fever May Not Impact Overall Survival for Patients With a Cancer Diagnosis]

    ###

    About the American Journal of Medical Quality

    The American Journal of Medical Quality (AJMQ) is the official journal of the American College of Medical Quality. AJMQ is focused on keeping readers informed of the resources, processes, and perspectives contributing to quality health care services. This peer-reviewed journal presents a forum for the exchange of ideas, strategies, and methods in improving the delivery and management of health care.

    About the American College of Medical Quality

    The American College of Medical Quality (ACMQ) is the organization for healthcare professionals responsible for providing leadership in quality and safety outcomes, who want or need the tools, experience, and expertise to improve the quality and safety of patient care. Membership in ACMQ provides a gateway to resources, programs, and professional development opportunities and a greater recognition of quality issues by the entire healthcare field.

    About Wolters Kluwer

    Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

    Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Chlorhexidine Disinfectant May Perform Best in Killing Bone Tumor Cells After Surgery

    Chlorhexidine Disinfectant May Perform Best in Killing Bone Tumor Cells After Surgery

    Newswise — October 28, 2022 – The widely used disinfectant chlorhexidine gluconate (CHG) appears to be the most effective irrigation solution for use as part of the surgical treatment of bone tumors, suggests an experimental study in The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

    Of the various solutions used to eliminate remaining tumor cells after surgery, a 0.05% CHG solution appears to be most effective in killing cultured bone tumor cells, according to the laboratory study by Matthew J. Thompson, MD, of the University of Washington, Seattle, and colleagues.

    CHG shows highest cytotoxicity against chondrosarcoma and giant cell tumors

    Some patients with bone tumors undergo a surgical procedure called intralesional curettage. In this procedure, the tumor is scraped away while preserving as much healthy bone as possible. A common adjuvant treatment is to irrigate the operative area of the bone with some kind of chemical solution. This irrigation is performed to reduce the number of remaining cells that could potentially lead to tumor recurrence and reseeding.

    Several different solutions have been used for irrigation of the tumor bed, including saline, ethanol, and various disinfectants. Dr. Thompson and colleagues performed a series of experiments to determine which of these solutions has the greatest cytotoxic (cell-killing) effects against bone tumor cells.

    The experiments used cultures of two types of bone tumors: giant cell tumor, a benign but aggressive tumor; and chondrosarcoma, a type of bone cancer. Tumor cell cultures were treated with one of six different solutions – sterile water, 0.9% saline, 70% ethanol, 3% hydrogen peroxide, 0.05% CHG, and 0.3% povidone-iodine. Cytotoxicity was compared for the different treatments.

    Of the six treatments, only CHG had cell-killing effectiveness equivalent to a control solution with 100% cytotoxicity, and this outcome was observed regardless of the treatment period (i.e., 2 minutes or 5 minutes).

    None of the other solutions approached the cell-killing effectiveness of CHG. Only two solutions (sterile water and hydrogen peroxide) were superior to a control treatment with low cytotoxicity. The other three solutions tested – saline, ethanol, and povidone-iodine – showed little or no cytotoxicity.

    Chlorhexidine is a familiar disinfectant with various medical uses, including as a topical antiseptic agent before surgery. The researchers write, “[CHG] is commonly used and readily available, with demonstrated in vivo safety in other surgical applications and a lower predicted toxicity compared with some currently used agents.”

    The new study shows that CHG is highly effective in killing bone tumor cells – at least under laboratory conditions. “Therefore, the use of a 0.05% CHG solution clinically could serve as a potential chemical adjuvant during intralesional curettage of chondrosarcoma and [giant cell tumors],” Dr. Thompson and coauthors conclude.

    The researchers emphasize that further studies will be needed to evaluate the outcomes of CHG irrigation in patients undergoing surgery.  Dr. Thompson comments: “We believe it is important to continue to explore better ways to achieve durable local control of benign aggressive tumors like giant cell tumor of bone, which are associated with a high risk of local recurrence when treated with conventional extended intralesional curettage.”

    Read [Cytotoxic Effects of Common Irrigation Solutions on Chondrosarcoma and Giant Cell Tumors of Bone]

    DOI: 10.2106/JBJS.22.00404

    ###

    About The Journal of Bone & Joint Surgery

    The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.

    About Wolters Kluwer

    Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

    Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,800 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link

  • Is ‘frozen shoulder’ a genetic condition? Study finds links to specific genes

    Is ‘frozen shoulder’ a genetic condition? Study finds links to specific genes

    Newswise — October 14, 2022 – Frozen shoulder, or adhesive capsulitis, is a common cause of shoulder pain and immobility. New findings point to specific genes associated with an increased risk of this condition, reports The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

    The risk genes are associated with nearly a sixfold increase in the odds of developing frozen shoulder – a stronger association for most known clinical risk factors, according to the new research by Mark T. Langhans, MD, PhD, of Hospital for Specialty Surgery, New York. The authors believe their findings may lend new insights into the causes, prevention, and treatment of adhesive capsulitis.

    Genome-wide association study finds ‘significant loci’ affecting frozen shoulder risk

    Patients with adhesive capsulitis develop painful and progressive loss of shoulder motion with associated pain. Frozen shoulder is one of the most common shoulder conditions, occurring in up to 10% of people at some time in their lives. Although the exact cause is unclear, frozen shoulder sometimes occurs after an injury, surgery, or other condition that reduces shoulder mobility. Loss of motion results from fibrosis (scarring or thickening) of the capsule around the shoulder joint.

    Certain clinical factors are associated with an increased risk of frozen shoulder, including diabetes, thyroid disease, and smoking. Recent studies have suggested that risk is also higher in people with affected relatives – suggesting a possible genetic predisposition. Dr. Langhans and colleagues performed a genome-wide association study to identify specific genes that might be related to the risk of frozen shoulder.

    Data studied from large British database

    The study used data from a large British database, the UK Biobank, which includes genetic and health data on approximately 500,000 patients. The analysis focused on 2,142 patients with adhesive capsulitis compared to those without this diagnosis. Possible genetic associations were adjusted for other factors, including sex, diabetes, thyroid disease, history of shoulder dislocation, and smoking.

    The study identified three significant loci for frozen shoulder. The strongest association was found for gene variants located at a site called WNT7B. This finding was consistent with previous studies that reported a possible link between WNT7B and frozen shoulder, along with several other orthopaedic-related conditions. Weaker associations were also found for two previously unreported genetic loci located near genes for POU1F1 and MAU2.

    All three associations remained significant after adjustment for other factors. Together, the three variants carried nearly a sixfold increase in the odds of developing frozen shoulder. That was greater than the risk associated with diabetes (about four-fold) or thyroid disease (less than two-fold), and second only to smoking (about 11-fold).

    New insights could lead to a new development

    The findings may lend new insights into the development of adhesive capsulitis. In particular, genes located at WNT7B have been shown to be expressed in bone-forming cells (osteoblasts) and to be involved in regulating fibrosis, along with a wide range of other functions. The two newly reported loci, POU1F1 and MAU2, are involved with cell division, which might lend clues into the cellular mechanism by which frozen shoulder develops.

    The researchers note some key limitations of their analysis, including the need for further studies of genetic associations in groups other than the white, British population that predominates in the UK Biobank.

    Meanwhile, the new study identifies several gene loci with the ability to predict a clinically relevant risk of frozen shoulder. Dr. Langhans and colleagues conclude: “Refining the genetic risk metric and including it in a larger clinical model could allow patients at risk for future adhesive capsulitis to be identified, leading to efforts at prevention, early diagnosis, and ultimately improved outcomes.”

    Click here to read “Genome-Wide Association Study of Adhesive Capsulitis Suggests Significant Genetic Risk Factors“

    DOI: 10.2106/JBJS.21.01407

    ###

    About The Journal of Bone & Joint Surgery

    The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.

    About Wolters Kluwer

    Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

    Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,800 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

    Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

    For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

    Wolters Kluwer Health: Lippincott

    Source link