Philadelphia, Pa. (March 22, 2013) –  Every five years, the Crohn’s & Colitis Foundation of America (CCFA) gathers top researchers in inflammatory bowel disease (IBD) to set the research agenda for the next five years.  The findings and recommendations of these expert workgroups are presented in a series of detailed “Challenges in IBD Research” reports, now available in Inflammatory Bowel Diseases, official journal of the CCFA.  The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Each workgroup is assigned to specific topic areas including genetics, epidemiology and environmental factors, the “microbiome” (intestinal bacteria), epithelial cell biology, innate and adaptive immunity, clinical classification and prognostic models, and optimizing medical therapy.  A special “Challenges in IBD Research” progress report appears in the March issue of Inflammatory Bowel Diseases.  The complete workgroup reports are available for direct download at http://links.lww.com/IBD/A77.

Experts Outline New Agenda for IBD Research

Based on a thorough review in each area, the workgroups have defined key research priorities for the next few years, including:

• Defining clinically relevant subgroups of IBD patients—using different types of information to predict aggressiveness of disease, complications, and response to treatment.
• Understanding the environmental factors affecting the risk and course of IBD—including environmental “triggers” and a specific focus on the role of diet.
• Clarifying the complex interrelationships among genes, bacteria, and epithelial and immune responses—focusing on cellular pathways and critical cell types that may lead to new “therapeutic targets.”
• Determining the optimal treatment approaches and strategies through comparative effectiveness studies.

The workgroup reports also identify the resources needed to carry out this ambitious research agenda, including a “centralized and distributable infrastructure” for integrated studies of IBD in humans and long-term follow-up studies of children and adults with IBD.

“Through development of the ambitious research goals outlined in this document, the Crohn’s & Colitis Foundation of America has again led the effort to further the understanding of IBD,” said Dr. Lee Denson of Cincinnati Children’s Hospital Medical Center.  “CCFA is keen to advance this research agenda in 2013 and beyond.”

Building on Recent Scientific and Clinical Advances

The CCFA research agenda builds on recent advances in scientific and clinical research.  They include major strides in IBD genetics—more than 160 genes affecting susceptibility to Crohn’s disease and ulcerative colitis have now been identified. Using sophisticated techniques, researchers have gained new insights into the complex interactions between intestinal bacteria and immune responses, including the role of specific types of immune cells.

Clinical studies have improved the ability to predict the response to IBD treatment in children and to track the short- and long-term adverse effects of IBD treatments.  Progress has also been made in understanding the risks and benefits of medical and surgical treatments for key patient subgroups, including pregnant women and newborns.  These studies point the way toward future efforts to optimize treatment for individual patients with IBD.

About Inflammatory Bowel Diseases

Inflammatory Bowel Diseases brings the most current information in clinical and basic sciences to physicians caring for patients with inflammatory bowel diseases, and investigators performing research in IBD and related fields. Each issue contains cutting-edge original basic science and clinical articles on diagnosis, treatment, and management of IBD from clinicians and researchers around the world. Coverage includes articles highlighting the unique and important issues in pediatric IBD, as well as articles pertaining to adult patients.

About the CCFA

The Crohn’s & Colitis Foundation of America is a non-profit, volunteer-driven organization dedicated to finding the cures for Crohn’s Disease and ulcerative colitis. It was founded in 1967 by Irwin M. and Suzanne Rosenthal, William D. and Shelby Modell, and Henry D. Janowitz, M.D.  Since our founding over four decades ago, CCFA has remained at the forefront of research in Crohn’s disease and ulcerative colitis. Today, we fund cutting-edge studies at major medical institutions, nurture investigators at the early stages of their careers, and finance underdeveloped areas of research.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes.

LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2012 annual revenues of €3.6 billion ($4.6 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

Study in AIDS Journal Uses Advanced Mapping Techniques to Assess Role of ‘Spatial Accessibility’

Philadelphia, Pa. (December 4,  2012) – Road networks and geographic factors affecting “spatial accessibility” have a major impact on the spread of HIV across sub-Saharan Africa, according to a study published online by the journal AIDS, official journal of the International AIDS Society. AIDS is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Using sophisticated mapping techniques and detailed databases, Dr Andrew J. Tatem of the University of Florida and colleagues have found “coherent spatial patterns in HIV-1 subtype distributions” across Africa.  The researchers write, “A comprehensive understanding and evidence-base on accessibility, travel and mobility in resource poor settings would…provide a valuable resource for the strategic planning of disease control.”  The article is available on the AIDS journal homepage and in the November 28 print edition. 

Molecular HIV Data Overlaid on Spatial Accessibility Maps…

Dr Tatem and his team performed a spatial analysis of the distribution of HIV for the years 1998 to 2008 to explore the impact of transportation networks and geography on the spread of HIV.  Molecular data on specific HIV subtypes were obtained and analyzed in relation to “detailed and complete” spatial datasets on Africa-wide road networks.

In addition to roads, the data included a wide range of factors affecting “spatial accessibility,” such as land cover, settlement locations, bodies of water, and topography.  Sophisticated models were used to calculate not just the distance between locations, but also the ease of traveling from one place to another.

Even simply laying a chart of HIV subtypes over a map of travel times between settled areas makes the link between spatial accessibility and HIV subtype “clearly evident.”  Dr Tatem and coauthors write, “[C]lusters of similar subtype distributions are well connected and easily accessible from one another, whereas regions of low accessibility separate groupings of similar subtype distributions.” 

…Show Role of Travel in Spread of HIV Subtypes

Transport networks and ease of travel—rather than the straight-line distances between locations—provided a much better explanation for the distribution of HIV subtypes.  The data showed clustering of certain subtype distributions in well-connected regions—such as the western, eastern, and southern Africa and Ethiopia—that are separated by areas of “limited connectivity.”

In contrast, the difficulty of travel in certain areas of central Africa likely restricted the spread of HIV, the researchers suggest.  “The relatively poor connectivity in central Africa likely contributed to the slow initial growth of the epidemic in the first half of the 20th century,” according to Dr Tatem and colleagues.  The same factor may explain why HIV rates remained relatively low in central Africa, while soaring elsewhere.

Although the study has some important limitations, it adds important evidence for understanding how transport infrastructure and geography have affected—and will continue to affect—the spread of HIV.  The authors hope that the modeling techniques used can be extended to map cultural and other factors affecting HIV subtype distribution and transmissibility.  More accurate data on “actual volumes and flows of human travel” could also lend new insights.

“The increased travel and mobility of people may lead to the accelerated spread of new variants and the further diversification of the global HIV epidemic,” Dr Tatem and coauthors write.  They believe that ongoing efforts to monitor the spread of HIV subtypes could have important implications for developing effective prevention and treatment strategies.

About AIDS

AIDS publishes the very latest ground-breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals.  With 18 issues per year, AIDS guarantees the authoritative presentation of even more significant advances. The Editors, themselves noted international experts who know the demands of HIV/AIDS research, are committed to making AIDS the most distinguished and innovative journal in the field.   Visit the journal website at www.aidsonline.com.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

Philadelphia, Pa. (November 27, 2012) – A test to detect brain amyloid deposits associated with Alzheimer disease (AD) provides doctors with useful information on treatment and further testing for patients with cognitive impairment, according to a study published online by the journal Alzheimer Disease & Associated Disorders. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Positron emission tomography (PET) scans using a biomarker called florbetapir F18 can show amyloid plaques in the brain—a characteristic feature of AD.  “Amyloid imaging results altered physicians’ diagnostic thinking, intended testing and management of patients undergoing evaluation for cognitive decline,” according to the study by Dr Mark Mintun of Avid Pharmaceuticals, Philadelphia, and colleagues.

Is It Alzheimer Disease?  Florbetapir Scan Provides Evidence

The researchers designed a “real-world” study to determine how florbetapir would affect clinical management of patients with cognitive impairment.  While a florbetapir PET scan showing amyloid plaques doesn’t prove that AD is present, it provides a previously unavailable piece of evidence to support the diagnosis.

The study included 229 patients seen by neurologists or other specialists for evaluation of cognitive decline or impairment of uncertain etiology.  Before the florbetapir PET scan, doctors provided a provisional diagnosis, an estimate of their diagnostic confidence, and their plans for further testing and treatment.  The goal was to assess the value of florbetapir PET in making the final diagnosis and in providing doctors with useful information for clinical decision making.

The florbetapir PET scans showed amyloid deposits in 113 out of 229 patients.  The information provided led doctors to change their diagnosis in 55 percent of cases. 

When the provisional diagnosis was AD, imaging results led to a change in diagnosis in 37 percent of cases.  When the pre-scan diagnosis was either “indeterminate” or another cause of dementia, the diagnosis changed in over 60 percent of cases.   In either direction, the scans increased the physicians’ ratings of diagnostic confidence by about 20 percent.

Impact on Treatment and Testing Decisions

Florbetapir PET also provided useful information for treatment decision-making:  in 87 percent of patients, the results contributed to at least one change in the treatment plan.  The main impact was in deciding whether or not to use medications that are helpful in AD.  The scan results also affected decisions on further testing—in many cases, physicians dropped plans to perform additional brain imaging studies or neuropsychological tests.

Alzheimer disease is the most common cause of dementia, but the diagnosis can be challenging to make.  The only definitive way to diagnose AD is by autopsy examination of the brain after death.  Up to 20 percent of patients diagnosed with AD turn out not to have had AD on autopsy, while up to 40 percent of patients diagnosed with other causes of dementia have evidence of AD at autopsy.

Florbetapir PET is the first FDA-approved imaging that can estimate amyloid deposits in the brain of a living patient.  Previous studies have shown that the scans are accurate in identifying patients later shown to have AD at autopsy.

The new results show that florbetapir PET scans can have a significant effect in “real world” clinical evaluation of patients with cognitive impairment.  By strengthening the case for or against a diagnosis of AD, this test can have a significant impact on patient management—particularly related to the use of AD medications and the need for further testing.  Additional studies will be needed to confirm whether “clinical care that includes amyloid imaging will translate into better outcomes” for patients with cognitive impairment and possible AD.

About Alzheimer Disease & Associated Disorders

Alzheimer Disease & Associated Disorders is a leading international forum for reports of new research findings and new approaches to diagnosis and treatment. Contributions fall within all relevant scientific fields and clinical specialties, including neurobiology, neurochemistry, molecular biology, neurology, neuropathology, neuropsychology, psychiatry, gerontology, and geriatrics.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

New York, NY (August 27, 2012) – Wolters Kluwer Health and the Crohn’s & Colitis Foundation of America, Inc. (CCFA) announced today an agreement to publish Inflammatory Bowel Diseases. Effective with the January 2013 issue, Lippincott Williams & Wilkins (LWW), part of Wolters Kluwer Health, will be the journal’s publisher of record.

Inflammatory Bowel Diseases® (IBD), the official journal of the CCFA, is the first journal dedicated exclusively to IBD. The journal covers topics of interest to the professional clinician or researcher in this burgeoning field with original, peer-reviewed articles in clinical and basic science areas, as well as invited in-depth reviews of key treatment issues and groundbreaking research. IBD covers the unique and important issues in pediatric IBD, as well as articles pertaining to adult patients.

“We are delighted to be selected by the highly regarded Crohn’s & Colitis Foundation of America as the publisher of IBD journal,” said Karen Abramson, President & CEO of Wolters Kluwer Health Medical Research. “IBD is a leading journal and critical resource among gastroenterology practitioners. Our partnership with the CCFA will help them to expand the journal’s reach and impact globally, and engage new and existing CCFA members through innovative publishing solutions and strategies.”

“The CCFA chose to partner exclusively with Wolters Kluwer Health and are excited about our partnership to elevate IBD’s impact globally,” said Marjorie Merrick, Vice President of Research and Scientific Programs at the CCFA.  “The LWW publishing team has taken a leadership position in innovating digital journal strategies, and we believe this is the best team to further develop and advance IBD as a leading resource accessible to our members and practitioners when and where they need access to inform clinical decisions and patient care.”

IBD is currently available for institutional access exclusively through Ovid’s medical research platform, OvidSP, used by more than 12,000 institutions globally. Ovid is part of Wolters Kluwer Health.

About CCFA

The Crohn’s & Colitis Foundation of America (CCFA) is the largest voluntary nonprofit health organization dedicated to finding cures for Inflammatory Bowel Diseases (IBD). CCFA’s mission is to cure Crohn’s disease and ulcerative colitis, and to improve the quality of life of children and adults who suffer from these diseases. The Foundation works to fulfill its mission by funding research, providing educational resources for patients and their families, medical professionals, and the public, and furnishing supportive services for those afflicted with IBD. For more information, visit www.ccfa.org,

About Wolters Kluwer Health and Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

Philadelphia, Pa. (August 7, 2012) – Patients using cholesterol-lowering statin drugs may be at increased risk of developing age-related cataracts, according to a study - “Age-related Cataract Is Associated with Type 2 Diabetes and Statin Use”, in the August issue of Optometry and Vision Science, official journal of the American Academy of Optometry.  The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

While further research is needed to understand the true nature of the association, the additional risk of cataracts in statin users appears similar to that associated with type 2 diabetes, according to the study by Carolyn M. Machan, OD, and colleagues of University of Waterloo, Ont., Canada.

Statins and Diabetes Both Increase Cataract Risk

The study included nearly 6,400 patients seen at the optometry clinic at the University of Waterloo in 2007-08.  Of these, 452 patients had type 2 diabetes.  Statin treatment and diabetes were evaluated as possible risk factors for age-related cataracts, controlling for other factors including sex, smoking, and high blood pressure.

Fifty-six percent of patients with type 2 diabetes were taking statins, compared to 16 percent of those without diabetes.  Both diabetes and statin use were significantly associated with an increased rate of age-related cataracts.

With adjustment for other factors, diabetes was associated with an 82 percent increase in cataract risk and statin use with a 57 percent increase.  Statistically, the increase in cataract risk associated with statins was similar to that associated with diabetes.

The associations differed for different types of cataracts.  For one specific type long linked to diabetes (posterior subcapsular cataract), the association with diabetes was no longer significant after adjustment for statin treatment.

Despite the high rate of statin use among patients with diabetes, the two risk factors appeared independent of each other.  At older ages, the risk of cataracts increased fastest in diabetic patients who took statins and slowest in nondiabetic patients who did not take statins.  On average, cataracts developed 5.6 years earlier in diabetic patients who took statins, compared to nondiabetic patients who did not take statins.

Type 2 diabetes is a known risk factor for the development of age-related cataracts—a common vision problem caused by clouding of the crystalline lens of the eye.  Studies in animals have shown a clear link between long-term treatment with statins (at high doses) and cataracts.

The new study suggests that statins may also be linked to cataracts in humans.  The authors emphasize that the study can’t prove that statins play any role in causing cataracts, but suggest that such a link is biologically plausible.

While further studies are needed, Dr Machan and colleagues emphasize that the known benefits of statin treatment for patients with type 2 diabetes probably outweigh any increased risk of cataracts.  They believe their results will help to increase awareness of the risks of treatments for type 2 diabetes, and may encourage the development of alternative cholesterol-lowering drugs that are not associated with an increased risk of cataracts.

Anthony Adams, OD, PhD, Editor-in-Chief of Optometry and Vision Science, comments, “Considering the increase in the prevalence of diabetes and the corresponding increase in the use of statins, the authors feel these findings serve to encourage further research on the long-term effect of statins on the human crystalline lens.”

To read the article “Age-related Cataract Is Associated with Type 2 Diabetes and Statin Use”, please visit http://journals.lww.com/optvissci/Fulltext/2012/08000/Age_Related_Cataract_Is_Associated_with_Type_2.12.aspx 

About Optometry and Vision Science

Optometry and Vision Science, official journal of the American Academy of Optometry, is the most authoritative source for current developments in optometry, physiological optics, and vision science. This frequently cited monthly scientific journal has served primary eye care practitioners for more than 75 years, promoting vital interdisciplinary exchange among optometrists and vision scientists worldwide.

About the American Academy of Optometry

Founded in 1922, the American Academy of Optometry is committed to promoting the art and science of vision care through lifelong learning.  All members of the Academy are dedicated to the highest standards of optometric practice through clinical care, education or research.

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com

Philadelphia, Pa. (July 11, 2012) – Specific types of “mindfulness practices” including Zen meditation have research-proven benefits for patients with certain physical and mental health problems, according to a report in the July Journal of Psychiatric Practice.  The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

“An extensive review of therapies that include meditation as a key component—referred to as mindfulness-based practices—shows convincing evidence that such interventions are effective in the treatment of psychiatric symptoms and pain, when used in combination with more conventional therapies,” according to Dr William R. Marchand of the George E. Wahlen Veterans Affairs Medical Center and the University of Utah in Salt Lake City.

Mindfulness Techniques Show Health Benefits

Dr Marchand reviewed published studies evaluating the health benefits of mindfulness-based practices.  Mindfulness has been described as “the practice of learning to focus attention on moment-by-moment experience with an attitude of curiosity, openness, and acceptance.”  Put another way, “Practicing mindfulness is simply experiencing the present moment, without trying to change anything.”

The review focused on three techniques:

• Zen meditation, a Buddhist spiritual practice that involves the practice of developing mindfulness by meditation, typically focusing on awareness of breathing patterns.
• Mindfulness-based stress reduction (MBSR), a secular method of using Buddhist mindfulness, combining meditation with elements of yoga and education about stress and coping strategies.
• Mindfulness-based cognitive therapy (MBCT), which combines MBSR with principles of cognitive therapy (for example, recognizing and disengaging from negative thoughts) to prevent relapse of depression.

Dr Marchand found evidence that MBSR and MBCT have “broad-spectrum” effects against depression and anxiety and can also decrease general psychological distress.  Based on the evidence, MBCT can be “strongly recommended” as an addition to conventional treatments (adjunctive treatment) for unipolar depression.  Both MBSR and MBCT were effective adjunctive treatments for anxiety.

Research data also supported the effectiveness of MBSR to help reduce stress and promote general psychological health in patients with various medical and/or psychiatric illnesses.   On its own, MBSR was helpful in managing stress and promoting general psychological health in healthy people.  There was also evidence that Zen meditation and MBSR were useful adjunctive treatments for pain management. 

How do these practices work to affect mental and physical health?  Dr Marchand discusses recent research showing the impact of mindfulness practices on brain function and structure, which may in part account for their psychological benefits.  “These mindfulness practices show considerable promise and the available evidence indicates their use is currently warranted in a variety of clinical situations,” he concludes.

The article includes some proposed evidence-based guidelines for incorporating mindfulness-based practices into health care.  So far there’s little evidence on which patients are most likely to benefit, but Dr Marchand suggests that patient preferences and enthusiasm are a good guide.  He comments, “The most important considerations may be desire to try a mindfulness-based practice and willingness to engage in the regular practice of seated meditation.”

About Journal of Psychiatric Practice

Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs—readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients.  Mental health professionals will want access to this review journal­—for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field.  Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative “how to” tips for surviving in a managed care environment

About Lippincott Williams & Wilkins

Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes. LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).

Contacts:

Robert Dekker
Director of Communications
Wolters Kluwer Health
+1 (215) 521-8928
Robert.Dekker@wolterskluwer.com

Connie Hughes
Director, Marketing Communications
Wolters Kluwer Health Medical Research
+1 (646) 674-6348
Connie.Hughes@wolterskluwer.com