Teens with High Blood Pressure Have Less Distress, Better Quality of Life

Posted on May 3, 2013

German Study in Psychosomatic Medicine Has Surprising Findings on Hypertension in Adolescents

Philadelphia, Pa. (May 3, 2012) – Teenagers with high blood pressure appear to have better psychological adjustment and enjoy higher quality of life than those with normal blood pressure, suggests a study in the May issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine, the official journal of the American Psychosomatic Society. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

“This is the first report linking elevated blood pressure to quality of life and psychosocial adaptation in a large epidemiological study of adolescents,” according to the report by Dr Angela Berendes of University of Göttingen, Germany, and colleagues. The authors speculate on some possible reasons for their surprising results—including “repressed emotions” or even a “stress-dampening effect” of high blood pressure (hypertension).

High Blood Pressure Linked to Better Quality of Life in Teens

The researchers analyzed data on blood pressure, quality of life, and psychological distress in approximately 7,700 teenagers from a German nationwide study. Overall 10.7 percent of the teens had high blood pressure—a rate about twice as high as expected.

Not surprisingly, adolescents with hypertension were more likely to be obese and less physically fit than those with normal blood pressure. They spent more time watching TV or playing video games and had more adverse health behaviors, including alcohol consumption.

But unexpectedly, teens with high blood pressure were better off in several ways—including being more academically successful than those with normal blood pressure. Quality of life was also rated better by adolescents with high blood pressure, with higher scores in the areas of family life, self-esteem, and physical well-being.

The difference in quality of life remained significant after adjustment for other factors, and was supported by parental ratings of fewer emotional, conduct, and other problems. Teens with high blood pressure were also less likely to have problems with hyperactivity.

Associations May Reflect High Achievement, Repressed Emotions, or…?

High blood pressure is one of the most frequent chronic conditions, leading to high rates of illness and death. It can remain asymptomatic for years, causing blood vessel and organ damage if not detected and controlled.

Hypertension may start in childhood and adolescence, persisting into adulthood. Previous studies have found lower levels of psychological distress in adults who have high blood pressure but are unaware of it. In contrast, quality of life appears to be reduced for patients whose hypertension is diagnosed and treated.

The new study finds similar, “seemingly contradictory” results in adolescents. Although their study can’t conclusively explain the associations, Dr Berendes and coauthors discuss some possible theories:

Teens who are more achievement-oriented and do better in school may experience increased stress, leading to higher blood pressure—but also to better self-esteem and quality of life.
Some teens may repress their negative emotions, causing them to have higher blood pressure—as well as to give higher ratings of psychological functioning and quality of life.
High blood pressure may actually act to dampen negative emotions—some studies have suggested that a rise in blood pressure may reduce perceived stress.

Whatever the explanations, the new study finds highly consistent links between high blood pressures, lower distress, and higher quality of life, suggesting “a real and epidemiologically relevant association,” Dr Berendes and coauthors conclude. More research is needed to clarify the study implications—particularly in young patients who are unaware of and have yet to experience long-term damage related to high blood pressure.

About Psychosomatic Medicine

Psychosomatic Medicine, Journal of Biobehavioral Medicine, founded in 1939, is the official peer-reviewed journal of the American Psychosomatic Society. It publishes experimental and clinical studies dealing with various aspects of the relationships among social, psychological, and behavioral factors and bodily processes in humans and animals. Psychosomatic Medicine, Journal of Biobehavioral Medicine is an international, interdisciplinary journal devoted to experimental and clinical investigation in behavioral biology, psychiatry, psychology, physiology, anthropology, and clinical medicine. The print journal is published nine times a year; most articles are published online ahead of print.

About the American Psychosomatic Society

The mission of the American Psychosomatic Society is to promote and advance the scientific understanding and multidisciplinary integration of biological, psychological, behavioral and social factors in human health and disease, and to foster the dissemination and application of this understanding in education and health care.

The American Psychosomatic Society is a worldwide community of scholars and clinicians dedicated to the scientific understanding of the interaction of mind, brain, body and social context in promoting health. The organization is devoted to biopsychosocial research and integrated clinical care, and to providing a forum via its website, Annual Meeting and journal, Psychosomatic Medicine, for sharing this research. Its members are from around the world, including specialists from all medical and health-related disciplines, the behavioral sciences, and the social sciences.

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

Violent Video Games Have Lower Effects on Highly-Exposed Teens

Posted on May 3, 2013

Boys Who Frequently Play Violent Games May Be Desensitized to Physiological and Emotional Effects, Suggests Study in Psychosomatic Medicine

Philadelphia, Pa. (May 3, 2013) – Teenagers who are highly exposed to violent video games—three or more hours per day—show blunted physical and psychological responses to playing a violent game, reports a study in the May issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine, the official journal of the American Psychosomatic Society. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

“High versus low experience of violent gaming seems to be related to different physiological, emotional and sleep related processes [after] exposure to violent video games,” concludes the paper by Malena Ivarsson of the Stress Research Institute at Stockholm University and colleagues.

Exposure Affects Teens’ Heart Rate Responses to Violent Games

The experimental study included two groups of boys, aged 13 to 15, with differing exposure to violent video games. Fifteen boys were highly exposed to violent gaming, playing at least three hours per day. The other fifteen had low exposure, no more than one hour per day.

The researchers monitored the boys’ reactions to playing two different video games: a violent game (“Manhunt”) and a nonviolent cartoon game (“Animaniacs”). The boys played the games at home, on two different evenings, for two hours each. Physiological, emotional, and sleep reactions to the two games were compared for boys with high versus low exposure.

Although there were few differences in reactions during the time spent playing the games, some significant differences appeared later. While sleeping later that night, boys in the low-exposure group had faster heart rates after playing the violent game, compared to the night after playing the nonviolent game. In contrast, for boys in the high-exposure group, heart rate was lower on the night after playing the violent game.

There were also some significant differences in heart rate variability (HRV), which measures beat-to-beat variations in heart rate. The patterns of HRV differences suggested blunting of sympathetic nervous system reactions among boys in the high-exposure group.

Emotional and Sleep Responses Also Affected

On sleep questionnaires, low-exposed boys also reported lower sleep quality on the night after playing the violent game, compared to the nonviolent game. For high-exposed boys, there was no difference in sleep quality after playing the two games. After playing the violent game, the low-exposed boys reported increased feelings of sadness.

Both groups had higher anxiety and stress levels after playing the violent game. “The violent game seems to have elicited more stress at bedtime in both groups and it also seems as if the violent game in general caused some kind of exhaustion,” Ivarsson and colleagues write. “However, the exhaustion didn’t seem to be of the kind that normally promotes good sleep, but rather as a stressful factor that can impair sleep quality, especially for low exposed gamers.”

Previous studies have shown that playing violent video games can induce anger and aggressive behavior, as well as sleep problems. Heart rate and HRV are useful indicators of physical reactions to stress and emotions—mediated through sympathetic nervous system responses. “Both types of violence-related psychophysiologic outcomes probably reflect increased sympathetic activation,” according to the authors.

The differences between groups may represent a desensitizing effect of frequent exposure to violent video games, the researchers speculate—although it’s also possible that boys with certain traits may be attracted to violent games. Ivarsson and coauthors note they had difficulty in finding and recruiting boys with high exposure to violent gaming to participate in the study.

The study adds to previous evidence that playing violent video games can affect sympathetic nervous system activity and physiological responses, which “proceed concurrently” with emotional and sleep responses. It adds the new information that these responses are different for appear to differ for youth with high versus low exposure to such games. The authors call for further study to “chisel out” the mechanisms of the responses, and to see if they’re linked to behavior changes related to violent gaming.

About Psychosomatic Medicine

About the American Psychosomatic Society

About Lippincott Williams & Wilkins

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

Posted in All Medicine, Psychiatry, Psychology and Addiction Medicine, Publications | Leave a comment

Contacts Uncomfortable? Changing Lens Type or Lens Care Product May Help

Posted on May 2, 2013

About Half of Patients See Improvement by Switching to a Different Lens/Solution Combination, Says Study in Optometry and Vision Science

Philadelphia, Pa. (May 1, 2013) – If your contact lenses are causing you discomfort, simply switching to a different type of contact lens or lens care product may bring improvement, reports a study, “Effect of Lens and Solution Choice on the Comfort of Contact Lens Wearers”, appearing in the May 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.

“Ocular comfort and symptoms in symptomatic contact lens wearers can be perceptibly improved by switching to an alternative contact lens-lens care product combination,” write Daniel Tilia, BOptom (Hons), MOptom, of Brien Holden Vision Institute, Sydney, and colleagues. Their study provides scientific support for a clinical approach commonly recommended by eye care professionals.

Experiment Tests Common Approach to Contact Lens Discomfort

The study included two groups of contact lens wearers: 24 patients who had discomfort related to their contact lenses at least part of the day—typically toward the end of the day—and 13 without symptoms. In random order, patients were assigned to use two different contact lens/lens care product combinations.

Based on previous studies, the combinations were ranked as providing the best (combination 1) and worst (combination 2) performance in terms of end-of-day comfort. Patients used each combination for eight days, without knowledge of which combination they were using. They then rated contact lens comfort and other symptoms during the two periods.

Patients with contact lens-related symptoms rated combination 1 more comfortable than combination 2. After eight hours of wear, the difference in ocular comfort (on a 10-point scale) was small but significant: 7.7 for combination 1 versus 7.1 for combination 2. Patients in the symptomatic group also rated combination 1 superior in reducing dry eyes and awareness of contact lenses in the eye.

In contrast, for patients who did not have symptoms before the study, there were no significant differences in ratings of the two combinations. For this asymptomatic group, scores were about the same with either the “most-comfortable” or “least-comfortable” combination.

Switching Improves Symptoms in About Half of Patients

Ocular discomfort is a common complaint among patients with contact lenses, and may contribute to the relatively low percentage of people wearing contact lenses for vision correction. “Properties of the lenses, organic deposits on worn lenses, and even the properties of the solutions used to clean lenses, are often blamed for this,” comments Anthony Adams, OD, PhD, Editor-in-Chief of Optometry and Vision Science.

Eye care professionals will often switch the contact lens, type of lens care product, or both, in an attempt to improve comfort. However, it has been unclear how well this common approach works. “Clinicians and researchers are always trying to achieve comfort levels comparable to not wearing contact lenses,” Dr Adams adds.

The new study was designed to evaluate the amount of improvement that might reasonably be expected by switching contact lenses and lens care products. The results indicate that “roughly half” of patients with contact lens-related symptoms have improved comfort by switching to a different lens/solution combination.

However, Tilia and coauthors note that, even with the improvement, discomfort still increases toward the end of the day. They call for continued efforts by eye care professionals and researchers to eliminate this persistent problem and provide “a maximally comfortable result,” for patients who wear contact lenses.

To read the article, “Effect of Lens and Solution Choice on the Comfort of Contact Lens Wearers”, please visit http://journals.lww.com/optvissci/Fulltext/2013/05000/Effect_of_Lens_and_Solution_Choice_on_the_Comfort.3.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

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

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Breast Augmentation Patients Report High Satisfaction Rates, Says Study in Plastic and Reconstructive Surgery

Posted on May 2, 2013

New Evidence on What Women Can Expect after Breast Augmentation Surgery

Philadelphia, Pa. (May 1, 2013) – Ninety-eight percent of women undergoing breast augmentation surgery say the results met or exceeded their expectations, according to a prospective outcome study published in the May issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Women also report improvements in self-esteem and quality of life after breast augmentation, according to the study by ASPS Member Surgeon Dr. Eric Swanson, a plastic surgeon in private practice in Leawood, Kan. The study adds high-quality information regarding expected outcomes after breast augmentation—including recovery time and psychological benefits.

98 Percent of Women Satisfied with Breast Augmentation Results

The survey study evaluated 225 consecutive women who returned for interviews at least one month after breast augmentation over a five-year period. Interviews included questions about the recovery, results, complications and psychological effects.

The average patient was 34 years old, and the majority of women received saline-filled breast implants placed under the muscle. The average implant volume was 390 cc.

On a 10-point scale, the women reported an average pain score during recovery of 5.9. On average, they used prescription pain medication for five days and were off work seven days. Patients felt they were “back to normal” about 25 days after surgery.

Eighty-five percent of women rated their new breast size “just right.” Thirteen percent would have preferred a larger size and less than two percent a smaller size. Only one percent expressed dissatisfaction with their scars, which were usually located in the crease under the breast. Seventy-five percent of women rated their breast firmness “just right.” When asked to rate the result, over half of the patients gave it a perfect 10 on a scale of 1 to 10. Almost all patients (98 percent) reported that the results met or exceeded their expectations.

Increased Self-Esteem and Other Psychological Benefits

Nearly 40 percent of the women surveyed experienced at least temporary nipple numbness after surgery. Persistent numbness was reported by only two percent. The complication rate reported by patients was 10 percent. When asked about psychological effects, 92 percent of women reported improved self-esteem after breast augmentation and 64 percent reported an improved quality of life. Before surgery, the majority of women (86 percent) were self-conscious about their breasts. After surgery, only 13 percent were self-conscious about them.

Breast augmentation is the most popular cosmetic surgery procedure in the United States—approximately 286,000 operations were performed in 2012, according to ASPS statistics. The study results provide new information for women considering breast augmentation, particularly in terms of their expectations of the recovery and results. “This study is valuable in providing information from the patient’s perspective, not the surgeon’s,” according to Dr. Swanson. “Patient satisfaction is the most important measure of surgical success.”

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About Plastic and Reconstructive Surgery

For more than 60 years, Plastic and Reconstructive Surgery® (http://journals.lww.com/plasreconsurg/) 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 (ASPS) is the world’s largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic 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. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at www.plasticsurgery.org or www.facebook.com/PlasticSurgeryASPS and www.twitter.com/ASPS_news.

About Lippincott Williams & Wilkins

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

Posted in All Medicine, Media, Publications, Surgery, Surgery - Plastic and Reconstructive | Leave a comment

Half of U.S. Plastic Surgeons Market Their Practice via Social Media

Posted on May 2, 2013

Social Media Engagement Has Risks as Well as Benefits, Reports Survey in Plastic and Reconstructive Surgery

Philadelphia, Pa. (May 1, 2013) – Half of U.S. plastic surgeons are using Facebook, Twitter and other social media platforms in their professional practice, according to a survey in the May issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

“Social media platforms represent a dynamic and powerful tool to educate, engage, market to and directly communicate with patients and professional colleagues,” writes ASPS Member Surgeon Dr. Reza Jarrahy and colleagues of University of California, Los Angeles. However, researchers add that for plastic surgeons, “The potential benefits associated with using this tool must be balanced against its potential pitfalls.”

Plastic Surgeons Report Engagement in Social Media…

The researchers sent an anonymous survey to more than 5,000 ASPS Member Surgeons. Responses from 500 surgeons provided information on their use of social media in plastic surgery practice, their reasons for using it and the perceived benefits and risks.

A little more than 50 percent of plastic surgeons said they regularly used social media for their professional practice. Facebook was by far the most popular platform, followed by LinkedIn, Twitter and YouTube. Surgeons who primarily perform cosmetic plastic surgery are more likely to use social media.

When asked their reasons for using social media, most plastic surgeons responded that incorporating social media into medical practice was inevitable. About half said that social media was an effective marketing tool and a useful forum for patient education.

About one-third of plastic surgeons saw positive effects of using social media. They felt it provided an effective, low-cost means of advertising and increased exposure of their practice. About half believed that engaging in social media led to increased patient referrals and positive feedback.

Few plastic surgeons—1.5 percent—reported negative effects of social media on their practice. Some surgeons had received criticisms or negative commentary from patients via social media, but most thought these criticisms hadn’t harmed their practice.

…But Feel the Need for Social Media Standards and Guidance

Plastic surgeons who weren’t using social media were asked why. They cited reasons including maintaining a sense of professionalism, protecting patient confidentiality and concerns about becoming too accessible.

About one-fourth of respondents felt that the ASPS and other governing bodies “should provide some oversight and/or monitoring of plastic surgeons’ use of social medial to ensure ethical online behavior.” ASPS is active on social media channels including Facebook (www.facebook.com/PlasticSurgeryASPS), Twitter (twitter.com/ASPS_News), Google + (http://bit.ly/YSXiMM) and YouTube (http://www.youtube.com/ASPSPlasticSurgery).

Social media has revolutionized the way in which people and businesses interact—including a growing role in the health care industry. Although plastic surgeons have been leaders in the development of online interactive content, there has been surprisingly little information on whether and how they are using social media.

The new study shows that many plastic surgeons have joined the social media revolution and believe it has benefited their practice in various ways. However, they also perceive a need for standards of practice and oversight to ensure appropriate and ethical use of social media. Dr. Jarrahy and colleagues conclude, “Because of our current level of engagement with existing social media services, plastic surgeons are uniquely poised to become leaders in developing the future of social media architecture to the maximal benefit of practitioners and patients alike.”

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About Plastic and Reconstructive Surgery

About ASPS

About Lippincott Williams & Wilkins

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

Posted in All Medicine, Media, Publications, Surgery - Plastic and Reconstructive | Leave a comment

Lippincott Williams & Wilkins Announces First Interactive Mobile Edition of Clinical Anesthesia

Posted on April 22, 2013

New Digital Package Offers ‘Dazzling’ Multimedia Features for Tablets, Smartphones and Desktops

PHILADELPHIA (April 22, 2013) — Lippincott Williams & Wilkins (LWW), part of Wolters Kluwer Health, today launched the first fully interactive, mobile edition of Barash’s Clinical Anesthesia, the authoritative text on anesthesiology. For the first time, readers can access the text plus all of the interactive multimedia content using their iPad® tablets and iPhones. The new digital package also allows subscribers to access the content online through a PC or Mac browser, and to receive the complete print edition—all for a single price.

Edited by six distinguished anesthesiologists from leading teaching institutions including Drs. Paul Barash of Yale University, Michael Cahalan of University of Utah, Bruce Cullen of University of Washington, Rafael Ortega of Boston University, textbook author Robert Stoelting, and Christine Stock of Northwestern University, Clinical Anesthesia, Seventh Edition covers the full spectrum of clinical options, providing authoritative coverage of pharmacology, physiology, co-existing diseases, surgical procedures, anesthesia equipment, and much more. All of the areas found on certification and recertification exams are covered in detail including patient preparation and positioning, airway management, nerve blocks and muscle relaxants, anesthetic effects on organ function, neonatal and pediatric considerations, and postoperative recovery.

The new e-textbook, built on the Inkling platform, incorporates a rich collection of video and images designed to give residents and practitioners one of the most detailed and comprehensive reviews of anesthesiology. Nearly 300 videos and more than 800 photographs and illustrations help demonstrate teaching points for procedures and concepts.

“It is the first anesthesia textbook of the 21st century to be built from the ground up specifically for use on an electronic platform,” said Dr. Barash. “Dazzling in its graphic make up, we use a combination of images, videos and tables which can be transferred to a PC, tablet or smartphone to enhance the reader’s understanding of our materials.”

The new Clinical Anesthesia e-textbook allows users to harness powerful interactive capabilities such as a precise index-based search across the entire text. Users also can select terms in the text and look them up on the fly using an electronic glossary, as well as highlight and take notes within the text and share with others in a study group. All referenced cases, studies and pages are linked throughout for instant access. Optimized video and high-resolution images offer breathtaking display on the iPad and iPhone.

All of the content is updated bi-monthly and includes regular postings of new videos.

Designed for residents, anesthetists in training, and practitioners, Clinical Anesthesia, Seventh Edition, is available now for one price that includes all three formats (print, website and mobile download) for $229.99. Download only is also available for the same price. For more information or to purchase, visit LWW.com.

About Lippincott Williams & Wilkins

Contacts:

Thomas Kivett
Managing Director
Kivett & Company Communications
+1 212-727-2935
tkivett@kivettandco.com

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

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‘Double Winner’ Talks about Beating Cancer and Heart Disease, Reports Heart Insight

Posted on April 22, 2013

Patrick Shaw’s Story Draws Attention to Heart Disease Risk in Long-Term Cancer Survivors

Philadelphia, Pa. (April 19, 2013) – Over the years, advances in treatment have improved the chances of survival for young patients with cancer. But long-term survivors need to be aware of cancer treatments that may place them at increased risk of heart disease later in life, according to an article in the May issue of Heart Insight, a quarterly magazine for patients, their families and caregivers. Heart Insight is published by the American Heart Association (AHA) and Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Cancer and heart disease survivor Patrick Shaw tells his story to Heart Insight’s Mark L. Fuerst. Pat’s experience highlights the long-term risk of heart disease for some groups of patients who have been treated for cancer—even years or decades previously. You can read the whole article—along with a special online-only bonus story on assessing the heart disease risk related to radiation therapy for cancer—using the new Heart Insight iPad® app, available as a free download from the iTunes app store.

Lifesaving Cancer Treatment Led to Heart Problems Two Decades Later

Pat was 29 and newly married when he was diagnosed with advanced Hodgkin’s lymphoma. Like most young patients with this type of cancer, Pat responded well to aggressive chemotherapy and radiation therapy.

But 20 years later, Pat began having new symptoms—he would wake in a cold sweat in the middle of the night and had little energy on the job and other usual activities. Pat resisted seeing a doctor for a while, but his wife Kim finally convinced him to go to the hospital. At first he was treated for dangerously high blood pressure. But continued symptoms soon led to a diagnosis of coronary heart disease.

Pat’s heart disease was a long-term after-effect of his cancer treatment—which included radiation therapy to the chest and treatment with anticancer drugs called anthracyclines. Both treatments are now known to cause long-term damage leading to an increased risk of heart disease later in life. Today, lower doses are used to decrease those risks.

Pat’s cardiologist, Dr Ronald Drusin of New York-Presbyterian Hospital, decided that stents to reopen the blocked coronary arteries were a better choice than bypass surgery, because of radiation-induced scarring in Pat’s heart. Pat felt better after the procedure, although his recovery was complicated by a stroke.

Today, Pat is grateful to be a “double winner,” having beaten first cancer, then heart disease. He pays close attention to his exercise and diet, checks his blood pressure regularly, and takes medications. On weekends he stays busy with his three sons’ lacrosse games and other activities. “Pat’s prognosis is fine as long as he takes good care of himself, which he does,” says Dr Drusin.

Pat thinks he might have saved some “wear and tear” on his body if he hadn’t waited to seek medical care for his heart disease symptoms. He hopes others with similar symptoms will see a doctor right away. “You have to be proactive,” says Pat. “You are in charge of your own heart.”

Get the Whole Story on Heart Insight for the iPad

Pat’s story highlights the potential heart disease risks for the growing number of long-term survivors after treatment for cancers in childhood, adolescence, or young adulthood. To read the full article, visit the iTunes app store and download the free Heart Insight app. You’ll also get access to a special online bonus story including information to help survivors assess their risks—especially those whose cancer treatment included radiation therapy to the chest or anthracycline chemotherapy.

Once you’ve downloaded the app, each issue of Heart Insight will be delivered directly to your iPad as soon as it’s published. Heart Insight for the iPad is a convenient way to read inspiring and informative stories of people successfully managing heart disease. Each colorful issue provides practical and trustworthy information on getting healthy and staying healthy, including features on heart disease and prevention, medical diagnosis and treatment, diet and lifestyle, and much more.

No iPad? No problem! You can also access each issue of Heart Insight on your computer, smartphone, or other device. Just point your browser to www.HeartInsight.com.

About Heart Insight

An official publication of the American Heart Association (AHA), Heart Insight is the first AHA consumer magazine―for patients, families, and their caregivers―that focuses exclusively on managing and preventing cardiovascular disease and related conditions. Heart Insight offers hope, inspiration, and encouragement by featuring articles about, and by, people who have first-hand experience dealing with cardiovascular conditions, either as patients or as caregivers themselves. Heart Insight is lively and upbeat, providing readers with the most up-to-date, authoritative and practical advice on a wide range of heart-related conditions on a quarterly basis. Heart Insight is available at cardiology offices and in other healthcare settings, as well as free online at www.HeartInsight.com.

About Lippincott Williams & Wilkins

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

Posted in All Medicine, Cardiology, Media, Oncology, Publications | Leave a comment

Facial Dog Bites in Children May Require Repeated Plastic Surgery

Posted on April 22, 2013

‘Revision’ Procedures Often Needed to Manage Scars, Reports Study in Journal of Craniofacial Surgery

Philadelphia, Pa. (April 22, 2013) – Dog bites to the face are a relatively common injury in young children, and often require repeated plastic surgery procedures to deal with persistent scarring, according to a report in the March Journal of Craniofacial Surgery, published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

In the study, Dr. Barry L. Eppley of Indiana University Health North Hospital, Carmel, and Dr. Arno Rene Schelich of Hans Privatklinikum, Graz, Austria, review a ten-year experience of the common dog bites of the face in children. “[R]egardless of the severity of the trauma, most dog bite injuries result in permanent scars, and secondary revision surgery is frequently needed,” the researchers write.

Dog Bites in Children—Patient Characteristics

From 1995 to 2005, Dr. Eppley treated 105 children with dog bits of the face, scalp, and neck. The children’s average age was about six years—the youngest was 6 weeks and the oldest 11.5 years. In contrast to previous studies showing that most dog bites occur in boys, Dr. Eppley’s patients were about equally divided between girls and boys.

In 95 percent of cases, the dog was known to the patient and family—belonging either to the family or to a friend, neighbor, etc. When the breed was known, the most common was Pit Bull, followed by Chow, German Shepherd, and Doberman Pinscher. Most of the bites were classified as “provoked,” occurring when the child was playing with, petting, or otherwise interacting with the dog.

In 90 percent of children, the bites caused a combination of crush, laceration, and shear injuries. However, in most cases the wound could simply be closed (ie, with stitches), with no significant risk of infection. Some bites required skin grafting or other reconstructive surgery. One child developed an infection and one was left with permanent injury to the facial nerve.

High Rate of ‘Scar Revision’ Surgery

In more than three-fourths of cases, the child underwent additional “scar revision” surgery in an attempt to improve the aesthetic results. About one-fourth of patients needed a second or even third revision surgery.

More than one-third of cases involved legal action, either against the dog’s owner or insurance companies. Because of the high litigation rate and possible denial of insurance claims for reconstructive procedures, Drs Eppley and Schleich advise surgeons to keep meticulous records, including photographs, of dog bite cases.

Dog bites are a common in children, with many of these injuries involving the head and neck. The new study highlights the characteristics of facial dog bites in children, including the young age of the patients and the fact that most bites are “provoked.” The researchers strongly suggest that young children be kept away from “high-risk” breeds.

“Even with favorable results from scar revisions, the patient and family may still regard the scars as a permanent disfigurement,” Drs. Eppley and Schleich write. They suggest that plastic and craniofacial surgeons treating dog bite injuries in children should advise parents about the possible need for further surgery for scar revision, and provide counseling to “align expectations with expected surgical outcomes.”

About The Journal of Craniofacial Surgery

The Journal of Craniofacial Surgery, edited by Mutaz B. Habal, MD, FRCSC, serves as a forum of communication for all those involved in craniofacial and maxillofacial surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. Affiliates include 14 major specialty societies around the world, including the American Association of Pediatric Plastic Surgeons, the American Academy of Pediatrics Section of Pediatric Plastic Surgery, the American Society of Craniofacial Surgeons, the American Society of Maxillofacial Surgeons, the Argentine Society of Plastic Surgery Section of Pediatric Plastic Surgery, the Asian Pacific Craniofacial Association, the Association of Military Plastic Surgeons of the U.S., the Brazilian Society of Craniofacial Surgeons, the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the Japanese Society of Craniofacial Surgery, the Korean Society of Craniofacial Surgery, the Thai Cleft and Craniofacial Association, and the World Craniofacial Foundation.

About Lippincott Williams & Wilkins

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

Posted in Pediatrics, Publications, Surgery, Surgery - General, Surgery - Plastic and Reconstructive | Leave a comment

Magnet Hospitals Achieve Lower Mortality, Reports Medical Care

Posted on April 17, 2013

Study Suggests Better Outcomes due to Investments in Nursing and Innovation, Fostered by Magnet Credentialing Process

Philadelphia, Pa. (April 16, 2013) – Lower mortality and other improved patient outcomes achieved at designated “Magnet hospitals” are explained partly—but not completely—by better nurse staffing, education, and work environment, reports a study in the May issue of Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

“Magnet hospitals have lower mortality because of investments in nursing,” comments Matthew D. McHugh, PhD, JD, MPH, RN, of University of Pennsylvania School of Nursing, Philadelphia, lead author of the new report. He adds, “Magnet recognition likely stimulates positive organizational behavior that improves patient outcomes.”

Magnet Hospitals Have Better Patient Outcomes

The researchers compared patient outcomes at Magnet hospitals versus non-Magnet hospitals in California, Florida, Pennsylvania, and New Jersey in 2006-07. Magnet hospitals are recognized for quality patient care, nursing excellence and innovations in professional nursing practice. The Magnet Recognition Program® is a voluntary recognition/certification program administered by the American Nurses Credentialing Center (ANCC), an arm of the American Nurses Association.

Dr McHugh and colleagues linked patient, nurse, and hospital data on 56 Magnet hospitals and 508 non-Magnet hospitals. The goal was to see if Magnet hospitals achieved better patient outcomes, and to identify characteristics of Magnet hospitals that led to improved outcomes.

The results showed important differences in nursing at Magnet hospitals. “Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor’s degrees and specialty certification,” the researchers write. Magnet hospitals also had higher nurse-to-patient staffing ratios.

Key patient outcomes were also better at Magnet hospitals. On analysis of more than 600,000 surgical patients, mortality rates were 20 percent lower at Magnet hospitals, after accounting for clinical factors. Magnet hospitals also had better performance on “failure to rescue”—that is, mortality rate among patients with recognized complications.

Magnet Designation Process Promotes Investment in Nursing and ‘Culture of Excellence’

Nurse staffing, education, and work environment explained much of the superior patient outcomes at Magnet hospitals. In addition, there was a residual mortality advantage attributable to the ongoing process of maintaining Magnet recognition status. “Even controlling for differences in nursing, hospital, and patient characteristics, surgical patients in Magnet hospitals had 14 percent lower odds of inpatient death within 30 days and 12 percent lower odds of failure-to-rescue compared to patients cared for in non-Magnet hospitals,” Dr McHugh and coauthors write.

Nursing services are a vital part of hospital care. A pivotal 1994 paper by the same research team—also published in Medical Care—found that hospitals with reputations for excellence in the management of nursing services had lower mortality rates. That study, among others, led to the development of the Magnet hospital designation. However, few studies since then have been done to confirm that Magnet hospitals achieve better patient outcomes.

The updated analysis provides new evidence that patients treated at Magnet hospitals have better outcomes, and that more favorable nurse staffing, more nurses with bachelor’s degrees, and better work environments are important contributing factors. However, the mortality advantage of Magnet hospitals also seems related to their membership in a network of institutions where innovation is encouraged through the ongoing process of Magnet redesignation. Dr McHugh notes, “This is the first study to suggest that the Magnet application process itself is an intervention that promotes better quality of care.”

Dr Jeroan Allison, Editor-in-Chief of Medical Care, comments, “This large study makes an important contribution to an emerging literature attempting to understand what makes some hospitals superior in terms of patient outcomes they obtain, how to best manage hospitals, and whether or not the Magnet designation process as it now exists truly designates institutions where patients fare better.”

About Medical Care

Rated as one of the top ten journals in health care administration, Medical Care is devoted to all aspects of the administration and delivery of health care. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of health care. Medical Care provides timely reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services. In addition, numerous special supplementary issues that focus on specialized topics are produced with each volume. Medical Care is the official journal of the Medical Care Section of the American Public Health Association

About Lippincott Williams & Wilkins

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

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Physician Entrepreneurs Are Key Contributors to New Medical Devices

Posted on April 17, 2013

New Rules on Financial Relationships Might Slow Medical Innovation, Suggests Study in Medical CarePhiladelphia, Pa. (April 16, 2013) – Startup companies founded by physician entrepreneurs are an important source of patents used in developing innovative new medical devices, suggests a study in the May issue of Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

“Device manufacturers gain more from the patents of physician-founded firms than from those of non-physician-founded firms in their subsequent invention and innovation efforts,” according to the study by Sheryl Winston Smith, PhD, and Andrew Sfekas, PhD, of the Fox School of Business at Temple University, Philadelphia. They raise concern that too-strict policies on financial relationships with physicians could hinder innovation in the medical device industry.

Doctors Make Key Contributions to New Medical Devices

The researchers analyzed a total 170 premarket approval applications (PMAs) filed by four major medical device companies between 1978 and 2007. The study also included data on patent applications from 119 startup companies—all of which had received investment dollars from the medical device industry. All four device makers had active corporate venture capital programs during the study period.

Using a sophisticated text-matching algorithm, Drs Smith and Sfekas assessed the information contributed by physician-founded startup companies versus non-physician-founded startups. The study focused on class III medical devices: the highest-risk classification, requiring significant testing to prove device safety and effectiveness.

The two groups of startups produced roughly the same number of patents. However, patents from physician-founded startup companies were cited more heavily in the PMAs, compared to those from non-physician-startups. “On average physician-founded companies account for eleven percent of the information in PMAs, compared to four percent from non-physician-founded companies,” Drs Smith and Sfekas write.

Two-thirds of PMAs overlapped by at least ten percent with patents from physician-founded startups, compared to about one-fourth with patents from non-physician startups. Of PMAs with at least twenty percent information from external sources, about 80 percent included information from physician-founded startups versus 40 percent from non-physician-funded startups.

Could New Rules Hinder Device Innovation?

Facing intense pressure for constant innovation, the medical device industry relies on corporate venture capital as a source of new ideas and patents. By assessing information overlap between PMAs and patents, the study algorithm helps in identifying which patents are more versus less important in developing successful new products. The results suggest that startup companies founded by physician entrepreneurs make uniquely important contributions to the development of new medical devices.

Historically, physicians have played a central role in the development process. Various types of financial relationships between physicians and medical device manufacturers are common, but are increasingly subject to policies regarding disclosure of potential conflicts of interest. These include the “sunshine provisions” of the Patient Protection and Affordable Care Act, under which drug and medical device manufacturers are required to report any financial relationships they have with physicians.

The new findings raise concerns that, if conflict of interest rules are too tight, they could have the unintended effect of slowing the pace of new advances in the medical device industry. Drs Smith and Sfekas write, “[R]estrictions on financial relationships between providers and industry, while potentially improving patients’ trust, may result in reduced medical innovation if physicians found fewer startups or if incumbent firms reduce investments in physician-founded startups.”

About Medical Care

About Lippincott Williams & Wilkins

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

Posted in All Medicine, Publications | Leave a comment

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