This early online publication from Annals of Internal Medicine concludes: “Despite limited evidence and variable development methods, recent guidelines on chronic pain agree on several opioid risk mitigation strategies, including upper dosing thresholds; cautions with certain medications; attention to drug-drug and drug-disease interacitons; and use of risk assessment tools, treatment agreements, and urine drug testing.” Click here to read full-text.
News You Can Use
Prevention of diabetes with Mediterranean diets and accompanying ‘Summaries for Patients’ “Does the Mediterranean diet prevent diabetes?”by jmiller on January 10, 2014
Article (Ann Intern Med, Jan 7) concludes: A Mediterranean diet enriched with EVOO but withoug energy restrictions reduced diabetes risk among persons with high cardiovascular risk. The PREDIMED trial provides strong evidence that long-term adherence to a Mediterranean diet supplemented with EVOO without energy restrictions, which is high in monounsaturated fat and bioactive polyphenols, results in a substantial reduction in the risk for type 2 diabetes among older persons with high cardiovascular risk. Click here to read full-text.
Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an updated systematic evidence review for the U.S. Preventive Services Task Forceby jmiller on December 27, 2013
This systematic review (Ann Intern Med, Dec 17) concludes: “Limited evidence supports any benefit from vitamin and mineral supplementation for the prevention of cancer or CVD. Two trials found a small, borderline-significant benefit from multi-vitamin supplements on cancer in men only and no effect on CVD. (Click here to read full-text)
Strategies for optimizing staff safety in a Radiology Department (Practice Policy and Quality Initiatives)by jmiller on December 12, 2013
“Employees in a radiology department are exposed to multiple risks, including injuries due to radiation exposure, poor ergonomics, or repetititve stress; those caused by wearing lead aprons or moving heavy equipment for portable studies; and needle sticks resulting in exposure to body fluids. Strategies to mitigate or prevent such risks include ergonomics inititatives for radiologists and technologists, appointment of a radiation safety officer to ensure compliande with radiation dose guidelines and policies, and use of equipment that prevents exposure to body fluids.” This is an excellent review of safety issues. (Radiographics, Oct) Click here to read full text.
Contextual issues influencing implementation and oucomes associated with an integrated approach to managing pain, agitation and delirium in adult ICUsby jmiller on December 12, 2013
This has been a very “hot” topic here at AAMC… This study (Critical Care Mdicine, Sept) was designed to identify which contextual factors facilitates/hinder the implementation of the awakening, breathing, coordination, delirium and early mobility (ABCDE) bundle for guidance in future study. “Successful implementation of the elements of the ABCDE cn result in significant improvements in ICU partient care. The results of this study highlight specific structural and cultural elements of ICUs and hospitals that can positively and negatively influence the implementation of complex bundles like the ABCDE bundle. Click here to read full text.
This article (Jama, Oct 7) concludes “among patients undergoing noncardiac surgery within 2 years of coronary stent placement, major adverse cardiac events (MACE) were associated with emergency surgery and advanced cardiac disease but not stent type and or timing of surgery beyond 6 months after stent implementation. Guideline emphasis on stent type and surgical timing for for drug eluting stents and bare metal stents. should be reevaluated. (click here for full-text)
“Increased nut consumption has been associated with a reduced risk of major chronic diseases, including cardiovascular disease and type 2 diabetes mellitus. Howver, the association between nut consumption and mortality remains unclear. In two large, independent cohorts of nurses and other health professionas, the frequency of nut consumption was inversely associated with total and cause-specific mortality, independently of other predictors of death. (NEJM, Nov.21) Click here to read full text.
The DeCesaris Cancer Institute and Rehabilitation Medicine are excited to announce the development of a comprehensive cancer rehabilitation program. Carol Tweed, MD, will serve as medical advisor.
Twenty-five clinicians from across the rehabilitation and cancer institute departments have been selected to receive training in the first session. Our goal is to have the program fully developed and “STAR”-certified by March 2014. STAR stands for Survivorship Training and Rehab Program.
What does it mean to be a “ STAR” certified program? The “STAR” certification program operating under the name of Oncology Rehabilitation Partners was developed by Dr. Julie Silver at Harvard Medical School. It has been implemented by more than 75 hospitals and cancer centers nationwide including Johns Hopkins Hospital. This program aims to provide healthcare professionals with new or enhanced knowledge that can be implemented in the evaluation and management of cancer and treatment-related impairments, ultimately ensuring the safe and effective restoration of cancer survivor’s function and quality of life. Emphasis will be placed on evidence based practice, understanding rationales for therapeutic interventions, as well as identifying areas where future research is needed in the field of cancer rehabilitation. “STAR” certification includes online educational training, expert-directed webinars, on-site self-directed in-service instructions, implementation support, outcomes measurements and support, marketing materials and continuing education.
The development of the comprehensive cancer rehabilitation program will involve a considerable combined effort among the professionals in the Cancer Institute, Outpatient Rehabilitation, Inpatient Rehabilitation, and Pulmonary Rehabilitation services. The complexity of developing an oncology rehab program requires provider expertise, consistent standards of education and treatment, and adherence to guidelines to achieve outcomes. Above all, it takes a commitment from all departments where these services are offered to come together as one team and achieve the standards we set. In addition, six patient and family advisers have been selected to work with of us providing valuable insight as we go along.
We are confident that we will achieve success together and make a difference for our cancer patients. Contact your director for more information or contact Cathy Copertino, executive director of the DeCesaris Cancer Institute, at 443-481-1336 or ccopertino@AAHS.org.