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)
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“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.
New statin guidelines were issued by the American Heart Association this past week (Circulation, Nov 12). The guidelines recommend statin therapy for people without cardiovascular disease who are 40 to 75 years old and have a 7.5 % or higher risk for heart attack or stroke within 10 years; people with a hx of heart attack, stroke, stable or unstable angina, peripheral artery disease, tia or coroanary or other revascularization; people 21 and older wwho have a very high level of cholesterol (190 mg/dl or higher; people with Type 1 or Type 2 diabetes who are 40 to 75 years old. Click here to read full guidelines.
“Safety and effectiveness of recombinant human bone morphogenetic protein-2 for spinal fusion”; “Effectiveness and harms of recombinant human bone morphogenic protein-2 in spine fusion” and editorial, “Closing in on the truth about recombinant morphogenetic protein-2″by jmiller on November 12, 2013
These two review articles and accompanying editorial (Ann Intern Med, June 18). Two independent studies suggesting that rhBMP-2 has no proven clinical advantage over bone graft and may be associated with important harms, making it difficult to identify clear indications for rhBMP-2. “The clinical question is of greta interest to orthopedic surgeons and relevant to internists who encounter patiens who have had or are considering having spinal fusion. These dual reviews spotlight the power of evidence sythesis, data sharing, peer review, and reproducible research.” Click here to read full text.
This article (Bull Am Coll Surg, Nov) was written by the daughter of one of our employees, Erin O’Neill, Senior Analyst, Supply Chain. Erin’s daughter is a 4th year medical student. “What are the best surgical apps? How are they actually used in practice? Have they changed the delivery of surgical care?. This article addresses these questions by examining apps for clinical practice. Click here to read ful text.
In this New England Journal of Medicine “Clinical Pracitce” summation (Oct. 17) , the potential benefits and harms of calcium intake are reviewed. Several studies have raised concerns about a possible increase in cardiovascualr ris associated with calcium supplementation as well as nephrolithiasis. Pending further data, “a reasonable approach is to preferentially encourage dietary calcium intake and discourage the routine use of calcium supplements”. click here to view full-text.
“Optimal management of patients with asymptomatic carotid artery stenosis remains unclear. Although 2 high quality clinical trials demonstrated reductions in stroke rates in patients without symptoms after carotid endarterectomy, medical therapy of asymptomatic carotid artery stenosis has reduced rates of stroke to approximately 1% per year, raising questions about generalizability of these previous trials to current medical practice. However, reductions in adverse events after revascularization can make revascularization more attractive. The emergence of percutaneous revascularization for arotid artery stenosis has raised further questions about optimal management of asymptomatic carotid artery stenosis. This Grand Rounds summarizes the factors to consider when counseling patients and making clinical decisions regarding medical therapy and revascularization for patients with asymptomatic carotid artery stenosis. This information should provide clinicians with the knowledge base to counsel patients about the risks and benefits of treatment options. (JAMA, Oct 16) Click here to read full text.