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2009/043 NICE Issues Guidance To Help Healthcare Professionals Identify Child Maltreatment
NICE has issued guidance to help healthcare professionals to identify children who may have been maltreated. The guidance provides a summary of alerting features that should prompt a healthcare professional to consider, suspect or exclude child maltreatment. Child maltreatment includes neglect, physical, sexual and emotional abuse, and fabricated or induced illness.
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Seniors Defend Medicare Advantage Plans
USA Today reports that Medicare Advantage, which allows seniors to buy Medicare coverage through private insurance companies, could provide one of the largest spending cuts for Congress to pay for an overhaul of the health care system though "President Obama has called (it) a "wasteful" subsidy for the health insurance industry. ... Debate over Medicare Advantage, which has 10.2 million enrollees - about one-fifth of all Medicare participants - illustrates a broader struggle Congress and Obama face as they look for ways to pay for a $1 trillion overhaul of health care without raising taxes on the middle class or compromising care. It has raised concerns among some seniors who might have to pay more for the program or enroll in regular Medicare instead."
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Autogenous Infrainguinal Bypass Outcomes Inferior In Hispanics
Researchers from the Brigham and Women"s Hospital and Harvard Medical School in Boston have released a 22-year study that reports Hispanic patients have poorer outcomes following infrainguinal bypass grafting for the treatment of peripheral arterial disease (PAD). Results showed that of all the study participants, Hispanics had a higher rate of bypass graft failure and amputation after revascularization compared to Caucasians. In an analysis that accounted for a myriad of important variables affecting limb salvage after bypass, Hispanic ethnicity was found to be independently predictive of eventual amputation. Details of the study appear in the Society for Vascular Surgery"s(R) June 2009 issue of the Journal of Vascular Surgery(R).
Public Health

Earlier Surgery Recommended For RA Patients

A new study published by the American Society of Plastic Surgeons reveals that one of the most common conditions caused by Rheumatoid Arthritis (RA) is best treated surgically, sooner rather than later. Patients with RA frequently experience a debilitating condition known as metacarpophalangeal joint disease, which is usually treated by replacing the knuckle joints with solid silicone joints. However, this treatment (and others like it) has spurred great disagreement between hand surgeons and rheumatologists regarding the indications, timing and perceived outcomes of the procedure; rheumatologists tend to refer late-stage patients for surgery whereas hand surgeons believe that earlier intervention can yield more positive outcomes. In the largest cohort study of its kind, researchers from Michigan, Maryland, and the United Kingdom evaluated the surgical outcomes of 70 RA patients who suffered from varying degrees of hand deformities. Following reconstruction, patients were separated into two groups based on the degree of deformity, and the outcomes of the reconstruction were assessed at 6 months and at years 1, 2 and 3. After reconstruction, both groups had positive self-reported hand outcomes and showed statistically significant improvement from baseline. However, researchers found that the more severe group still had significant deformities - showing that the more serious the malformation, the more difficult it is to correct. This study acknowledges that the management of rheumatoid hand and wrist problems is challenging because of the lack of evidenced-based research regarding the management of these difficult patients. Findings from this study support the general view of hand surgeons that surgery is beneficial to both the early stage and late stage patients. Both specialties agree that working together in a team approach will enhance the quality of life for the RA population. This study appears in the June issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS). ASPS Public Relations American Society of Plastic Surgeons


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