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Version 10.5

April 2015

What's New in the Healthwise Knowledgebase lists new documents, noteworthy enhancements to existing documents, and medically significant changes to existing documents. We do not list every change, such as editorial changes, made for this release. Refer to Tech Docs for a complete list of new and updated documents.

  • New Health and Disease Topics
  • New Online Forms
  • New Medical Test Topics
  • Enhanced Content
  • New NCI Topics
  • New Medication Topics
  • New Aisle 7 (CAM) Content
  • Actionset Updates
  • Decision Point Updates
  • Health and Disease Topic Updates
  • Illustration, Interactive Health Tool, and Online Form Updates
  • Medical Test Topic Updates
  • Symptom Topic Updates
  • NCI Topic Updates
  • Medication Topic Updates
  • Aisle 7 (CAM) Content Updates
  • Topic Title Changes and Topic Replacements
  • Medical Guideline Review
  • What's Next
  • Arthritis: Shots for Knee Pain: This new topic explains the role of steroid shots, also called cortisone or corticosteroid shots. The topic discusses how well they work and what the side effects may be.
  • Body Fluids Tests: This new topic describes tests that may be done on body fluids such as pleural, pericardial, peritoneal, synovial, and genital fluids. The tests look for infection and other problems.
  • Complementary Medicine for Arthritis: This new topic explains the types of complementary medicine that may be used by people who have arthritis, such as diet supplements, acupuncture, and massage.
  • Physical Therapy for Knee Arthritis: This new topic discusses the use of physical therapy as a treatment for arthritis. It includes the role of education in physical therapy, as well as a description of some of the techniques used.
  • Rhabdomyolysis: This new topic provides an overview of rhabdomyolysis, its causes and symptoms, and how it is treated.
  • Rheumatoid Arthritis: Finding the Right Medicine For You: This new topic explains the different types of medicine used for controlling rheumatoid arthritis; what treatment guidelines recommend for when and how to try nonbiologic and biologic DMARDs, corticosteroids, and NSAIDs; and how to work with your doctor to find the right RA treatment.
  • Tumor Markers: This new topic explains what tumor markers are and how they are used to diagnose and treat cancer. The topic gives examples of several tumor markers.
  • Your Baby's First Vaccines: What You Need to Know: We added this new CDC vaccine information sheet.
  • Myoglobin: This new topic explains why myoglobin tests are done and what they can show. It tells how to prepare for the test and what is done during the test. It explains how the test feels and what to look for afterward.
  • Blood-Clotting Disorders: This topic now covers all blood-clotting disorders rather than just inherited blood-clotting problems.
  • Children's Growth Chart: This topic has been updated with a link to the clinical growth chart from the Centers for Disease Control and Prevention (CDC).
  • Chronic Fatigue Syndrome: Using Healthy Thinking: This topic has been enhanced to focus on healthy thinking as a way to cope with chronic fatigue. It describes cognitive-behavioral therapy, but it also includes self-help instructions for practicing healthy thinking.
  • COPD and Sex: This topic has been rewritten in plain language that is easy to understand and that has a less clinical tone. We have added some more tips for managing COPD before and during sexual activity.
  • Growth and Development, Ages 11 to 14 Years: This topic has been updated with a link to the clinical growth chart from the Centers for Disease Control and Prevention (CDC).
  • Medicare: What You Need to Know: This topic now includes information about the health insurance marketplace and how it affects Medicare. It includes information for people who have Medicare and for those who don't yet have it.
  • Physical Development, Ages 15 to 18 Years: This topic has been updated with a link to the clinical growth chart from the Centers for Disease Control and Prevention (CDC).
  • Triggers of Sudden Heart Failure: This topic has been enhanced to change the tone to make it more approachable and actionable.

Refer to Tech Docs for a complete list of new National Cancer Institute content.

Medication topics from Cerner Multum, Inc., are not included in all systems. Added topics may include new information and/or the addition of new drug names. Refer to Tech Docs for a complete list of new titles.

Refer to Tech Docs for a complete list of new Aisle 7 (CAM) content.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Compression Stockings: How to Use Them: We revised the information about the effectiveness of compression stockings to prevent post-thrombotic syndrome. We now say that stockings may help relieve symptoms of deep vein thrombosis.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Low Back Pain: Should I Try Epidural Steroid Shots?: Based on an FDA Drug Safety Communication on neurologic problems after epidural corticosteroid injections for pain, we added the risk of serious side effects.
  • Stroke Prevention: Should I Have a Carotid Artery Procedure?: We made changes based on the American Heart Association/American Stroke Association 2014 Guidelines for the primary prevention of stroke.
  • Stroke: Should I Move My Loved One Into Long-Term Care?: In Get the Facts under "What happens after a stroke?" we removed the statistics about how many people have a permanent loss of some function. We now say "Many people who have a stroke recover well enough to go home from the hospital. But a stroke can cause very serious problems. Some people need long-term care in a center."
  • Varicose Veins: Should I Have a Surgical Procedure?: We revised "How well do procedures work for varicose veins?" We now say that all the procedures that close varicose veins and keep them from coming back seem to work about the same.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Adjustable Gastric Banding Surgery: In How Well It Works, we added that weight loss is usually slower and less than weight loss with gastric bypass.
  • Aminosalicylates for Inflammatory Bowel Disease: Throughout this document, we updated statements regarding the role of aminosalicylates in the treatment of Crohn's disease to reflect the latest evidence and practice patterns.
  • Asthma in Children: We updated checkup intervals to reflect Global Initiative for Asthma (GINA) 2014 recommendations. A checkup is recommended every 1 to 12 months, depending on asthma control.
  • Crohn's Disease: In Treatment Overview and Medications, we updated statements regarding the role of aminosalicylates in the treatment of Crohn's disease to reflect the latest evidence and practice patterns.
  • Diabetes: Steps for Foot-Washing: To align with current practice, we removed the text that said you can soak your feet for about 10 minutes if you want to.
  • Diabetic Retinopathy: In Other Treatment, we added the intravitreal medicine aflibercept for diabetic macular edema.
  • Multiple Sclerosis: Other Treatments Under Study: In the list of monoclonal antibodies, we removed alemtuzumab (Campath). This medicine has been approved for treatment of MS.
  • Obesity: In Medications, we added a new FDA-approved weight loss drug, liraglutide (Saxenda).
  • Overactive Bladder: In "How is it treated?" under "Medicine," we now list specific drugs used to treat overactive bladder. In "Other treatments," we updated statements about electrical nerve stimulation and surgeries to reflect treatments that may be done when severe overactive bladder hasn't been controlled by other methods.
  • Parkinson's Disease: Levodopa Versus Dopamine Agonists: We added the side effect of impulse control issues in some people who take dopamine agonists.
  • Preventing Poisoning in Young Children: In "Preventing poisoning," we added detergent pods to the list of poisonous substances.
  • Shingles: In the Topic Overview under "What are the symptoms?" we now say that a rash or blisters on the face or the tip of the nose can be a warning of eye problems, and that getting treatment right away may help avoid permanent eye damage.
  • Sickle Cell Disease: In Treatment Overview, we added the medication hydroxyurea, and we added that tests for hepatitis C infection may be done if frequent blood transfusions are given.
  • Stroke and TIA: Who Is Affected: We revised the prevalence of stroke for African Americans. We now say "African Americans are more likely than people of other races to have a stroke."
  • Stroke Rehabilitation: In Topic Overview under "Does a stroke cause permanent problems?" we revised the statistics about how many people regain the ability to care for themselves to say "Some people do have permanent problems after a stroke. But rehab can help you learn new skills that will help you take care of yourself as much as possible."
  • Sudden Infant Death Syndrome (SIDS): Under "What can yo do to reduce the risk of SIDS?" we added that it is not safe to place your baby on a couch to sleep.
  • Varicose Veins: In Surgery, we now say that the size of your varicose veins affects your treatment options. Typically, larger varicose veins are treated with ligation and stripping, endovenous laser treatment, or radiofrequency treatment. For some people, a combination of treatments may work best. Smaller varicose veins and spider veins are usually treated with laser therapy on your skin or sclerotherapy.
  • Varicose Veins: Radiofrequency Ablation: We now say that radiofrequency ablation closes off varicose veins in about 88 out of 100 people.
  • Vein Ligation and Stripping: We now say that vein ligation and stripping removes varicose veins successfully in 80 out of 100 people.

We made changes based on the American Diabetes Association Standards of Medical Care in Diabetes—2015.

  • Diabetes: Blood Sugar Levels
  • Diabetes: Lower Your Heart Disease Risk
  • Diabetes: Tests to Watch for Complications
  • Diabetic Nephropathy
  • Gloria's Story: Adding Activity to Help Control Blood Sugar
  • Stages of Chronic Kidney Disease
  • Type 1 Diabetes
  • Type 1 Diabetes: Children Living With the Disease
  • Type 2 Diabetes
  • Type 2 Diabetes: Screening for Adults
  • When to Have a Cholesterol Test

We made changes based on the 2014 American Heart Association/American College of Cardiology guideline for the management of patients with non-ST-elevation acute coronary syndromes.

  • Acute Coronary Syndrome
  • Angina
  • Coronary Artery Disease
  • Heart Attack and Unstable Angina
  • Heart Attack: How to Prevent Another One
  • Using Nitroglycerin for Angina

We revised the information about the effectiveness of compression stockings to prevent post-thrombotic syndrome. We now say that stockings may be used to help prevent post-thrombotic syndrome and that stockings may help relieve symptoms of deep vein thrombosis.

  • Compression Stockings for Deep Vein Thrombosis
  • Deep Vein Thrombosis
  • Post-Thrombotic Syndrome

We made changes based on the American Heart Association/American Stroke Association 2014 guidelines for the primary prevention of stroke.

  • Alcohol and Heart Disease
  • Aspirin to Prevent Heart Attack and Stroke
  • Carotid Artery Disease
  • Carotid Artery Stenting
  • Carotid Endarterectomy for TIA and Stroke
  • Coronary Artery Disease
  • Heart Disease and Stroke in Women: Reducing Your Risk
  • Myxoma Tumors of the Heart
  • Stroke
  • Transient Ischemic Attack (TIA)

We added a teething gel warning, "If your child is under 2 years of age, ask your doctor if you can give your child numbing medicines."

  • Cancer: Home Treatment for Mouth Sores
  • Canker Sores
  • Creams and Ointments for Cold Sores

We revised our kidney transplant content to reflect the latest evidence and practice around topics such as HLA tissue matching and donor characteristics.

  • Donating a Kidney
  • Kidney Transplant
  • Organ Transplant
  • Planning to Be an Organ Donor

In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

Illustration updates

  • Carotid Endarterectomy : In the caption, we now say that the graft may be man-made.

Interactive health tool updates

  • Interactive Tool: Are You at Risk for a Heart Attack?: To align with the latest guidelines on cardiovascular risk assessment, we converted this risk calculator into a noninteractive text description of working with your doctor on risk screening. The title is now "Heart Attack and Stroke Risk Screening."

Online form updates

We updated these online forms.

  • Adult Immunization Schedule: We updated this CDC immunization schedule to the 2015 version. It replaces the 2014 schedule.
  • Childhood Immunization Catch-Up Schedule: Ages 4 Months to 18 Years: We updated this CDC immunization schedule to the 2015 version. It replaces the 2014 schedule.
  • Childhood Immunization Schedule: Ages 0 to 6: We added this new CDC easy-to-read schedule. It replaces Childhood Immunization Schedule: Ages 0 to 18 Years.
  • Childhood Immunization Schedule: Ages 7 to 18: We added this new CDC easy-to-read schedule. It replaces Childhood Immunization Schedule: Ages 0 to 18 Years.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Cardiac Enzyme Studies: We made changes based on the 2014 American Heart Association/American College of Cardiology Guideline for the management of patients with non-ST-elevation acute coronary syndromes.
  • Home Blood Glucose Test: We made changes based on the American Diabetes Association guideline Standards of Medical Care in Diabetes—2015.
  • Mammogram: In Test Overview, we now list the types of mammograms as standard mammogram, digital mammogram, and 3-D mammogram, and we give a short description of each. In the description of 3-D mammogram, we say that this test uses both digital mammogram and breast tomosynthesis.
  • Syphilis Tests: We added information on a newly approved rapid finger-stick syphilis test. Unlike other tests, the blood sample is not sent to a laboratory. You can find out the results at your doctor visit.
  • Tissue Type Test: We made changes to reflect the latest evidence and practice around HLA tissue matching and its impact on antirejection drugs.

We continually monitor changes in medicine to ensure our topics are accurate and up-to-date. In the following documents, we made medically significant revisions, added new medical information, or removed outdated medical information. While medically significant changes are listed here, documents that have minor revisions, such as editorial or consistency changes, are not listed.

  • Chest Problems: We made changes based on the 2014 American Heart Association/American College of Cardiology guideline for the management of patients with non-ST-elevation acute coronary syndromes.
  • Diabetes-Related High and Low Blood Sugar Levels: We made changes based on the American Diabetes Association's Standards of Medical Care in Diabetes—2015.
  • Mouth and Dental Injuries: We added a teething gel warning, "If your child is under 2 years of age, ask your doctor if you can give your child numbing medicines."
  • Toothache and Gum Problems: We added a teething gel warning, "If your child is under 2 years of age, ask your doctor if you can give your child numbing medicines."

Refer to Tech Docs for a complete list of updated National Cancer Institute content.

Medication topics from Cerner Multum, Inc. are not included in all systems. Updates may include new information and/or the addition of new drug names. Refer to Tech Docs for a complete list of updated titles.

Refer to Tech Docs for a complete list of updated Aisle 7 (CAM) content.

Topic title changes

  • Chronic Fatigue Syndrome: Using Cognitive-Behavioral Therapy is now titled Chronic Fatigue Syndrome: Using Healthy Thinking.
  • COPD and Sexual Activity is now titled COPD and Sex.
  • Inherited Blood-Clotting Problems is now titled Blood-Clotting Disorders.
  • PTSD and Suicide is now titled PTSD and Suicide Thoughts.

Topic replacements

We archived the following searchable topics, and we name the replacement topics below. Refer to Tech Docs for a complete list of archived documents.

  • Are You at Risk for a Heart Attack? has been removed and replaced with Heart Attack and Stroke Risk Screening.
  • Cholesterol and Stroke has been removed. You can find related content in Stroke.
  • Diabetes: Exams and Tests You Need has been removed. You can find the content in Diabetes: Tests to Watch for Complications.
  • High Cholesterol: Using the TLC Diet has been removed. You can find related content in Therapeutic Lifestyle Changes (TLC) for High Cholesterol.
  • Physical Examination for Lumbar Spinal Stenosis has been removed. You can find related content in Lumbar Spinal Stenosis.
  • Risks and Benefits of Medicines for Heart Failure has been removed. You can find related content in Heart Failure.
  • Symptoms of an Aneurysm has been removed. You can find the content in Aortic Aneurysm.
  • Therapeutic Lifestyle Changes (TLC) has been removed. You can find related content in Therapeutic Lifestyle Changes (TLC) for High Cholesterol.
  • Tips for Success With the Therapeutic Lifestyle Changes (TLC) Diet has been removed. You can find related content in Therapeutic Lifestyle Changes (TLC) for High Cholesterol.
  • Type 1 Diabetes: Test Schedule 3 to 5 Years After Diagnosis has been removed. You can find related content in Diabetes: Tests to Watch for Complications.

Drug details

Healthwise is changing its drug content policy. As part of this policy, we are archiving all Healthwise drug details. Healthwise will continue to provide hundreds of other pieces of drug content as well as nearly 2000 pieces on specific medications for those clients who license Multum.

We will now focus on the drugs tied to quality measures issued by organizations such as NCQA, the Joint Commission, and the Centers for Medicare and Medicaid Services. For these drugs, we will be adding new consumer-facing content as well as content that provides a behavioral approach to medication adherence.

Refer to Tech Docs for a complete list of drug details that were archived this quarter.

To ensure the medical accuracy and consistency of Healthwise consumer health content, our medical content specialists, physicians, and librarians regularly review medical guidelines and association statements, gold-standard journals, news, and evidence-based publications and databases.

The medical guidelines listed below are examples of updated guidelines we reviewed for this release.

  • American Academy of Ophthalmology (2014). Diabetic retinopathy summary benchmarks for preferred practice pattern guidelines.
  • American Academy of Pediatrics (2014). Policy statement: Maintaining and improving the oral health of young children.
  • American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health (1998, reaffirmed 2014). Guidance for effective discipline.
  • American Diabetes Association (2015). Standards of medical care in diabetes—2015.
  • American Heart Association/American College of Cardiology (2014). Guideline for the management of patients with non-ST-elevation acute coronary syndromes.
  • American Heart Association/American Stroke Association (2014). Guidelines for the primary prevention of stroke.
  • American Optometric Association (2014). Evidence-based clinical practice guideline: Eye care of the patient with diabetes mellitus.
  • American Urological Association and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (2014). Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline.
  • Global Initiative for Asthma (GINA) (2014). Global strategy for asthma management and prevention.
  • Ralston S, et al. (2014). Clinical practice guideline: The diagnosis, management, and prevention of bronchiolitis.
  • Tuttle KR, et al. (2014). Diabetic kidney disease: A report from an ADA consensus conference.
  • Yawn B, et al. (2014) Management of sickle cell disease: Summary of the 2014 evidence-based report by expert panel members.

New topics

These topics are in development and are expected to release within the next six months:

  • Antidepressant withdrawal
  • Calf muscle injury
  • Celiac disease antibodies medical test topic
  • Chikungunya fever
  • Does aspirin prevent cancer?
  • High-sensitivity C-reactive protein medical test topic
  • Radiation for early-stage breast cancer
  • Seizure medicine levels in blood medical test topic



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