New Topics and Topic Updates

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What's New in the Healthwise® Knowledgebase

Version 10.8

February 2016

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 Medical Test Topics
  • New NCI Topics
  • New Medication Topics
  • New Aisle 7 (CAM) Content
  • Enhanced Content
  • CDC Vaccine Immunization Statements
  • Decision Point Updates
  • Health and Disease Topic Updates
  • Illustration Updates
  • NCI Topic Updates
  • Medication Topic Updates
  • Aisle 7 (CAM) Content Updates
  • Topic Title Changes and Topic Replacements
  • Medical Guideline Review
  • What's Next

New Health and Disease Topics

We added one new health and disease topic:

  • Dementia: Assessing Pain: This new topic explains how dementia makes communication difficult. It teaches basic ways of communicating with a person who has dementia as well as ways to look for signs of pain in a person with severe dementia. And it stresses the value of knowing a person's unique habits and behaviors, which makes a caregiver a valuable member of the treatment team.
  • Zika Virus: This new topic describes the symptoms and treatment of Zika virus and how it spreads. The topic also includes information about the risk to pregnant women and to women who are thinking about getting pregnant.

New Medical Test Topics

We added one new medical test topic:

  • Swallowing Study: Barium and Dynamic: This new topic explains what a swallowing study is and why it's done. It describes two different types: barium and dynamic. It also tells how to prepare for the test, how it feels, and what the results mean.

New NCI Topics

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

New Medication Topics

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.

New Aisle 7 (CAM) Content

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

CDC Vaccine Immunization Statements

The Centers for Disease Control and Prevention (CDC) creates Vaccine Information Statements (VISs). Each VIS includes information about the purpose of the vaccine and about risks, precautions, and who should get the vaccine.

We added a new VIS published by the CDC:

  • Serogroup B Meningococcal Vaccine (MenB): What You Need to Know

We replaced the previous version of these VISs with the latest version provided by the CDC:

  • Your Child's First Vaccines: What You Need to Know
  • Pneumococcal Conjugate Vaccine: What You Need to Know

Decision Point Updates

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.

  • Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?: We added that doctors know how to quickly reverse the effects of dabigatran to stop or prevent bleeding.
  • Lumbar Spinal Stenosis: Should I Have Surgery?: We added that some surgeons are doing a newer, less invasive procedure that involves inserting small metal devices between the bones of the spine. We also added information about when a second surgery may be needed. And we added that changing the way you do your activities is another way to manage your symptoms. We now say that steroid injections help relieve symptoms for only a short time. And we now say that one of the risks of surgery is the chance that the surgery won't relieve your symptoms. And even if you get better with surgery, there is a chance that you may get new symptoms in the future.
  • Prostate Cancer: Should I Choose Active Surveillance?: We now say that men with low-risk localized prostate cancer have a very low risk of dying from prostate cancer no matter what approach they choose. We also say that right now there isn't strong evidence to show which treatment—active surveillance, surgery, or radiation—provides the best long-term survival in men who have low-risk cancer. We added information on "How is active surveillance different from watchful waiting?"
  • Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?: We now say that there isn't strong evidence to show that one treatment works better than the other when it comes to helping a man live longer. We also say that if a man's main goal is to get the cancer out of his body, he may want to choose surgery. And we say that radiation may be a better choice for men older than 80 years of age or men who have other serious health problems. We added information on "Why is it important to know the risk level of your cancer?" and "Does one treatment work better than the other?" We also now list the side effects from external beam radiation, brachytherapy, and hormone therapy.

Health and Disease Topic Updates

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.

  • Active Surveillance for Prostate Cancer:
    • How Well It Works: We added that men with low-risk localized prostate cancer who choose active surveillance have a very low risk of dying from prostate cancer, and that right now there isn't strong evidence to show which treatment—active surveillance, surgery, or radiation—provides the best long-term survival in men who have low-risk cancer.
    • What To Think About: We say that if a man chooses active surveillance, he can change his mind at any time and have surgery or radiation, even if his prostate cancer hasn't changed.
  • Antidiarrheals for Irritable Bowel Syndrome: We added eluxadoline (such as Viberzi) to the list of antidiarrheal options.
  • Avian Influenza (Bird Flu): We updated the statistics on bird flu cases in North America and added information from the U.S. Centers for Disease Control and Prevention (CDC) advisory on what to do if you may have been exposed to the virus.
  • Brain Aneurysm: We added that endovascular embolization involves risks such as rupture of the aneurysm.
  • Breast Cancer Types: We added information on how breast cancer cells may be affected by estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER-2).
  • Donating a Kidney: We updated the information on the risks of kidney donation.
  • Heart Failure:
    • Medications: We added that you might take an ARB that is combined with another medicine in one pill (referring to sacubitril/valsartan (Entresto)).
  • Hidradenitis Suppurativa: We say that this skin problem involves irritation and inflammation of the hair follicles, causing them to swell and form lumps. We also say that treatment may include medicines, corticosteroid injections, hormone pills, or removal of infected tissue.
  • High Blood Pressure:
    • When to Call a Doctor: We rewrote this section to reflect American Hospital Association recommendations.
  • Irritable Bowel Syndrome:
    • Medications: We updated information on the use of rifaximin (Xifaxan).
  • Prostate Cancer:
    • Treatment Overview: We now include side effects of treatment for surgery, radiation, and hormone therapy. We added that men who have high-risk cancer may have radiation along with hormone therapy. We also say that in the first 2 to 5 years after treatment, problems with erections and leaking urine are usually worse with surgery, while bowel problems are more likely with radiation, but at 15 years, the risks of these problems are about the same with either treatment. And we say that right now there isn't strong evidence to show whether surgery or radiation helps a man live longer, but most studies found that men who had surgery lived longer than men who had radiation (external-beam radiation therapy), especially for healthier men under 65. But for men over 80 and men who had other serious health problems, radiation worked better.
    • Other Treatment: We updated the information on high intensity focused ultrasound (HIFU) based on the approval of the first HIFU system for ablating prostate tissue by the U.S. Food and Drug Administration in October 2015.
  • Radiation Therapy for Prostate Cancer:
    • How Well It Works: We say that right now there isn't strong evidence to show what treatment helps men who have localized prostate cancer live longer, and that high quality studies comparing radiation with surgery for men with localized prostate cancer haven't yet been completed.
    • Risks: We now say that radiation treatment may increase a man's risk for having another cancer later in life. We list common side effects, such as erection problems, bowel problems, and bladder problems, and say that with external-beam radiation, a man may need to urinate more often or have a sudden urge to urinate, while with brachytherapy, a man may have a slow or weak urine stream or be unable to urinate, or he may leak urine from an overfull bladder without any urge to urinate.
  • Radical Prostatectomy:
    • How Well It Works: We say that studies found that men who had surgery for localized prostate cancer lived longer than men who had radiation (external-beam radiation therapy), especially for healthier men under 65. But for men over 80 and men who had other serious health problems, radiation worked better.
  • Sexual Problems in Women: We added information about flibanserin.
  • Skin Cancer, Nonmelanoma:
    • Treatment Overview: We added sonidegib (Odomzo) to the list of medicines used for basal cell carcinoma, which spreads after treatment with surgery and radiation.
  • Stroke:
    • Topic Overview: We added that a procedure may be done to remove the blood clot and restore blood flow.
    • Treatment Overview: For ischemic stroke treatment, we added that a procedure may be done to restore blood flow.
  • Vaccine Information Statements: We added a vaccine information statement (VIS) for the meningococcal vaccine (MenB). This is a new VIS published by the CDC. And in the list of VISs, we changed "Baby's First Vaccines" to "Child's First Vaccines."

We revised cardiac rehabilitation phase names so that they refer to the description of the phase rather than a phase number. We revised Phase I to Hospital Program. We revised Phase II to Home Program. We revised Phase III to Outpatient Program. We revised Phase IV to Maintenance Program. We made these changes to the following documents:

We updated content on the benefits and risks of aspirin in the primary prevention of cardiovascular disease, and we incorporated shared decision making.

Illustration Updates

We updated one illustration topic:

NCI Topic Updates

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

Medication Topic Updates

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.

Aisle 7 (CAM) Content Updates

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

Topic Title Changes and Topic Replacements

Topic title changes

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.

  • Shopping for Organic and Chemical-Free Foods has been removed and replaced with Organic Foods.

Medical Guideline Review

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 College of Obstetricians and Gynecologists (2015). Emergency contraception.
  • American Heart Association/American Stroke Association (2015). 2015 AHA/ASA Focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment.
  • American Heart Association/American Stroke Association (2015). Guidelines for the management of patients with unruptured intracranial aneurysms: A guideline for healthcare professionals.
  • North American Menopause Society Statement (2015). North American Menopause Society statement on continuing use of systemic hormone therapy after age 65.

What's Next

New topics

The following topics are a sample of the topics that are being developed. They are expected to release within the next six months.

  • Alzheimer's and Other Dementias: Coping With Sundowning
  • Avulsion Fracture
  • Bilateral Mastectomy for Early-Stage Breast Cancer
  • Ductal Carcinoma in Situ (DCIS)