Royal Free London NHS Foundation Trust’s Post

Five percent of the patients with multiple myeloma (MM) evaluated in the outpatient clinic require hospitalization during the first three months after starting the follow-up due to intense tumor activity, pneumonia, other septic processes, fractures, renal failure, hypercalcemia, and anemia. Kidney disease is one of the most frequent complications in patients with MM. The multidisciplinary team evaluates the patient for the first time, and a protocol is initiated to remit the patient for algological management, management of bone disease, repair of damage due to bone disease, minimizing the risk of serious infections, nutritional support, rehabilitation, and transplanting the patient. These Guidelines for Comprehensive Support for Multiple Myeloma 2023 presents the measures for the prevention and treatment of bone disease as well as the criteria for radiotherapy in symptomatic bone lesions, indications for improving function and quality of life, with the analgesic effect of vertebrocementoplasty, oncological orthopedics, considerations on thrombosis and hemostasis, rehabilitation and palliative care in MM.

Our colleagues in Canada are making waves in limb preservation! The recently published study on the Toe and Flow Model (TFM) in Alberta, Canada, led by podiatric surgeons, highlights remarkable outcomes for patients with diabetic foot complications (DFCs). With diabetes being a leading cause of non-traumatic lower extremity amputations (LEAs) in Canada, the significance of this research cannot be overstated. "Our goal at ZLPC is to help establish best practices for diabetes-related foot complications and amputation prevention across Canada," says Dr. Karim Manji, DFCon faculty, and co-author of the study. "We continue to work with Canadian Universities and Health Care Organizations to set up more Toe and Flow centres across the country." "The study is a testament to the power of multidisciplinary approaches in healthcare," adds ALPS founding president, Dr. David Armstrong. "It highlights the importance of collaboration among various medical specialties to improve patient outcomes and reduce the burden on the healthcare system. As healthcare continues to evolve, studies like this pave the way for more integrated and patient-centered care models." Read the publication here: https://lnkd.in/gTsfX4su The TFM emphasizes early detection and coordinated care, resulting in substantial reductions in amputation rates. What's more, this multidisciplinary approach has shown promising results in reducing hospitalization rates and length of stay (LOS) for patients with DFCs. The collaborative efforts among specialists from various disciplines underscore the importance of holistic treatment paradigms. From podiatric surgery to vascular surgery, orthopedics, and beyond, this integrated approach ensures comprehensive care for patients in need. Let's celebrate this groundbreaking work and continue to champion multidisciplinary approaches for better limb preservation outcomes worldwide! #LimbPreservation #MultidiscplinaryTeams #ActAgainstAmputation #CanadianHealthcare #DiabeticFoot David Armstrong, Georgia Krehbiel, MBA, Ryan Crews, Stephanie Wu, DPM, MSc, Joseph Mills MD, Brian D. Lepow, Michael Conte, Bent von Eitzen, Annkathrin Mathe, Alison Evans, Katharine McGinigle, MD MPH, Cyaandi Dove, DPM, Ali Manji, Reza Basiri, Francois Harton, Kenton Rommens MD FRCSC FACS, Karim Manji

Laparoscopic sleeve gastrectomy promotes relatively rapid weight loss, reduces obesity-related health issues and improves eligibility for kidney transplantation for patients with advanced chronic kidney disease and obesity, according to new research from Mayo Clinic. Read More: https://lnkd.in/dKKFnfGZ “In earlier research, we found that conservative weight-loss approaches do not adequately result in significant weight loss in patients with advanced chronic kidney disease,” says Aleksandra Kukla, M.D., a Mayo Clinic transplant nephrologist and the study’s first author. “These new findings support the value of surgical gastrectomy for patients with advanced chronic kidney failure, stage 4-5D, to improve general health and access to kidney transplantation.” Effective therapy for obesity among patients with advanced chronic kidney disease is understudied, in part because high body mass index (BMI) is often considered beneficial in patients receiving kidney dialysis. “Treatment of obesity in this population has been limited to nonsurgical options in the past,” says Tayyab Diwan, M.D., a Mayo Clinic transplant surgeon and co-author of the study. #mededgemea #kidneytransplant #OrganDonation #renalhealth #organtransplantation #KidneyHealth #LivingDonor #healthcare #medicaltreatment #chronickidneydisease #patientcare #healthandwellness

Hypertrophic cardiomyopathy (HCM) is a genetic heart disorder characterized by abnormal thickening of the heart muscle, which can lead to obstructed blood flow and other complications. Effective management of HCM requires a comprehensive, patient-centred approach involving both medical and lifestyle interventions. Patient Perspectives: Diagnosis and Information: Early and accurate diagnosis is crucial. Patients often experience symptoms like chest pain, shortness of breath, and palpitations, which need timely evaluation. Patients value clear, accessible information about their condition, treatment options, and lifestyle modifications. Emotional Support: HCM can be associated with anxiety and fear of sudden cardiac events. Emotional and psychological support is vital. Involvement in Care: Patients prefer being actively involved in their care decisions. Shared decision-making enhances patient satisfaction and adherence to treatment. Regular follow-ups and open communication with healthcare providers are important for monitoring disease progression and adjusting treatments.   Clinician Perspectives Diagnosis and Risk Assessment: Clinicians emphasize the importance of genetic testing and detailed family history to identify HCM and assess risk accurately. Advanced imaging techniques, such as echocardiograms and MRI, are essential for detailed evaluation of the heart’s structure and function Treatment Strategies: Beta-blockers and calcium channel blockers are commonly used medications to manage symptoms. In some cases, surgical interventions like septal myectomy or alcohol septal ablation are necessary. Implantable cardioverter-defibrillators (ICDs) may be recommended for patients at high risk of sudden cardiac death. Interdisciplinary Approach: Effective management of HCM often involves a multidisciplinary team, including cardiologists, geneticists, electrophysiologists, and sometimes surgeons. Coordinated care and communication among healthcare providers are critical for optimizing patient outcomes. Ongoing Education and Research: Clinicians need to stay informed about the latest research and treatment advances in HCM. Participation in clinical trials and registries can provide valuable insights into the disease and improve care practices. Click here to continue reading the Journal: https://lnkd.in/g8MXWQDZ

First-of-its-kind procedure at Christ Hospital a game-changer for heart patients WLWT Updated: 10:58 AM EDT Jul 23, 2024 Emily Sanderson CINCINNATI — A first-of-its-kind procedure at the @Christ Hospital could be a game-changer for the future of heart patients. The Christ Hospital said they successfully completed the procedure which implants a unique sensor designed to help heart failure patients.The procedure was performed by Sitaramesh Emani, MD, Director of Heart Failure Clinical Trials at The Christ Hospital Health Network. The implant allows people to remotely monitor patient congestion and self-management of the disease. The sensor was created by Vectorious Medical Technologies Ltd. Christ Hospital says the miniature pressure sensor is implanted in the heart through a minimally invasive transvenous catheterization. Once it's in, the sensor directly measures left atrial pressure, which the hospital network says is the earliest and most accurate indicator of fluid overload and congestion status. "The successful first U.S. V-LAP implantation represents a pivotal moment in heart failure management," Emani said in a statement. "By integrating real-time left atrial pressure monitoring into patient care, we are on the cusp of a transformative shift towards more proactive, personalized treatment strategies. This innovative approach aims to improve patient outcomes through a reduction in hospitalizations and enhancement of overall quality of life for heart failure patients. Data collected from this trial will be game-changing for care in the future." By utilizing the pressure sensor, heart failure patients can take an active role in the management of their disease. "We look forward to expanding our clinical activities in the U.S. and work closely with physicians, nurses, FDA and our partners towards a pivotal trial," Eyal Orion, MD, co-founder and CEO of Vectorious, said in a statement. "Recent data published in JAMA Cardiology suggests recent plateaus or reversals after long-standing declines in cardiovascular mortality, particularly for heart failure-related mortality in the U.S. between 1999 and 2021. I strongly believe that the technology and treatment paradigm we develop have the potential to reverse this concerning trend, and our team is fully committed to this mission.” The Christ Hospital of Cincinnati and Cleveland Clinic continue to lead the nation in cardiac care and further demonstrate why Ohio is the #HeartOfItAll #WayToGoOhio

Diabetic amputations increase among Black patients: Is it time to start the conversation? A staggering 1 in 20 Americans over 50 years of age experience peripheral artery disease (PAD). These patients are unaware of their risks, the common signs and symptoms and as such not well informed on how to start the conversation. The Association of Black Cardiologists (ABC), Society for Cardiovascular Angiography & Interventions (SCAI), Society of Interventional Radiology (SIR), and Society for Vascular Surgery (SVS), have joined forces together as the PAD Pulse Alliance, announced the “Get a Pulse on PAD” public awareness initiative. Key Takeaways: -         Foster early dialogue between providers and patients to kick off screening and treatment. -         Approximately 80% of Black and Hispanic report never having a doctor or healthcare provider discuss PAD with them. -         Black people are twice as likely to have PAD and up to four times more likely to undergo an amputation compared to white people. -         Educate more people on the risk factors and early warning signs associated with PAD. -         Know your numbers and be proactive. -         The need to create more racially diverse research cohorts in clinical research. Diabetic foot ulcers and amputations occur in minority individuals at an increased rate compared to their white counterparts. Thus, a lower extremity is amputated due to diabetes every 20 seconds, according to an article published by Edmonds M et al., (2021) in J Clin Orthop Trauma. This can be attributed to lack of access to care for the racial and ethnic minorities. These individuals usually go to the hospital when the disease is in a more severe stage. In a study conducted by Lavery et al., (1996) and published in Diabetes Care journal, demonstrated that more amputations occurred in African American people (61.6%) and Hispanic people (82.7%) than in non-Hispanic White people (56.8%) (p<0.001). Two Sundays ago, I watched an ABC News story reported by Steve Osunsami. The report explored the rise in life-altering amputations among Black and Latino patients. The report featured Johnson & Johnson very own Richard Browne, MD FACC of Save Legs. Change Lives. ™ initiative. This initiative is raising awareness of PAD, bringing free education and screening resources to communities across the US at risk of PAD related amputations. See the comments section for the full ABC News article. #SaveLegsChangeLives #CardiovascularDisease #ClinicalTrials #diversityinclusion #diversityequityinclusion #medicaldevices #medicalaffairs #Diversityinmedicalaffairs #DEI

Primary care providers are exposed to the greatest variety of pathology, which can require further evaluation from specialists. For example, diabetes (and the related development of peripheral artery disease) is a commonly treated disease in the primary care setting. Often, patients with diabetes have a need for revascularization therapies in patients with diabetes. While revascularization may be performed via open surgical techniques, these procedures have high risks. New endovascular techniques performed by interventional radiologists are preferred in appropriate cases due to a higher safety profile and efficacy. Therefore, PCP awareness of IR can help facilitate better health-care outcomes in this patient population. https://lnkd.in/gAzUyeX7

Using conduits made of https://lnkd.in/gWGAzecr that are expandable with or without stents may be helpful.

🔍 A new meta-analysis reveals that complete revascularization offers better outcomes for older #STEMI patients compared to culprit-only #PCI. Learn more about the findings and their impact on clinical practice. Read more ➡️ https://lnkd.in/gGsqbzdK #Cardiology #InterventionalCardiology #HeartHealth

Very interesting article! I’d be interested to know more about the anticoagulation strategies used between groups and the size of the fenestrations placed. I’m keen to see how this may impact the next era in SV managemt.