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Archive for May, 2015

Athletic Injuries of the Foot and Ankle

Thursday, May 28th, 2015

foot x-rayBy Sourendra Raut, M.D.

From ATLANTA Medicine, Vol. 86, No. 1

Foot and ankle injuries are common in both recreational and competitive athletes. As we encourage our patients to become more active, we will begin to see an increasing number of these ailments, both on the sideline and in our clinics.

At the collegiate level, ankle ligament sprains accounted for 14.9 percent of all injuries during practice and competition, a staggering number when compared to ACL tears (2.6 percent) and concussions (5.0 percent). At the high school level this is even more pronounced, with almost 40 percent of athletic injuries being to the foot and ankle.

The appropriate initial evaluation and management of athletic foot and ankle injuries is crucial to a successful recovery process, and the physician should be on the lookout for many serious and unique injuries for an accurate diagnosis.

Evaluation

When approaching the evaluation of an athlete with an injury in the foot and ankle, it is important to first localize the injured bony or soft tissue structures. This allows a focused physical examination and will assist in formulating a good differential diagnosis. It will also guide the need for further testing and radiographic studies.

The mechanism of injury often yields clues regarding the injured structures and the severity of the injury, including injuries to other parts of the skeletal system and body.

Another critical component of the initial evaluation is determining the timeframe for a safe return to play. This decision must take into account the severity of the injury, the sport, temporal issues and the level of competition.

Injury prevention is of vital importance when dealing with the athletic population, and it should be an integral component of training and education in all athletes. When specifically evaluating the foot and ankle, one should begin by observing the patient’s gait, following this with a thorough exam of the patient’s ankle strength in inversion, eversion, plantar and dorsiflexion. Range of motion of the hind foot and forefoot joints should be performed, as well as palpation for any points of tenderness. A detailed exam for any sensory deficits, loss of pulses and capillary refill should be included in every physical exam.

Special attention should be paid to four specific injuries that are frequently seen and often missed when evaluating foot and ankle injuries in the athlete. These include the turf toe injury, ankle sprains (specifically high ankle sprains), Lisfranc injuries and stress fractures.

Turf Toe

The classic turf toe injury is caused by a hyperextension of the big toe metatarsophalangeal joint (MTP). The classic mechanism of injury consists of a direct axial stress on the heel when the foot is in plantar flexion with the toe in dorsiflexion.

In this type of injury, the plantar ligament and capsule of the MTP joint are disrupted, which can often lead to joint instability. The incidence of this injury is increasing at all levels of competition. A recent study by Rodeo et al2 found that 45 percent of professional football players had experienced a significant turf toe injury.

Patients with this injury will frequently describe the aforementioned mechanism and complain of a difficulty with push-off activities and challenges with cutting drills. The keys to examining these injuries include evaluation of the MTP stability and flexion strength at the MTP joint.

Athletes presenting with this type of injury should get weight-bearing comparative radiographs of both feet. The position of the sesamoid bones should be carefully compared, with any proximal migration suggestive of a plantar capsule injury. Care should be taken to look for fractures of the sesamoid bones.

If differences in either the the position or the separation between the sesamoid fragments are noted, an MRI can often be a supplemental tool to assess the soft tissue structures.

Based on the severity, these injuries can be treated with simple immobilization in a hard-soled sandal, casting and protected weight-bearing or surgical approximation of the disrupted sesamoid bone.

A return to play is dictated by the severity of the injury but can extend all the way up to 4 to 6 months post-injury.

Ankle Sprains

There are two major categories of ankle sprains: inversion and eversion sprains. Inversion sprains are the most common injury in competitive athletics and usually involve injuries where athletes report having “rolled” their ankle.

Athletes who can bear weight after such an injury and can demonstrate running, cutting and jumping techniques can return to sports immediately. If they can’t do these things, then further evaluation is necessary.

Inversion injuries are associated with copious acute swelling and bruising anterolateral in the ankle. These injuries can be classified into three grades depending on severity. Grade 1 injuries result from a stretched lateral ligament, grade 2 injuries are due to a partial tear of the ligament and grade 3 injuries consist of a complete tear of the ligaments.

A patient’s clinical presentation mimics the severity of tear, with grade 1 injuries resulting in swelling and pain but ability to weight bear, while grade 2 and 3 injuries often present with increased swelling and impaired ability to walk.

The initial management of these injuries consists of rest, ice, compression and elevation. Immobilization for a short period of time in a walking boot, followed by early mobilization with lace-up brace support and directed rehabilitation is the mainstay of treatment for these injuries.

The vast majority of people with this type of injury recover with non-operative management within an 8-week time frame. Those that do not often need an MRI for further evaluation, with the possibility of requiring surgical intervention to stabilize the ligamentous structures.

Eversion injuries are more commonly known as high ankle sprains or syndesmosis injuries. These are rarer injuries, occurring only 1 percent of the time, but require a much longer recovery with a high incidence of residual symptoms.

The index of suspicion for these injuries should be higher in collision sports. The most common mechanism is direct contact to the leg with the foot fixed on the ground. This causes the knee to externally rotate, stressing the ligaments between the tibia and fibula.

For these injuries, one will find swelling or ecchymosis proximal to the ankle, and squeezing the fibula above the injury can elicit pain in these ligaments.

Radiographic imaging should be initially used, with care taken to look at the tibiofibular overlap on single leg standing ankle X-rays. MRI imaging can be helpful in demonstrating findings that are in keeping with a more subtle injury.

If radiographs show no widening, then the injury is considered stable and can be managed with immobilization until the patient is pain free, an expected recovery time for this lower level of injury. Hopping 15 times on the affected extremity is a good measure of when an athlete can return to play with such an injury.

If there is radiographic evidence of widening of the tibiofibular space or of the medial clear space in the ankle, surgery is the preferred method of treatment.

Return to play is often protracted with these injuries, often approaching 9 months for those treated operatively.

Tarsometatarsal Joint Injuries

Injuries to the tarsometatarsal joints (midfoot) in an athletic environment occur as a result of an axial loading mechanism. These injuries are often very subtle clinically and radiographically, and so a high index of suspicion is needed to appropriately treat them.

Most athletes will describe feeling a “pop” in the foot followed by great difficulty bearing any weight. When examining these patients, pain can be elicited with compression of the midfoot, twisting it or pushing the first ray dorsally or plantarly.

Weight-bearing radiographs of both feet should be obtained, and on these radiographs, there should be a displacement of >2 mm between the first and second metatarsal bases when compared to the opposite side. Sometimes a small fleck of bone can be seen arising from the lateral edge of the medial cuneiform or medial side of the second metatarsal base.

An MRI can be used to diagnose more subtle injuries if there are no findings on X-ray, but this investigative tool is not necessary if the X-rays show clear evidence of a diastasis.

The treatment of these injuries can range from non-surgical management for injuries showing no displacement on radiographs to surgical stabilization with plates and screws. The goal of surgery is to restore the normal anatomy of the affected joints and to preserve this anatomy until the body has a chance to heal the injuries.

These injuries require adherence to a strict protocol of non-weight bearing for 6 weeks, followed by progression of weight bearing with an arch support at 6 weeks. The typical return to sports is 4 months, although elite-level athletes will often need to wait a full year.

Stress Fracture

Stress fractures are the most common overuse injury seen in the athlete and can potentially be one of the most serious. The vast majority of these fractures involve the lower extremity, especially the tibia and bones of the foot.

These injuries are frequently seen in athletes who engage in repetitive activities, such as runners. If care is not taken to manage them appropriately, they may progress to full fractures or heal slowly.

Typical findings within a patient’s history that should lead one to think of a stress fracture include an increase in training intensity, major changes in a training program, changes in shoe wear and running on hard surfaces.

Three stress fracture patterns in particular are highly missed, and special care should be taken to evaluate for these injuries. They include navicular stress fractures, fifth metatarsal stress fractures and medial malleolar stress fractures. These three injuries are at the highest risk of progressing to a more complicated recovery.

Patients with stress fractures will frequently present with swelling and pain located in a specific part of the foot and ankle. A one-legged hop test may also elicit pain, as would percussion over the site of the injury.

It is not uncommon for plain radiographs to be negative with this type of injury, so one should have a very low threshold for obtaining further imaging, specifically an MRI that has a very high sensitivity and specificity. Once identified, a CT scan can often delineate any subtle displacement at the fracture site.

The vast majority of stress fractures can be managed non-surgically, either in a boot or cast with protected weight bearing for 6 to 8 weeks.

Impact activities should be avoided, but low-impact and limited weight-bearing activities like biking, swimming and elliptical machines can be used.

In the setting of recurrent or frequent stress fractures, nutritional considerations are important, specifically eating deficiencies that may predispose an athlete to repeatedly fracturing.

Other Considerations

As more individuals become athletic, and as our high school and collegiate athletes get bigger, stronger and better conditioned, higher-energy injuries are becoming more common. Changes in shoe wear, from more robust, stiffer shoes to softer, lightweight flexible shoes also puts athletes at a greater risk of injury.

The physician taking care of the athletic patient has to act as an intermediary among multiple parties, including parents, coaches, teams and the athlete themselves, tempering expectations while still striving for the fastest return to activity.

Management of foot and ankle injuries in a highly active patient population therefore involves a delicate balancing act between aggressive rehabilitation and early return to sport while taking care not to compromise healing or long-term clinical outcomes in these patients.

The challenge is formidable, but with appropriate attention paid to all of the medical, social and environmental details surrounding an injury, the outcomes are generally quite rewarding.

References: Anderson RB et al. Management of Common Sports-related Injuries About the Foot and Ankle J Am Acad Orthop Surg 2010;18: 546-556

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Bursitis and Hip Pain

Thursday, May 28th, 2015

By Bob Yarbrough, M.D.

From ATLANTA Medicine, Vol. 86, No. 1

Hip anatomyInjuries surrounding the hip are common sources ofpain in adults. Effective treatment relies on accurate diagnoses and pointed treatments. Often, hip pain is mistakenly diagnosed as back pain and vice versa. Simultaneous evaluation of the lumbar spine is recommended in these patients.

Accurate diagnosis of hip problems requires a sound understanding of the anatomy and pathophysiology of hip disorders. The hip is a universal ball and socket joint that connects the lower extremity to the pelvis. The acetabulum forms the socket of the hip. The labrum, a ring of fibrous tissue that attaches around the rim of the acetabulum deepens the socket giving the hip joint inherent stability given its constrained design.

The hip is capable of motion in all three planes. Even during simple walking, motion occurs in all coronal, sagittal and transverse planes. Forces transmitted across the hip joint have been measured to be three to five times a person’s body weight and increase with activities such as stair climbing and running.

FEMOROACETABULAR IMPINGEMENT

Femoroacetabular Impingement, or “FAI” is a relatively new diagnosis in the realm of orthopaedics. FAI is a source of groin pain and is caused by abnormal morphology of the hip. Active men and women ages 40 to 50 are most often affected. They can present with anterior hip or groin pain during and after activities and may also complain of stiffness and loss of hip motion. The pain is typically intermittent and sharp. Continued FAI can lead to further cartilage damage and often develops into osteoarthritis.

There are two separately identifiable morphologic features of FAI: Cam and pincer lesions of the hip. Cam lesions are found on the femoral side and represent a loss of true sphericity of the femoral head. This lesion essentially creates a bump on the normally rounded edge of the femoral head. The lesion has been described as a “pistol-grip” deformity of the femoral head.

The pincer lesion is found on the acetabular side. Pincer lesions reflect “over coverage” of the femoral head. These lesions are often represented by a sharp spur or protuberance off the lateral edge of the acetabulum. Both lesions are visible on routine hip X-rays, best seen on the AP.

Physical examination of the hip reveals a loss of passive motion. Internal rotation and adduction are most affected. A positive “impingement” test consists of recreation of the patients’ characteristic groin pain with hip flexion, internal rotation and adduction. This is best elicited with the patient supine on the examining table. This test reproduces in the abnormal femoralacetabular contact with recreation of pain.

Standing radiographs, AP and lateral tests should be ordered to help make the diagnosis. Radiograpshs often reveal the pathognomonic cam and pincher lesions
about the hip. An MRI arthrogram can be helpful to identify associated tears of the acetabular labrum. Treatment consists of activity modification, NSAID therapy, rehabilitation and intraarticular hip injections under fluoroscopic or ultrasound guidance. When conservative measures fail, surgical intervention may be an option. Surgical options include arthroscopic repair and “hip reshaping.” Joint replacement is reserved for severe cases that fail conservative treatment.

BURSITIS

Bursitis is a painful condition caused by inflammation of the bursa, a fluid-filled sac found adjacent to many joints in the body. Hip pain in adults is frequently due to bursitis. The diagnosis is most commonly seen in females around 50 years of age.

Overuse results in excessive friction about the hip, which commonly leads to the development of bursitis. Post-traumatic bursitis is a result of a direct injury or blow to the hip. Anatomic features such as a wide pelvis also contribute to the development of bursitis.
There are three different bursae located around the hip: ischial, iliopectineal and the trochanteric. The ischial bursa is located along the posterior pelvis region and the iliopectineal is found anterior to the hip.

Trochanteric bursa is located along the lateral aspect of the hip between the iliotibial band (or IT band) and the greater trochanter of the hip. It is by far the most frequent location of bursitis. With trochanteric bursitis, patients often complain of lateral hip pain aggravated with sleeping on a side, rising from a chair and walking. Tenderness is elicited with palpation of the lateral hip, and pain is provoked with external rotation of the hip. Tightness of the overlying IT band often contributes to the problem. In addition, individuals with a broad pelvis or leg length inequality may be at increased risk for the development of trochanteric bursitis.

Treatment of trochanteric bursitis consists of activity modification, a short course of non-steroidal anti-inflammatory drugs (NSAIDs) and daily stretching of the IT band. Symptoms commonly last for several months. Refractory cases are treated with steroid injections and prescribed physical therapy. A minimum of 3 months is allowed between repeat steroid injections in the same location.

These cases can commonly persist for six months and sometimes longer. Surgery is rarely indicated.

SNAPPING HIP SYNDROME

Snapping Hip Syndrome (SHS) is a painful problem in which an audible and tactile snap occurs with certain hip movements. Typically the snapping occurs during hip flexion and extension.

The cause of the snap can be intraarticular or external to the hip joint.

When a tight iliotibial band slides over the greater trochanter, it can cause external hip snapping. The snapping is often felt and heard over the trochanteric or lateral area of the hip. Patients can usually reproduce the snapping by standing and squatting. Normally the IT band glides smoothly over the greater trochanter; however, when the posterior portion of the ITB becomes thickened, snapping can result.

Snapping can also be caused by the iliopsoas tendon catching on the femoral head as the hip moves from flexion to extension. This snapping is felt more medial, near the groin. It can often be reproduced with the patient supine on the examining table and moving the hip from extension to flexion.

Intraarticular causes of snapping hip include loose bodies, chondral damage and labral disease. The snapping is felt over the anterior hip near the groin. These patients usually cannot reproduce the snapping in clinic and often present with the complaint of hip pain and episodic “catching” of the hip. Snapping hip syndrome is usually found in younger populations and frequently related to overuse injuries involved with athletics.

A patient history and physical exam is the mainstay of diagnosis for both types of snapping. Routine X-ray imaging is recommended. In difficult or chronic cases, an MRI can be helpful to rule out other etiologies of hip pain, such as avascular necrosis, stress fracture and chondromalacia. If intra-articular snapping is suspected, an MRI arthrogram can provide a better picture of labral injuries.

With a detailed history and physical exam, most hip disorders can be accurately diagnosed at the initial presentation. Plain radiographs are very helpful at ruling out arthritis and malignancies as potential sources of pain. An MRI examination is useful in cases that are elusive and resistant to conservative treatments. Disorders of the lumbar spine must be considered and evaluated simultaneously to ensure precise treatment recommendations.

Cortisone injections can be utilized in select cases to help accelerate recovery. Consult your orthopaedist when needed.

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Emory Healthcare to Offer WATCHMAN Left Atrial Appendage Closure Implant

Thursday, May 28th, 2015

WATCHMAN implantEmory Healthcare is among the first health care systems in the United States to offer patients with non-valvular atrial fibrillation (AFib) an alternative to long-term warfarin medication with the FDA-approved

According to the American Heart Association, atrial fibrillation (AFib) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications in the nearly 2.7 million Americans it affects. The most common treatment to reduce stroke risk in patients with AFib is blood-thinning warfarin medication.

“The WATCHMAN device is an important advancement in stroke management for non-valvular AFib patients who are seeking alternatives to warfarin,” says cardiologist David DeLurgio, MD, professor of medicine, Emory University School of Medicine and director of electrophysiology at Emory Saint Joseph’s Hospital.

DeLurgio and the Emory team have been implanting the WATCHMAN device for the last seven years in clinical trials testing the new technology. He recently implanted the region’s first device since FDA approval was granted in March.

During the minimally invasive procedure, the WATCHMAN implant is delivered to the heart via a catheter, closing off an area of the heart called the left atrial appendage (LAA). The LAA is a thin, sack-like appendix attached to the heart and is believed to be the source of the majority of stroke-causing blood clots in people with non-valvular AFib.

“By closing the LAA and keeping these harmful blood clots from entering the blood stream, the risk of stroke may be reduced and, over time, patients could be freed from the challenges of long-term warfarin therapy,” says DeLurgio.

Despite its proven efficacy, long-term warfarin medication is not well tolerated by some patients and carries a significant risk for bleeding complications. Nearly half of AFib patients eligible for warfarin are currently untreated due to tolerance and adherence issues.

The WATCHMAN Implant, developed by Boston Scientific, has been approved in Europe since 2005. It has been implanted in more than 10,000 patients and is approved in more than 70 countries around the world

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Georgia CORE Receives Funding Award

Thursday, May 28th, 2015

The Georgia Center for Oncology Research and Education (Georgia CORE), will receive an award from the Patient-Centered Outcomes Research Institute (PCORI) to support “Patient-Centered Cancer Survivorship Care: Improving Quality of Care and Quality of Life for Survivors in Georgia.”

This Pipeline to Proposal project was developed collaboratively with Lanell Bellury, PhD, an expert in cancer survivorship and Associate Professor at Georgia Baptist College of Nursing of Mercer University. The award from PCORI will enable Georgia CORE to engage cancer survivors, healthcare providers and many other stakeholders in the process of developing research to address the needs of vulnerable cancer survivors in Georgia. “The on-going healthcare needs of cancer survivors, especially vulnerable older and minority survivors, are well recognized yet little evidence exists to guide the best care for survivors. With the number of cancer survivors growing exponentially, it is imperative that we discover the best way to meet the needs of survivors across the state,” notes Dr. Bellury.

According to Nancy Paris, Georgia CORE’s President, “Angie Patterson, Georgia CORE’s Vice President and a 14 year cancer survivor, will work with Dr. Bellury to develop and implement the Patient-Centered Cancer Survivorship Care program.” The award is one of only two contracted out in Georgia by PCORI in this round. Technical assistance and support will be provided by the Southern Pipeline to Proposal Award Office in the Georgia State University Andrew Young School of Policy Studies to ensure the success of this effort.

In 2014, Ms. Patterson led the development of Georgia CORE’s Cancer Survivorship Connection (www.GeorgiaCancerInfo.org/Survivorship) with funding from Tom and Karen Chapman. The interactive website serves as a resource center for the state’s growing survivorship population — now estimated at 356,000. “As a breast cancer survivor and the daughter of a two-time lung cancer survivor, I know first-hand how vitally important it is for survivors and caregivers to have access to care plans and resources. This work is near and dear to my heart,” said Ms. Patterson.

Georgia CORE is a public-private partnership led by a Board of Directors of cancer experts focused on bringing higher quality, better organized and more cost-effective care to cancer patients and survivors across the state of Georgia. Georgia CORE’s flagship resourcewww.GeorgiaCancerInfo.org is the only online information center of its kind, where details can be found on oncologists, clinical trials, treatment centers and survivorship resources throughout the state. The organization’s funders and sponsors include the State of Georgia, Georgia Department of Public Health, Georgia Society of Clinical Oncology, Georgia Research Alliance, Georgia Department of Community Health, State Office of Rural Health, Northside Hospital Cancer Institute, private foundations and individual donors. More information on Georgia CORE can be found at www.georgiacore.org.

Pipeline to Proposal Awards enable individuals and groups that are not typically involved in clinical research to cultivate the means to develop community-led funding proposals focused on patient-centered comparative effectiveness research (CER). Established by the non-profit PCORI, the program funds three tiers of awards that help individuals or groups build community partnerships, develop research capacity, and hone a comparative effectiveness research question that could become the basis of a research funding proposal to submit to PCORI or other health research funders.

PCORI is an independent, non-profit organization authorized by Congress in 2010 to fund comparative effectiveness research through contracts that will provide patients, their caregivers, and clinicians with the evidence needed to make better-informed health and healthcare decisions. PCORI is committed to seeking input from a broad range of stakeholders to guide its work.

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New Cancer Care Outpatient Infusion Center at WellStar Kennestone Hospital

Thursday, May 28th, 2015

WellStar Health System opened a new Outpatient Infusion Center at Kennestone Hospital, providing patients undergoing chemotherapy with a higher level of comfort, amenities and emotional support during their cancer treatments.

Located on the WellStar Kennestone Regional Medical Center campus, the infusion center capacity expanded by 25 percent. Twenty motorized, reclining chairs better accommodate patients and help minimize wait times. In the future, the space can expand to accommodate up to 25 patients at a time.

The 6,600 square-foot area is divided into semi-private nursing bays, each with a nurse dedicated to four patients.

“The new Outpatient Infusion Center at Kennestone Hospital was designed with the patient in mind,” said Joel Helmke, vice president of oncology services. “We made sure that our patients not only have access to the most advanced treatments and technology, but there is enough room for family and visitors. Having someone there to hold your hand can provide healing and assures patients they are not alone in their fight against cancer.”

“They have put so much thought into the new center,” said Sherry Reid, a patient undergoing chemotherapy for ovarian cancer who only has two infusion treatments remaining. “I won’t be here much longer, but the improvements have made it so much nicer. There’s a light over the chair with a dimmer and a flat screen TV. The volume comes out of a speaker in the handheld remote instead of the TV which makes for a more peaceful environment.

“I would have really benefitted from some of the updates when I first started infusion treatments,” she continued. “There are automatic doors, so you don’t have to pull the door open. You don’t have to manually adjust the chairs now because they’re motorized. They really thought of everything when they planned this space for people with cancer.”

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Emory Offering Breakthrough Heart Failure Monitoring Device

Thursday, May 28th, 2015

CardiomemsEmory Healthcare is the first health care system in Atlanta offering patients a miniaturized, wireless monitoring sensor, implanted in the pulmonary artery (PA), to help remotely manage heart failure (HF).

The CardioMEMS HF System is the first and only FDA-approved heart failure monitoring device that has demonstrated in clinical trials to reduce hospital admissions when used by physicians to manage heart failure.

During a non-surgical procedure, the CardioMEMS device is delivered to the heart via catheter and implanted in the PA. The paper clip-sized sensor directly measures pressure inside the PA.

Increased PA pressures appear before weight and blood pressure changes, which are often used as indirect measures of worsening heart failure.

Once implanted, the wireless sensor sends regular PA pressure readings to an external patient electronic system, allowing physicians to monitor the patient’s heart failure status and offer proactive management of the disease. There is no pain or sensation for patients during the readings.

“This is a breakthrough development in the monitoring of our heart failure patients,” says cardiologist Rob Cole, MD, assistant professor of medicine (cardiology), Emory University School of Medicine.

“We’re able to detect changes from a distance and, if needed, adjust a patient’s medication regimen to stabilize PA pressures, ultimately reducing thier likelihood of visiting a hospital.”

Cole and his Emory colleagues recently implanted Metro Atlanta’s first CardioMEMS device since FDA approval was granted last year. Emory Healthcare has been implanting the device for several years during a national clinical trial for the new technology.

“Our study findings showed a statistically significant reduction in heart failure-related hospitalizations for the participants whose doctors had access to this critically important pulmonary artery pressure data,” says Cole.

The CHAMPION clinical trial studied the effectiveness of the CardioMEMS HF System in New York Heart Association (NYHA) Functional Classification System class III heart failure patients who had been hospitalized for heart failure in the previous 12 months.

Results of the trial demonstrated a statistically significant 28 percent reduction in the rate of heart failure hospitalizations at six months, and 37 percent reduction in heart failure hospitalizations during an average follow-up duration of 15 months.

Roughly 1.4 million patients in the U.S. have NYHA Class III heart failure, and historically these patients account for nearly half of all heart failure hospitalizations.

Heart failure occurs when the heart is unable to pump enough blood to meet the body’s demands. According to the Centers for Disease Control and Prevention, more than 5.1 million Americans have heart failure, with 670,000 new cases diagnosed each year. Patients with heart failure are frequently hospitalized, have a reduced quality of life and face a higher risk of death.

The CardioMEMS HF System, from device manufacturer St. Jude Medical, was invented at Georgia Tech using technology created to sense the pressure changes in jet engines. The CardioMEMS sensor is designed to last the lifetime of the patient and does not require batteries.

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West Georgia Health Set to Join WellStar Health System

Tuesday, May 26th, 2015

West Georgia Health announced it has signed a formal letter of intent to join with WellStar Health System.

The healthcare industry is going through a period of substantial transition.  With ever-changing government regulations and reimbursements, health systems are looking for new efficiencies that will allow for improved access to healthcare, lower cost and higher quality.  By joining withWellStar Health System, West Georgia Health, Troup County and the surrounding community will benefit from WellStar’s care models, population health initiatives and advanced care.

“We were looking for a strong partner, but we were also looking for a good fit – the right fit,” said Jerry Fulks, president and CEO of West Georgia Health. “WellStar is that fit.  They’ve amassed the size and financial muscle you need to succeed in today’s healthcare world, and they’ve done that while keeping a sharp focus on patient care and employee satisfaction – and the relationship between those two.  Culturally, I believe this is a very good marriage.”

“As not-for-profits, WellStar and West Georgia Health have similar missions and commitments to our communities,” said Reynold Jennings, CEO of WellStar Health System.  “WellStar was formed 20 years ago when five hospitals came together to create a new health system.  By bringing West Georgia Health into the regional system, we are continuing our commitment to deliver world-class healthcare to the communities we serve.  Through an in-depth review, we have been very impressed with the level of care that is delivered by the entire West Georgia Health team.”

This announcement follows more than a year of work by the Strategic Planning Committee, which was appointed by the LaGrange-Troup County Hospital Authority.  As part of that process, the committee worked with JP Morgan, a leading financial advisor to the healthcare sector, to solicit partnership proposals from a number of larger healthcare systems in Georgia and beyond.

WellStar operates five community hospitals serving Bartow, Cherokee, Cobb, Douglas and Paulding counties.  WellStar Medical Group, an entity within WellStar, consists of more than 800 physicians and advanced practitioners across more than 160 office locations. With nearly 14,000 team members, it also operates a 180-bed nursing home, 16 imaging centers, eight urgent care centers, two health parks, a pediatric center and two hospice facilities.  In addition, WellStar operates one of the busiest emergency departments in the state.

Fulks and Jennings said they expected to complete the remaining due diligence and negotiations within the next three to six months.

 

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Georgia Neurological Society Annual Spring Meeting

Friday, May 22nd, 2015

May 22-24, 2015, Cloister at Sea Island, Sea Island, Ga. For more information, visit Georgia Neurological Society

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May 2015 Trauma Commission Meeting

Thursday, May 21st, 2015

May 21, 2015, Atlanta. For more information, visit Georgia Trauma Commission

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MAA Board Meeting

Thursday, May 21st, 2015

May 21, 2015, Atlanta. For more information, visit Medical Association of Atlanta 

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