New and Updated Topics

What's New in the Healthwise® Knowledgebase

Version 9.6

January 2013

What's New

New Health and Disease Topics
New Illustrations
New Medical Test Topics
Enhanced Content
New NCI
New Medication Topics
New Aisle 7 (CAM) Content
Updated Actionsets
Updated Decision Points
Updated Health and Disease Topics
Updated Illustrations
Updated iTools
Updated Online Forms
Updated Medical Test Topics
Updated Symptom Topics
Updated NCI Topics
Updated Medication Topics
Topic Title Changes and Topic Replacements
Medical Guideline Reviews
What's Next

New Health and Disease Topics

High Blood Pressure During Pregnancy: This new topic explains high blood pressure during pregnancy that is not preeclampsia. It includes information on symptoms, exams and tests, treatment, and what you can do at home when you are pregnant and you have high blood pressure.
Long-Term Care Choices: This new topic covers what long-term care is and why it may be necessary. It gives examples of the different types of long-term care and how they differ. It also provides help on how to decide about long-term care.
Low Testosterone: This new topic discusses causes and symptoms of low testosterone. It covers testosterone replacement, including risks and side effects of this treatment.
Turning Off Your ICD: This new topic covers why someone might want to turn off his or her ICD (implantable cardioverter-defibrillator). It provides information on what happens when an ICD is turned off and some things to thing about when making this decision.
Vascular Access Failure: This new topic explains how to take care of a vascular access for hemodialysis. It includes symptoms of access failure, when to call a doctor, and what happens if an access gets infected or stops working properly.

New Illustrations

New illustrations were added to these topics:

A new illustration of the FACES pain scale appears in the topic Pain Management.

New Medical Test Topics

Nuchal Translucency Screening Test: This new topic explains why the nuchal translucency screening test is done and what it 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.

Enhanced Content

We've revised the following documents so that they are more concise and easier for readers to explore and use. The content is now more streamlined, there is less repetition across the various sections of each document, and we've provided more cues to the reader in the form of improved headings, lists, and well-placed links.

Other Enhancements

We revised the description of a speculum in the following documents. We now say "a lubricated tool called a speculum."

New NCI Topics

There are new Physician Data Query (PDQ) topics from the National Cancer Institute. Refer to your product Tech Docs for a complete list of new and updated titles.

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 the Tech Docs for a complete list of new and updated titles.

New Aisle 7 (CAM) Content

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

Updated Actionsets

A primary care physician or a specialist in the field reviewed the following topics. We verified all information for medical accuracy and added new medical information if available. While medically significant changes are listed here, minor revisions, such as editorial changes, may not be listed.

Bowel Disease: Caring for Your Ostomy: In "How do I care for my ostomy?" we added a list of possible problems to watch for after an ostomy.

A primary care physician or a specialist in the field reviewed the following topics. No medical revisions were needed.

Updated Decision Points

Bed-Wetting: Should I Do Something About My Child's Bed-Wetting?: In Get the Facts under "How well do treatments for bed-wetting work?" we removed self-awakening training and dry-bed training, because they no longer are standard treatments.
Osteoporosis: Should I Take Bisphosphonate Medicines?: In Compare Your Options under "What are the risks and side effects?" we say that it is not clear how long you should take bisphosphonates.

A primary care physician or a specialist in the field reviewed the following topics. No medical revisions were needed.

Updated Health and Disease Topics

A primary care physician and/or a specialist in the field reviewed the following topics. We verified all information for medical accuracy and added new medical information if available. While medically significant changes are listed here, minor revisions, such as editorial changes, may not be listed.

Altitude Sickness:
- Topic Overview: Under "Can you prevent altitude sickness?" we now mention a study that showed that starting to take ibuprofen 6 hours before climbing to high elevations and then taking it every 6 hours while climbing may help prevent altitude sickness.
Bed-Wetting:
- Treatment Overview: Under "What to think about," we now say that treatment is usually not a cure and that the goal is to reduce the number of times the child wets the bed and to manage the wetting until it goes away on its own.
- Other Treatment: We now say that it's not a good idea to have your child wear diapers or pull-ups at night on a regular basis.
- Daytime Accidental Wetting (Diurnal Enuresis) (Special): Under "Home treatment," we removed bladder exercises, because research hasn't shown that they work well.
- Moisture Alarms for Bed-Wetting (Special): We now say that moisture alarms aren't meant for children who wet the bed only once or twice a week.
Bursitis: Under "How is it treated?" we say that NSAIDs come in pills and in a cream.
Cardiac Rehabilitation: Throughout the topic we renamed the phases of cardiac rehab. We renamed the Home Program to Phase II. In turn, we renamed Phase II to Phase III and Phase III to Phase IV.
Cervical Cancer Screening: We updated the information about screening for cervical cancer to include the new guidelines from the American College of Obstetricians and Gynecologists (ACOG).
COPD (Chronic Obstructive Pulmonary Disease):
- Medications: We added that the newly-approved medicine aclidinium (Tudorza Pressair), which is delivered through a dry powder inhaler, may be taken as a daily controller medicine to prevent COPD exacerbations.
Colorectal Cancer, Metastatic or Recurrent:
- Treatment Overview: We now include targeted therapy with monoclonal antibodies and say this may be given along with chemotherapy. We also include a section on pain control and say that cancer pain can almost always be controlled.
Crohn's Disease:
- Biologics for Inflammatory Bowel Disease: In What to Think About under "Drug safety," we added information on who may be at risk for getting the brain infection progressive multifocal leukoencephalopathy (PML). In How Well It Works under "Ulcerative colitis," we added research about adalimumab (Humira).
Farsightedness (Hyperopia):
- Dry Eye Syndrome (Special): We now include other treatment options, such as prescription eyedrops, punctal occlusion, or omega-3 fatty acid supplementation.
Health Screening: Finding Health Problems Early:
- Screening, Adult Women: We revised the cervical cancer screening information based on new guidelines from the American College of Obstetricians and Gynecologists (ACOG).
Hepatitis A:
- Combination Vaccine for Hepatitis A and B (Drug Detail): In How It Works, we added that the combination hepatitis A and B vaccine can be given in a 4-dose schedule.
- Viral Hepatitis (Special): We added that hepatitis E may be spread by contact with contaminated pigs.
Hepatitis E: Under "How is hepatitis E spread?" we added that people also can get hepatitis E from contact with an animal, such as eating undercooked meat from or touching an infected pig.
Lice:
- Treatment Overview: We now say if you still see live lice on a household member 7 to 10 days after he or she had the first treatment, it's best for that person to have a second treatment.
- Lice: Cleaning Lice From Combs, Clothing, and Other Items (Special): We now say that removing lice from objects is not a necessary part of treatment for head lice. We updated the list of tips based on CDC recommendations.
HIV: Preventing Infections: We now say it is important to be up to date on PCV, PPSV, and Tdap immunizations.
Human Immunodeficiency Virus (HIV) Infection:
- Topic Overview: Under "How can you prevent HIV?" we added "You also can take antiretroviral medicine to help protect yourself from HIV infection. But to keep your risk low, you still need to practice safer sex even while you are taking the medicine."
- Exams and Tests: In a new section called "Home test kits for HIV," we describe the test OraQuick and a home blood test kit.
- Nucleoside/Nucleotide Reverse Transcriptase Inhibitors for HIV (Drug Detail): We added the medicine Stribild (cobicistat, elvitegravir, emtricitabine, and tenofovir) as an example of a combination medicine that contains a nucleoside/nucleotide reverse transcriptase inhibitor for HIV.
Immunizations:
- Adult Immunizations: Regarding pneumococcal vaccination, we now say that people ages 19 and older who have immune system problems, cerebrospinal fluid leaks, cochlear implants, no spleen, or a damaged spleen need both PCV and PPSV.
Irritable Bowel Syndrome:
- Medications: Under "Constipation medicines," we added the newly approved medicine linaclotide (Linzess).
Marijuana: We added information about synthetic marijuana and its side effects.
Medical Marijuana: We added information about synthetic marijuana and its side effects.
Osteoporosis:
- Other Treatment: We say that there is not good evidence that soy products reduce the chance of broken bones, but that they are a good source of non-dairy protein. We also deleted hip protectors, since they are no longer widely used.
- Bisphosphonates for Osteoporosis (Drug Detail): Under What to Think About, we now say "It is not clear how long you should take bisphosphonates. Experts have suggested that taking bisphosphonates for 3 to 5 years may be enough if you are at low risk of fractures. Talk to your doctor about how long you should take these medicines."
- Raloxifene (Drug Detail): Under Why It Is Used, we say that raloxifene may be a good choice for women who are considering medicines to prevent or treat osteoporosis and who also have a high risk for breast cancer.
Osteoporosis in Men: Under "How is it treated?" we added denosumab.
Pain Management:
- Knowing When Pain Is Worse: Under "Use a pain scale," we added a link to a new illustration of the FACES pain scale.
Pneumonia:
- Prevention: We now say that some adults need both types of pneumococcal vaccine.
Skin Cancer, Nonmelanoma:
- Laser Surgery for Skin Cancer (Surgical Detail): This new topic that explains how laser surgery is used to remove skin cancers.
Surgery: What to Expect:
- Before Surgery: Under "Just before surgery," we added a link to a new illustration of the FACES pain scale.
Tendon Injury (Tendinopathy):
- Treatment Overview: We say that NSAIDs come in pills or in a cream that you rub over the sore area. We also say that platelet-rich plasma (PRP) is being studied.
Type 1 Diabetes: We organized, streamlined, and used plain language to make content easier to understand and reduce redundancy within the topic.
Urinary Incontinence in Women:
- Electrical Stimulation for Urinary Incontinence (Other Detail): We added posterior tibial nerve stimulation (PTNS) as another treatment of this kind.
Warts and Plantar Warts:
- Treatment Overview: We now talk about treating warts in children. Under "Treatment by your doctor," we include chemical peels.
- Home Treatment: We include information on over-the-counter cryotherapy kits.

A primary care physician or a specialist in the field reviewed the following topics. No medical revisions were needed.

Updated Illustrations, iTools, and Forms

Updated Illustrations

The illustration of a view from a farsighted eye has been revised. It appears in the topic Farsightedness (Hyperopia).

Updated Interactive Health Tools

A primary care physician or a specialist in the field reviewed the following topics. No medical revisions were needed.

Updated Online Forms

Chronic Pain: Pain Control Diary(What is a PDF document?)
Cancer Pain: Pain Diary(What is a PDF document?)

Updated Medical Test Topics

Body Temperature:
- How to Prepare: We added information about temporal artery thermometers.
- How It Is Done: We added the steps that explain how to take a temporal artery temperature.
Human Immunodeficiency Virus (HIV) Test:
- What to Think About: We added information about the OraQuick home test kit for HIV infection.

Potassium (K) in Urine:
- How It Is Done: We removed the instructions for a "clean-catch midstream one-time urine collection," because this test is almost always done on a urine sample collected over 24 hours.

A primary care physician or a specialist in the field reviewed the following topics. No medical revisions were needed.

Updated Symptom Topics

Burns and Electric Shock:
- Check Your Symptoms: We removed the question about decreased consciousness, because all other 911 questions cover this symptom.
Head Injury, Age 3 and Younger:
- Check Your Symptoms: In the question on forceful injury, we removed the language about a penetrating object and added language about a forceful sports injury.
Head Injury, Age 4 and Older:
- Check Your Symptoms: In the question on forceful injury, we removed the language about a penetrating object and added language about a forceful sports injury.
Postoperative Problems:
- Check Your Symptoms: We added a question about arm or leg surgery with a vascular problem with a Red "call now" disposition.
Problems After Delivery of Your Baby:
- Check Your Symptoms: We added a question about a new, different, sudden, and severe headache with 911 "call emergency." We also added a question about a new, different, and severe headache with Red "call now" disposition.
Sunburn:
- Check Your Symptoms: We added a question about babies less than 3 months old who have a sunburn and blisters with a Red "call now" disposition.

A primary care physician or a specialist in the field reviewed the following topics. No medical revisions were needed.

Updated NCI Topics

There are updated Physician Data Query (PDQ) topics from the National Cancer Institute included in this release. Refer to your product Tech Docs for a complete list of new and updated titles.

Updated Medication Topics

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 your product Tech Docs for a complete list of new and updated titles.

Topic Title Changes, Topic Replacements, Medical Guideline Reviews

Topic Title Changes

Amputation for Diabetic Foot Problems is now titled Diabetes: Amputation for Foot Problems.
Bone Marrow Transplant for Sickle Cell Disease is now titled Stem Cell Transplant for Sickle Cell Disease.
Burns is now titled Burns and Electric Shock.
Cardiac Rehabilitation Home Program: Hospital to Home is now titled Cardiac Rehabilitation Phase II: Hospital to Home.
Cardiac Rehabilitation Phase II: Outpatient Program is now titled Cardiac Rehabilitation Phase III: Outpatient Program.
Cardiac Rehabilitation Phase III: Long-Term Lifestyle Change is now titled Cardiac Rehabilitation Phase IV: Long-Term Lifestyle Change.
Early Disease Detection is now titled Health Screening: Finding Health Problems Early.
Farsightedness: Treatment Pros and Cons is now titled Refractive Error: Treatment Pros and Cons.
First-Generation Antipsychotics for Treating Schizophrenia is now titled Antipsychotics for Treating Schizophrenia.
How to Remove a Tick is now titled Ticks: How to Avoid and Remove Ticks.
Injectable Antispasmodics for Cerebral Palsy is now titled Cerebral Palsy: Medicines to Relax Spastic Muscles.
Mebendazole for the Treatment of Pinworms is now titled Anthelmintics for Pinworms.
Medicines That Can Cause Osteoporosis is now titled Medicines, Osteoporosis, and Fractures.
Multiple Sclerosis: Assistive Devices is now titled Assistive Devices for People With Disabilities.
Osteoporosis: Should I Have a Dual X-Ray Absorptiometry (DEXA) is now titled Osteoporosis: Should I Have a Dual-Energy X-Ray Absorptiometry (DXA) Test?
Parathyroid Hormone for Osteoporosis is now titled Teriparatide for Osteoporosis.
Partial Colectomy for Diverticular Disease is now titled Bowel Resection.
Preeclampsia and High Blood Pressure has been split into two topics that are titled Preeclampsia and High Blood Pressure During Pregnancy.
Prothrombin Time is now titled Prothrombin Time and INR.
Scaphoid Fracture of the Wrist is now titled Navicular Fracture of the Wrist
Schizophrenia: Helping Someone Deal With Negative Symptoms is now titled Schizophrenia: Encouraging Social Skills.
Stress Incontinence: Should I Have Surgery? is now titled Stress Incontinence in Women: Should I Have Surgery?

Topic Replacements

The following searchable topics have been archived, and replacement topics are listed. Many rank-3 frames, which are non-searchable documents, have also been archived, because they contained duplicate information. See your product Tech Docs for a complete list of archived documents.

Albendazole for the Treatment of Pinworms has been removed. You can find the content in Anthelmintics for Pinworms.
Antispasmodics (Muscle Relaxants) for Cerebral Palsy has been removed. You can find the content in Cerebral Palsy: Medicines to Relax Spastic Muscles.
Bladder Exercises for Bed-Wetting has been removed. You can find the content in the Other Treatment section of Bed-Wetting.
Clozapine for Schizophrenia has been removed. You can find the content in Antipsychotics for Treating Schizophrenia.
Desmopressin for Hemophilia has been removed. You can find the content in Hemophilia.
Diabetes: Tracking My Portions From Each Food Group has been removed. You can find the content in Healthy Eating: Tracking My Servings From Each Food Group(What is a PDF document?).
Disposable Underpants for Bed-Wetting has been removed. You can find the content in the Other Treatment section of Bed-Wetting.
Dry-Bed Training for Bed-Wetting has been removed. You can find the content in the Other Treatment section of Bed-Wetting.
Exercise Tips if You Have a Pacemaker or ICD has been removed. You can find the content in Heart Problems: Living With a Pacemaker and Heart Problems: Living With an ICD.
Hemophilia: Should I Have Regularly Scheduled or On-Demand Clotting Factor Replacement? has been removed. You can find the content in Clotting Factor Replacement for Hemophilia.
Job Training for People With Schizophrenia has been removed. You can find the content in Vocational Training.
Lindane for Lice has been removed. You can find the content in the Medications section of Lice.
Oxybutynin for Daytime Wetting and Bed-Wetting has been removed. You can find the content in Daytime Accidental Wetting (Diurnal Enuresis).
Pelvic Floor (Kegel) Exercises for Urinary Incontinence in Women has been removed. You can find the content in Behavioral Methods for Urinary Incontinence.
Schizophrenia: Other Health Problems That May Occur has been removed. You can find the content in the What Happens section of Schizophrenia.
Second-Generation Antipsychotics for Treating Schizophrenia has been removed. You can find the content in Antipsychotics for Treating Schizophrenia.
Self-Awakening for Bed-Wetting has been removed. You can find the content in the Other Treatment section of Bed-Wetting.
Taking Medicines for Schizophrenia has been removed. You can find the content in Keeping Track of Medicines.
Type 1 Diabetes: Living With Complications has been removed. You can find the content in Type 1 Diabetes.
Type 1 Diabetes: Living With the Disease has been removed. You can find the content in Type 1 Diabetes.
Type 1 Diabetes: Recently Diagnosed has been removed. You can find the content in Type 1 Diabetes.
What You Need to Know Before Exercising With an Implantable Cardioverter-Defibrillator (ICD) has been removed. You can find the content in Heart Problems: Living With an ICD.

Medical Guideline Reviews

The following medical guidelines have been reviewed to ensure Healthwise content is accurate, consistent, and helpful to consumers.

American College of Obstetricians and Gynecologists (2012). Screening for Cervical Cancer. ACOG Practice Bulletin No. 131. Obstetrics and Gynecology.
Centers for Disease Control and Prevention (2012). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP).

What's Next

The next release of the Healthwise Knowledgebase is scheduled for April 2013.

New Topics

New topics on the following subjects are in development and are expected to release within the next 6 months:

Aggression in youth
Anal cancer
End-of-life care: Newborn
Golfer's elbow
Growth and development milestones
High- and low-potassium foods
Hodgkin's lymphoma
Sonohysterogram
Staying healthy around animals
Suprapubic catheter
Teens and birth control
Unused medicine

Enhancements

The following topics are currently being revised to improve the readability and key actions for consumers:

Bed Rest in Pregnancy
Chronic Lung Disease in Infants
Colorectal Cancer
Colorectal Cancer, Metastatic or Recurrent
Cushing's Syndrome
Cystic Fibrosis
Developmental Dysplasia of the Hip
Dupuytren's Disease
Gum Disease
Hair Loss
Hammer, Claw, and Mallet Toes
Hip Fracture
Hypertrophic Cardiomyopathy
Ménière's Disease
Nephrotic Syndrome
Paget's Disease of Bone
Patellar Tracking
Placenta Abruptio
Placenta Previa
Poison Ivy, Oak, or Sumac
Spina Bifida
Tooth Decay
Urinary Incontinence in Men
Wisdom Tooth Problems

Updates

We will be updating the following topics:

Abdominal Problems, Age 11 and Younger
Abdominal Problems, Age 12 and Older
Abnormal Pap Test
Abscessed Tooth
Achilles Tendon Problems
Acne
Age-Related Macular Degeneration
Angiogram
Arthroscopy
Atrial Fibrillation
Bartholin Gland Cyst
Basic Dental Care
Benign Paroxysmal Positional Vertigo (BPPV)
Blisters
Body Temperature
Bone Marrow Aspiration and Biopsy
Bruises and Blood Spots
Burns
Child Abuse and Neglect
Chlamydia
Chronic Fatigue Syndrome
Chronic Pain
Clubfoot
Color Blindness
Confusion, Memory Loss, and Altered Alertness
Depression
De Quervain's Disease
Diabetic Nephropathy
Dizziness, Lightheadedness, and Vertigo
Exposure to Sexually Transmitted Infections
Eyelid Problems
Family Life Cycle
Feeling Depressed
Fibrocystic Breasts
Folic Acid Deficiency Anemia
Genital Herpes
Growth and Development, Newborn
Health and Safety, Ages 2 to 5 Years
Health and Safety, Birth to 2 Years
Healthy Eating
Homocysteine
Hospital Discharge Planning
Iron Deficiency Anemia
Kawasaki Disease
Klinefelter Syndrome
Leukemia
Male Genital Problems and Injuries
Malocclusion and Orthodontics
Meningitis
Miscarriage
Mitral Valve Prolapse
Navigating Your Hospital Stay
Ophthalmoscopy
Oral Cancer
Parkinson's Disease
Pelvic Inflammatory Disease
Postoperative Problems
Post-Traumatic Stress Disorder
Preterm Labor
Prevent Medical Errors
Pulmonary Embolism
Radon
Ringworm of the Scalp and Beard
Ringworm of the Skin
Scabies
Scalp Problems
Seborrheic Keratosis
Shingles
Skin Changes
Sleep Problems, Age 12 and Older
Smallpox
Speech and Language Development
Stroke
Suicidal Thoughts or Threats
Swollen Glands and Other Lumps Under the Skin
Tennis Elbow
Testicular Cancer
Testicular Problems
Tonsillitis
Type 1 Diabetes: Children Living With the Disease
Uterine Cancer
Vitamin B12 Deficiency Anemia
Von Willebrand's Disease
Weakness and Fatigue

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