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Background: Arthroscopic rotator cuff repair generally provides satisfactory results including decreased shoulder pain and improved shoulder motion. Unfortunately, imaging studies demonstrate that the retear rate associated with the available arthroscopic techniques may be high. The purpose of this study was to evaluate the clinical and magnetic resonance imaging (MRI) results of arthroscopic rotator cuff repair with and without the use of platelet-leukocyte membrane in patients with a large posterosuperior rotator cuff tear.Methods: Eighty consecutive patients with a large full-thickness posterosuperior rotator cuff tear were enrolled. All tears were repaired using an arthroscopic single-row technique. Patients were randomized to treatment either with or without a platelet-leukocyte membrane inserted between the rotator cuff tendon and its footprint. In patients treated with this membrane, one membrane was utilized for each suture anchor. The primary outcomes were the difference between the preoperative and postoperative Constant scores and the repair integrity assessed by MRI according to the Sugaya classification. The secondary outcome was the difference between the preoperative and postoperative Simple Shoulder Test (SST) scores.Results: The only significant differences between the two groups involved the patient age and the preoperative and postoperative Constant scores; the differences in the Constant score were due to differences in the shoulder pain subscore. At a mean of thirteen months of follow-up, rotator cuff retears were observed only in the group of patients in whom the membrane had not been used, and a thin but intact tendon was observed more frequently in this group as well. The use of the membrane was associated with significantly better repair integrity (p = 0.04).Conclusions: The use of the platelet-leukocyte membrane in the treatment of rotator cuff tears improved repair integrity compared with repair without membrane. However, the improvement in repair integrity was not associated with greater improvement in the functional outcome. In fact, the Constant scores of the two groups would have been similar if the shoulder pain component (which had differed preoperatively) had been excluded. [ABSTRACT FROM AUTHOR]

Purpose: Interprofessional teams are increasingly being recognized as a best practice for enhancing cooperation among multiple disciplines in delivering person-centered care and improving outcomes. Unlike previous models, such as the multidisciplinary team in which each profession or discipline remained largely siloed, with interprofessional teams collaboration occurs across disciplines. For case managers, the interprofessional team concept aligns with the collaborative, professionally diverse nature of the field of practice. As the Commission for Case Manager Certification (CCMC) states: "The practice of case management is professional and collaborative, occurring in a variety of settings where medical care, mental health care, and social supports are delivered. Services are facilitated by diverse disciplines in conjunction with the care recipient and their support system" (2024b, CCMC Definition and Philosophy, p.1). Although interprofessional teams may be more familiar in settings such as acute care, this dynamic can be found, formally and informally, across health and human services. Professional case managers who actively participate in interprofessional teams will likely find more opportunities to optimize collaboration and collective decision-making that bring out the best of every profession and discipline., Primary Practice Settings: Interprofessional teams can be found in multiple care settings including acute care, subacute care, community-based care, palliative/end-of-life and other settings that benefit from a person-centered approach that supports successful transitions of care and improved outcomes., Implications for Case Management Practice: Professional case managers are valued members of interprofessional teams, in that they are typically collaborative, promote open communication, and encourage cooperation among various disciplines. Interprofessional teams, however, may require a shift in thinking away from the former multidisciplinary model, in which case managers often acted as the hub connecting the spokes of each discipline. Within interprofessional teams, the individual is at the center, and every discipline will share leadership based on the individual's needs or the treatment protocol or other intervention needed in the moment. In this way, interprofessional teams become a model for empowering and allowing each discipline to step up and address specific aspects of treatment or other interventions., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: The authors report no conflicts of interest.

Competing Interests: The authors report no conflicts of interest.

Competing Interests: The authors report no conflicts of interest.

Competing Interests: The authors report no conflicts of interest.

Competing Interests: The author reports no conflicts of interest.

Purpose: Social determinants of health (SDOH), the environmental, economic, and social factors that influence people's health outcomes, are widely recognized across health and human services. In addition, there are other factors that can exacerbate SDOH; among them is immigration status. Its influence is so profound that it has been suggested that immigration be considered an SDOH in and of itself (National Academies of Sciences, Engineering, and Medicine, 2018). Across the continuum, case managers need to be aware of the immigration status of their clients (the individuals for whom they advocate and provide services). This is particularly important when addressing the care needs and discharge plans for clients in acute care, community-based health, and workers' compensation. With workers' compensation, when an individual is undocumented and severely injured, immigration status directly impacts the services they may receive under state mandates. Moreover, such limitations can present ethical dilemmas for case managers, including what happens to workers if they are returned to their home countries., Primary Practice Settings: SDOH and immigration status can impact individuals in acute care, subacute care, community-based care, and workers' compensation., Implications for Case Management Practice: SDOH and immigration status highlight the disparities that exist within health and human services. Although equity is a core value of case management practice, the case manager's ability to provide equal access to care and resources can be severely limited because of the individual's immigration status. At all times, case managers must practice within their licensure and certifications. By recognizing that immigration status should be an SDOH, case management professionals and health and human services organizations can elevate the discussion of how to care for individuals with catastrophic injuries and illnesses who are undocumented., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Objectives: Studies on rotator cuff tears (RCT) in patients younger than 50 years have focused on the post-operative outcomes. Little is known about cuff tear etiopathogenesis, although it is a common belief that most tears are due to trauma. We have retrospectively verified the prevalence of medical conditions, whose role in tendon degeneration development have been widely demonstrated, in a group of patients younger than 50 years with postero-superior RCT. Materials and Methods : 64 patients [44M-20F; mean age (SD): 46.90 (2.80)] were enrolled. Personal data, BMI, smoking habit, diseases (diabetes, arterial hypertension, hypercholesterolaemia, thyroid diseases, and chronic obstructive pulmonary disease) were registered. The possible triggering cause and the affected side and tear dimensions were recorded, and statistical analysis was then performed. Results : 75% of patients had one or more diseases and/or a smoking habit for more than 10 years. In the remaining 25%, only four patients referred had had a traumatic event, while in the other eight patients, both medical condition and trauma were registered. The presence of two or more diseases did not affect RCT size. Conclusions : In our series, three quarters of patients with RCT had a smoking habit or medical conditions predisposing them to a tendon tear; therefore, the role of trauma in RCT onset in patients younger than 50 years is markedly resized. It is plausible that in the remaining 25%, RCT may be due to trauma or to genetic or acquired degeneration. Level of Evidence: IV.

Competing Interests: The authors report no conflicts of interest.

Purpose: Social determinants of health (SDOH) continue to gain attention as the factors that weigh heavily on physical and mental health. In response, professional case managers need to develop a deeper understanding of the entrenched nature of SDOH, particularly the spiraling and compounding effects of economic, environmental, and social factors on the health and well-being of individuals and populations. Professional case managers are essential to helping identify both the barriers experienced by individuals in accessing and receiving the care they need and the resources to eliminate or mitigate those barriers. These responsibilities should be most keenly felt by case managers who are board-certified and therefore held accountable by codes of ethics to ensure justice and fairness. By embedding greater awareness of SDOH into the case management process-from intake and assessment through implementation, evaluation, and across care transitions-case managers can establish rapport with clients (known as "patients" in some care settings) and support improved outcomes through best practices in care coordination, thus contributing to the Triple Aim of improving the health of people and populations and reducing the per capita cost of care., Primary Practice Settings: SDOH impact individuals across the health and human services, including acute care, subacute care, primary care, community-based care, and workers' compensation., Implications for Case Management Practice: Case management plays a vital role in providing people with episodic care and ensuring adequate follow-up. The latter includes if and how people are able to access the ongoing care they need, including medications (access and affordability), doctors' visits, therapies and other services, healthy nutrition, and more. However, a lack of affordability undermines an individual's ability to receive preventive care and treatment of chronic illnesses and potentially more serious and life-threatening conditions such as cancer. Compounding the impact of affordability can be a lack of transportation that inhibits access to health care professionals, which can affect individuals in both rural and inner-city environments. Although poverty and homelessness play a direct role in SDOH, case managers cannot assume which clients are impacted by these factors and which are not. Higher costs of living, loss of job or reduced income, unexpected expenses, and death of, or divorce from, a partner/spouse can negatively impact a client's ability to access and afford care. With this understanding, case managers can meet individuals where they are to explore how SDOH affects their lives, without judgment, bias, or assumption., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: The authors report no conflicts of interest.

Introduction: Conducted under the auspices of the Italian Society of Consultation Liaison Psychiatry (SIPC) the aim of this study was to describe the characteristics of Consultation Liaison Psychiatry (CLP) activity in Italy (SIPC-2-2018) over the past 20 years by comparing with data from the first Italian nation-wide study (SIPC-1-1998)., Methods: We collected data on CLP visits of 3,943 patients from 10 Italian hospitals over a period of 1 year. Data were compared with those from the SIPC-1 1998 study (4,183 participants). Patients were assessed with the same ad hoc 60-item Patient Registration Form recording information from five different areas: Sociodemographic, hospitalization-related, consultation-related, interventions and outcome., Results: Compared with participants from the previous study, SIPC-2-2018 participants were significantly older ( d = 0.54) and hospitalized for a longer duration ( d = 0.20). The current study detected an increase in the proportion of referrals from surgical wards and for individuals affected by onco-hematologic diseases. Depressive disorders still represented the most frequent psychiatric diagnosis, followed by adjustment and stress disorders and delirium/dementia. Also, CLP psychiatrists prescribed more often antidepressants (Φ = 0.13), antipsychotics (Φ = 0.09), mood stabilizers (Φ = 0.24), and less often benzodiazepines (Φ = 0.07)., Conclusion: CLP workload has increased considerably in the past 20 years in Italy, with changes in patient demographic and clinical characteristics. A trend toward increase in medication-based patient management was observed. These findings suggest that the psychiatric needs of patients admitted to the general hospital are more frequently addressed by referring physicians, although Italian CLP services still deserve better organization and autonomy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zerbinati, Palagini, Balestrieri, Belvederi Murri, Caruso, D’Agostino, Ferrara, Ferrari, Minervino, Milia, Nanni, Pini, Politi, Porcellana, Rocchetti, Taddei, Toffanin, Grassi and Italian Society of Consultation-Liaison Psychiatry.)

Competing Interests: The authors report no conflicts of interest.

Competing Interests: The authors report no conflicts of interest.

Competing Interests: The authors report no conflicts of interest.