15 Aug Surgical Volume Standards Not Practical For Most Hospitals
Posted at 14:15h
in Author Interviews, JAMA, Outcomes & Safety, Surgical Research, University of Michigan
MedicalResearch.com Interview with:
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Dr. Sheetz[/caption]
Kyle Sheetz, MD, MSc
Research Fellow
Center for Healthcare Outcomes and Policy
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Various patient safety organizations and clinical societies continue to advocate for volume thresholds as a means to improve the short-term safety and overall effectiveness of high risk cancer surgeries in the United States.
We asked two questions with this study:
1) What proportion of U.S. hospitals meet discretionary volume standards?
2) Do these standards differentiate hospitals based on short-term safety outcomes (mortality and complications)?
We found that a relatively low proportion of hospitals meet even modest volume standards put forth by the Leapfrog Group. These standards did not differentiate hospitals based on outcomes for 3 of 4 high risk cancer operations reported by the Leapfrog Group. However, using higher thresholds, we were able to demonstrate a significant relationship between higher hospital volume and better outcomes, which has been reported numerous times.





Prof Ching-Chi Chi,[/caption]
Prof Ching-Chi Chi, MD, MMS, DPhil (Oxford)
Department of Dermatology
Chang Gung Memorial Hospital, Linkou
Taiwan
MedicalResearch.com: What is the background for this study?
Response: Psoriasis has been associated various inflammatory comorbidities including diabetes mellitus, coronary artery disease, etc. Moreover, obesity is prevalent among psoriasis patients and has been considered as an independent risk factor for occurrence and worsening of psoriasis by promoting systemic inflammation.
Notably, body weight (BW) gain of psoriasis patients after biologics use has been observed. However, there are inconsistent reports on whether biological therapy relates to BW gain.
Prof. Satchi-Fainaro[/caption]
Prof. Ronit Satchi-Fainaro, PhD
Head, Cancer Research and Nanomedicine Laboratory
Department of Physiology and Pharmacology,
Sackler Faculty of Medicine,
Tel Aviv University,
Tel-Aviv 69978, Israel
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Prof. Florindo[/caption]
Prof. Helena Florindo, PhD
Head, BioNanoSciences – iMed.ULisboa
Faculty of Pharmacy,
University of Lisbon
Lisbon, Portugal
MedicalResearch.com: What are the main findings?
Response: The war against cancer in general, and melanoma in particular, has advanced over the years through a variety of treatment modalities, such as surgery, chemotherapy, radiation therapy and immunotherapy. The immune checkpoint inhibitors brought a breakthrough solution for advanced melanoma patients, but only a low percentage of those respond to this therapy, developing resistance and being affected by severe side effects. Despite the success of several vaccines against viral diseases, this success has not been materialized yet against cancer.
This study led by my lab at Tel Aviv University, and Helena Florindo’s lab at the University of Lisbon, describes the development of an effective nano-vaccine against melanoma, that also sensitizes the immune system to immunotherapies.
This nano-vaccine prevented melanoma, and also led to remarkable tumor inhibition and prolonged survival in mice already affected by this disease.


Dr. Gery Guy[/caption]
Gery P. Guy Jr., PhD, MPH
Senior Health Economist
Division of Unintentional Injury Prevention
CDC
MedicalResearch.com: What is the background for this study?
Response: In 2017, among the 70,237 drug overdose deaths in the United States, 47,600 (67.8%) involved prescription or illicit opioids. Distribution of the opioid receptor antagonist naloxone to reverse overdose is a key part of the public health response to the opioid overdose epidemic. The 2016 CDC Guideline for Prescribing Opioids for Chronic Pain recommended clinicians consider offering naloxone when overdose risk factors, such as history of overdose or opioid use disorder, higher opioid dosages, or concurrent benzodiazepine use, are present.
However, recent analyses examining pharmacy-based naloxone dispensing are lacking. To address this gap and to inform future overdose prevention and response efforts, CDC examined trends and characteristics of naloxone dispensed from retail pharmacies at the national and county level in the United States.