MedicalResearch.com Interview with:Ze'ev Ronai, Ph.D.
Professor and scientific director of Sanford-Burnham Medical Research Institute La Jolla San Diego, Calif.
MedicalResearch.com: What are the main findings of the study?Answer:This study provides the first direct evidence of the importance of the PDK1 enzyme in the development of melanoma and in the metastasis of this aggressive tumor type. We demonstrate, with a genetic mouse melanoma model (harboring the Braf/Pten mutations commonly seen in human melanomas) and/or pharmacological inhibitors against PDK1, that melanoma requires this enzyme for its development, and more so – for its ability to metastasize. Since PDK1 is key kinase that regulates a number of protein kinases, which are currently being assessed in clinical trials (including AKT), our finding points to a new set of targets that could be more amenable for effective combination therapy in melanoma.
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Matthew Daubresse, MHS Research Data Analyst
Center for Drug Safety and Effectiveness
Johns Hopkins School of Public Health
615 N. Wolfe Street, Suite W6023
Baltimore, MD 21205
MedicalResearch.com: What are the main findings of the study?Answer: Over the past decade, prescriptions for non-opioid medications remained stable or declined among ambulatory pain visits in the United States. In visits for new-onset musculoskeletal pain, non-opioid prescribing decreased from 38% of visits in 2000 to 29% of visits in 2010. During this time, opioid prescriptions nearly doubled. Few patient, provider, and visit characteristics were associated with the likelihood of opioid receipt, suggesting increases in opioid prescribing have occurred generally across different groups of patients. (more…)
MedicalResearch.com Interview with:Faisal G. Bakaeen, MD FACS
Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas
MedicalResearch.com: What are the main findings of the study?Dr. Bakaeen: The relative use of off-pump CABG peaked at 24% in 2003, followed by a slow decline after that to about 19%. In addition, the conversion rate from off- to on-pump decreased with time and has stayed below 3.5% in recent years. Perioperative mortality rates decreased over time for both on- and off-pump CABG and have stayed below 2% since 2006. The mortality associated with converted cases was high regardless of the surgery year.
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MedicalResearch.com Interview with:Mine Tezal, DDS, PhD
Oral Biology
University at Buffalo
NYS Center of Excellence in Bioinformatics and Life Sciences
MedicalResearch.com: What are the main findings of the study? Dr. Tezal: We observed an inverse association between dental caries and head and neck cancer (HNSCC), which persisted among never smokers and never drinkers. Besides untreated caries, two other objective measures of long-standing caries history (endodontic treatments and crowns) were also inversely associated with HNSCC with similar effect sizes, supporting the validity of the association. Missing teeth was associated with increased risk of HNSCC in univariate analyses, but after adjustment for potential confounders, its effect was attenuated and was no longer statistically significant.
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MedicalResearch.com Interview with:
Laura A. Petersen, MD, MPH
MEDVAMC Associate Chief of Staff, Research
Director, VA HSR&D Center of Excellence (152)
Houston TX 77030
Professor of Medicine
Chief, Section of Health Services Research
Baylor College of Medicine
HSR&D Center of Excellence
Michael E. DeBakey Veterans Affairs Medical Center
Houston, Texas 77030
MedicalResearch.com: What are the main findings of the study?Dr. Petersen: VA physicians randomized to the individual incentive group were more likely than controls to improve their treatment of hypertension. The adjusted changes over the study period in Veterans meeting the combined BP/appropriate response measure were 8.8 percentage points for the individual-level, 3.7 for the practice-level, 5.5 for the combined, and 0.47 for the control groups. Therefore, a physician in the individual group caring for 1000 patients with hypertension would have about 84 additional patients achieving blood pressure control or appropriate response after 1 year. The effect of the incentive was not sustained after the washout period. Although performance did not decline to pre-intervention levels, the decline was significant. None of the incentives resulted in increased incidence of hypotension compared with controls. While the use of guideline-recommended medications increased significantly over the course of the study in the intervention groups, there was no significant change compared to the control group. The mean individual incentive earnings over the study represented approximately 1.6% of a physician’s salary, assuming a mean salary of $168,000.
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MedicalResearch.com Interview with:Elisa Ebrille, MD
Department of Cardiology, School of Medicine
Fiorenzo Gaita, M.D.
Director Division of Cardiology Department of Medical Sciences
University of Turin, Turin, Italy
MedicalResearch.com What are the main findings of the study?
Answer: We evaluated 33 patients with long-standing atrial fibrillation and valvular heart disease who underwent valve surgery and concomitant cryoablation (pulmonary veins isolation, mitral isthmus and roof line lesions) from 2000 to 2002. The surgically created ablation lesion was validated with electroanatomic mapping. Percutaneous radiofrequency ablation was performed in cases with lesion incompleteness and these patients were followed for over 10 years.
A hybrid approach, combining surgical ablation procedure consisting of pulmonary veins isolation and creation of left atrial linear lesions (mitral isthmus and roof lines), along with endocardial ablation, when necessary, led to a significant clinical improvement in patients with long-standing atrial fibrillation and valvular heart disease during a long-term follow-up (> 10 years).
With the hybrid approach, pulmonary veins isolation and transmural left atrial linear lesions were obtained in a high percentage of patients (79%). When achieved and electrophysiologically demonstrated, the complete ablation scheme was effective in more than 80% of patients in maintaining sinus rhythm throughout follow-up. (more…)
MedicalResearch.com Interview with:Cori L. Ofstead, MSPH
President and CEO
OFSTEAD & ASSOCIATES
400 Selby Avenue, Suite V |Blair Arcade West
Saint Paul, MN 55102-4520
MedicalResearch.com: What are the main findings of the study?Dr. Ofstead: Our researchers found evidence that endoscope reprocessing lapses, which involved a failure to properly clean and disinfect endoscopes after patient use, were very common. These lapses occurred in hospitals, clinics, and ambulatory surgery centers, and involved various steps of the process. In many cases, the reprocessing problems persisted for months or years before being discovered. Over the past several years, thousands of patients have been exposed to contaminated endoscopes, which had significant implications for both patients and their medical providers. For example, we found quite a few cases where exposed patients had to be notified that proper procedures were not followed. In some cases, testing confirmed transmission of pathogens with an increase in morbidity and mortality.
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MedicalResearch.com Interview with:Fabian Bamberg, MD, MPH
Department of Clinical Radiology
Ludwig Maximilians University, Klinikum Grosshadern
Marchioninistrasse 15, 81377 Munich, Germany
MedicalResearch.com: What are the main findings of the study? Dr. Bamberg: Our study shows that there is a substantial and heterogenous degree of subclinical cardiovascular disease burden in patients with diabetes undergoing whole-body MRI. These whole-body MRI findings have significant prognostic relevance. For instance, our results show that patients without any pathologic findings experience no adverse cardiovascular event over a period of six years while the risk for a heart attack or stroke increases with the degree of disease burden.
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MedicalResearch.com Interview with:Svetlana Popova, M.D., M.P.H., Ph.D.
Senior Scientist, Social and Epidemiological Research,
Centre for Addiction and Mental Health
Assistant Professor, Epidemiology Division
Dalla Lana School of Public Health, University of Toronto
Assistant Professor, Factor-Inwentash Faculty of Social Work, University of Toronto
Graduate Faculty Associate Member, Institute of Medical Science, University of Toronto
CAMH, 33 Russell Street, Room # T507
Toronto Ontario, Canada M5S 2S1
MedicalResearch.com: What are the main findings of the study?Dr. Popova: We conducted a systematic literature review and meta-analysis of internationally published and unpublished studies that reported the prevalence of FAS and/or FASD in all types of child care systems (e.g., orphanage, foster care, boarding school, adoption centre, or child welfare system).
The primary objective was to estimate a pooled (combined) prevalence for FAS and FASD in various child care systems using data from existing studies that used an Active Case Ascertainment method (when researchers/clinicians actively seek and diagnose FASD cases).The available data was analyzed byusing a standard statistical technique (called meta-analysis).
This study revealed that the vast majority of existing studies report that the prevalence of Fetal Alcohol Spectrum Disorder (FASD) in the various child-care settings in the different countries is extremely high.
Our analysis of these studies demonstrated that the pooled prevalence of FAS in child care settings (6%) was found to be approximately 9-30 times higher than the prevalence of FAS in the general population of North America, which is reported to range from 2 to 7 cases per 1,000 individuals in the USA and 1 per 1,000 in Canada. Thus, children in care represent a high-risk population for FASD.
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MedicalResearch.com Interview with: Dr. Eung Y. Kim
Department of Radiology
Gachon University Medical Center
Incheon, South Korea.MedicalResearch.com: What are the main findings of the study?Answer: The extent of calcification involving intracranial artery significantly correlates with that of coronary artery in patients with ischemic stroke. The Agatston score measured in the intracranial arteries may be an independent predictor of asymptomatic coronary artery disease in patients with ischemic stroke. (more…)
MedicalResearch.com Interview with:Pranab K. Mukherjee, Ph.D.
Assistant Professor
Center for Medical Mycology
Department of Dermatology
University Hospitals Case Medical Center
Case Western Reserve University
Cleveland, OH 44106-5028
MedicalResearch.com: What are the main findings of the study?Answer: We performed a randomized double-blinded placebo-controlled pilot clinical trial to assess the safety, tolerability and effectiveness of a cetylpyridinium chloride (CPC)-based oral spray in the prevention of acute upper respiratory tract infections (URIs).
The tested CPC spray (ARMS-I, developed by Arms Pharmaceutical LLC, Cleveland, OH) was safe and exhibited high tolerability and acceptability among study participants
The product exhibited a trend to protect against URIs (55% relative reduction compared to the placebo), based on confirmed URIs, post-medication exit interviews, and daily electronic diaries completed by study participants
There was statistically significant reduction in frequency of cough and sore throat in the active group
The number of days (duration) of cough was significantly reduced in the active group compared to placebo arm
URI-associated viruses (influenza, rhinovirus and coronavirus) were detected in three individuals, all in the placebo arm. No virus was detected in the active arm/
No drug-related adverse events or oral lesions were observed
Previous vaccination status of the study participants did not affect the study outcome.
MedicalResearch.com Interview with:
Nasser Malyar, MD
Division of Vascular Medicine
Department of Cardiovascular Medicine
University Hospital Muenster
Albert-Schweitzer-Campus 1, A1
48149 Muenster, Germany
MedicalResearch.com: What are the main findings of the study?Dr. Malyar: The main findings of the study were that
1) PAD as a main or co-diagnosis is common among in-hospital treated patients
2) The prevalence of PAD among hospitalized patients is disproportionately increasing, particularly in the subset with critical limb ischemia
3) Despite all efforts and increasingly use of endovascular and surgical revascularization procedures PAD patients still have a poor in-hospital outcome in terms of limb amputation and in-hospital mortality
4) Last but not least the reimbursement costs for in-hospital treatment of patients with PAD are markedly increasing.
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MedicalResearch.com Interview with: Koji Ikeda, MD, PhD
Assistant Professor
Department of Cardiology
Graduate School of Medical Science,
Kyoto Prefectural University of Medicine
Kyoto, Japan
MedicalResearch.com: What are the main findings of the study? Dr. Ikeda: The main findings of this study is the identification of a novel mechanism that regulates glucose homeostasis and energy metabolism, provided by Ecscr. Consequently, Ecscr modifies the insulin sensitivity and the progression of obesity, indicating that Ecscr is a new target for the treatment of metabolic syndrome.
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MedicalResearch.com Interview with:
Nariya Cho, MD
Departments of Radiology
Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
MedicalResearch.com: What are the main findings of the study?Dr. Cho: Smaller reduction in tumor volume and a smaller reduction in washout component on dynamic contrast agent–enhanced MR imaging assessed by computer-aided evaluation after neoadjuvant chemotherapy were independent parameters of worse recurrence-free survival and overall survival in breast cancer patients who received neoadjuvant chemotherapy.
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MedicalResearch.com Interview with:Dr. Evgeny Pokushalov, MD, PhD
State Research Institute of Circulation Pathology, Rechkunovskaya 15, 630055 Novosibirsk 55, Russia
MedicalResearch.com: What are the main findings of the study?Dr. Pokushalov: The main finding of this study is that after the failure of the first catheter ablation procedure for PAF, a redo ablation was more effective at eradicating recurrent AF than treatment with AAD.
In this randomized controlled clinical trial, we observed that:
1. The AF progression rate was considerably higher in patients randomized to AAD (79%) use compared with patients treated with a second ablation procedure (25%).
2. The AF burden significantly increased on AAD during followup compared with patients of reablation group (18.8±11.4% versus 5.6±9.5%, respectively).
3. There was a much greater rate of progression to persistent AF if AAD was used rather than redo ablation (23% versus 4%, respectively).
These findings support the need for consideration of a timely intervention in patients with PAF who have responded inadequately to an initial PVI.
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MedicalResearch.com Interview with:David F Jarrard, MDVice Chair for Clinical Affairs
Professor of Urology
John Livesey Chair in Urologic OncologyMedicalResearch.com: What are the main findings of the study?
Dr. Jarrard: We have developed and externally validated an accurate nomogram for predicting Gleason score 6 upgrading for use in low-risk prostate cancer patients. This nomogram incorporates only variables available at the time of diagnosis and is unique in its assessment of clinical as well as pathological factors. Furthermore, we externally validated this study in patients with Gleason 6 prostate cancer of which 90% met the D’Amico criteria for low-risk cancer at 2 other centers (total 2000 patients). This nomogram will aid in the decision-making process of patients diagnosed with low-risk prostate cancer.
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MedicalResearch.com Interview with:Magnus G. Rasch MD
Faculty of Health Sciences, University of Copenhagen
1455 København K, Denmark
Department of Infectious Diseases
Copenhagen University Hospital, Rigshospitalet, Denmark
MedicalResearch.com: What are the main findings of the study?Dr. Rasch: In the study “Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population” we found that the risk of acute renal replacement therapy (aRRT) and the risk of chronic renal replacement therapy (cRRT) was increased substantially in HIV patients compared with the background population.
The risk of aRRT was highest the first year after HIV diagnosis.
Factors associated with increased risk of aRRT were intravenous drug use, hypertension and an AIDS-defining illness. Risk factors for cRRT were hypertension and baseline estimated glomerular filtration rate.
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MedicalResearch.com Interview with:Dr. Robert A. Wise MD
Professor of Medicine Johns Hopkins University School of Medicine
5501 Hopkins Bayview Circle
Baltimore, MD 21224
MedicalResearch.com: What are the main findings of the study? Dr. Wise: The TIOSPIR trial was a landmark study, one of the largest ever conducted for chronic obstructive pulmonary disease (COPD). It was designed to test the comparative safety and effectiveness of two delivery devices of tiotropium, a long-acting bronchodilator. One formulation is the Respimat multi-dose soft mist inhaler and the other formulation is the single dose HandiHaler dry powder inhaler.
After following more than 17000 patients for an average of 2.3 years, TIOSPIR showed that there was no difference in either the safety in terms of mortality or adverse cardiovascular events between the two devices. Moreover, both devices showed similar effectiveness in terms of time to first COPD exacerbation.
A lung function substudy in 1370 patients showed that the 5 microgram dose of Respimat was equivalent to the HandiHaler as a bronchodilator, but the 2.5 microgram dose was not quite as effective.
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MedicalResearch.com Interview with:Dr. Elsie Taveras
Massachusetts General Hospital for Children
Division of General Pediatrics, Department of Pediatrics
100 Cambridge St, 15th Floor
Boston, MA 02114
MedicalResearch.com: What are the main findings of the study?Dr. Taveras: The main findings of the study were that, overall, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group. Children in the intervention group were sleeping about 45 minutes longer than children in the control group. Time spent watching television on weekends dropped about an hour per day in the intervention group, leading to a significant difference from the control group, which increased weekend TV viewing. Both groups had a small reduction in weekday TV viewing, with a greater decrease in the intervention group, as well.
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MedicalResearch.com Interview with:
Ramit Ravona-Springer M.D., PsychiatristDirector of Memory Clinic,Sheba Medical Center, Tel Hashomer,IsraelMedicalResearch.com: What are the main findings of the study?Answer: In a cohort of elderly, cognitively normal type 2 diabetes (T2D) subjects, those with Haptoglobin (Hp) 1-1 genotype present lower cognitive performance compared to Hp 2 carriers (Hp 1-2 and Hp 2-2). The contribution of cardiovascular risk factors to cognition was significantly higher in subjects with Hp1-1 genotype compared to Hp 2 carriers.
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MedicalResearch.com Interview with:Madelein Hoogwegt, MSc
Promovenda
Center of Research on Psychology in Somatic diseases (CoRPS)
Department of Medical and Clinical Psychology
Kamer P711 Tilburg University 5000 LE Tilburg
MedicalResearch.com: What are the main findings of the study?Answer: The main finding was that we found a significant relation between positive affect and mortality, and that exercise explained this relationship. With respect to the second outcome, hospitalization, we found a significant relation between positive affect and hospitalization, a significant relation between positive affect and hospitalization, but exercise did not mediate this relationship.
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MedicalResearch.com Interview with:Courtney A. Miller, PhD Assistant Professor
Department of Metabolism & Aging
Department of Neuroscience
The Scripps Research Institute
Jupiter, FL 33458
MedicalResearch.com: What are the main findings of the study?Dr. Miller: The relapse rate for drug abusers, smokers and alcoholics is high because abstinence is so difficult. A major factor is the craving that drug associations can trigger. These range from seeing the neighborhood where someone used to buy, in the case of illicit drugs, to social drinking for a smoker. We’ve found a way to disrupt these drug-associated memories without affecting other, more benign memories.
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MedicalResearch.com Interview with:Jean-Pierre Le Floch, MD
Diabetology-Endocrinology
Villecresnes Medical Hospital
94440 Villecresnes
MedicalResearch.com: What are the main findings of this study?Answer: The main finding of the study is the association between classical macrovascular complications of diabetes and impaired scores of five geriatric scale scores exploring cognition, activities of daily life, instrumental activities, mood and nutrition.
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MedicalResearch.com Interview with:R. Gilberto González, MD, PhD
Massachusetts General Hospital
Department of Radiology, PO Box 9657
Boston, MA
MedicalResearch.com: What are the main findings of the study?Dr. González: Administration of IV tPA to patients with a severe stroke syndrome caused by occlusion of the distal internal carotid artery and/or the proximal middle cerebral arteries results in good outcomes in 35% compared to 17% of similar patients who did not receive tPA.
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David R. Fulton, M.D. Associate Cardiologist-in-Chief for Administration
Tommy Kaplan Chair in Cardiovascular Studies
Chief, Cardiology Outpatient Services
Department of Cardiology
Children's Hospital Boston
Boston, MA 02115
MedicalResearch.com: What are the main findings of this study?Dr. Fulton: The main findings of this study demonstrated that using a quality improvement methodology (SCAMPs), a diverse population of children and adolescents with chest pain could be managed with relative uniformity and cost effectiveness in a multi-center collaborative. Only 2 patients of the 1016 children who formed the basis for this review were shown to have a cardiac etiology. The clinicians were able to screen and reach a diagnostic conclusion in a large segment of this population using history, physical examination and ECG.
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MedicalResearch.com Interview with: Thanh N. Huynh, MD, MSHS
Clinical Instructor
UCLA Division of Pulmonary Critical Care
MedicalResearch.com: What are the main findings of the study?Dr. Huynh: Our study shows that it is common for ICU doctors to recognize that futile treatment is provided to patients who cannot benefit from it. In our study, 11% of ICU patients were perceived as receiving futile treatment. The outcomes of these 123 patients were uniformly poor, with 85% dying within 6 months. Advances in critical care medicine has allowed us to save lives, but it has also allowed us provide aggressive life-sustaining treatments that may not benefit all patients. When aggressive treatment is poorly matched with a patient’s prognosis, doctors will consider such treatment as futile and our study shows that this is not an uncommon occurrence in our health system.
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MedicalResearch.com Interview with:Ricardo E. Carrión, PhD
Division of Psychiatry Research
The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, New YorkCenter for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Manhasset, New York
MedicalResearch.com: What are the main findings of your study:Answer: Reduced neurocognition, poor functioning, and other behavioral symptoms at baseline were associated with an increased risk of long-term social difficulties and school/work problems in adolescents and young adults at high clinical risk for psychosis.
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Dr. Bettina Scholtka Universität Potsdam
Institut für Ernährungswissenschaft
Abt. Ernährungstoxikologie
Arthur-Scheunert-Allee 114-116
14558 Nuthetal, Germany.
MedicalResearch.com: What are the main findings of the study?Answer: The extremely high sensitivity of the WTB-HRM technique allows to find
very low amounts of different types of colon cancer initiating gene
mutations even in stool samples of patients. The method is able to
find the expected mutations as well as unknown mutations. So, by
applying WTB-HRM to a panel of especially selected marker genes, it is
possible to detect cancer precursors in feces before they progress
into a malignant stage.
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MedicalResearch.com Interview with:Lu Qi, MD, PhD, FAHA
Assistant Professor of Medicine
Harvard Medical School
Assistant Professor of Nutrition
Harvard School of Public Health
MedicalResearch.com: What are the main findings of the study?Answer:It has been known that weight loss diets may improve metabolic status, in parallel with reduction of body weight. We found that the beneficial of various weight loss diets, such as high-fat and low-fat diets, may be different for people carrying different genotype.
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MedicalResearch.com Interview with:Dr. Amy Sanderson MD
Department of Anesthesiology
Perioperative & Pain Medicine
Boston Children’s Hospital
Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?Dr. Sanderson: There is substantial variability in the interpretation of a DNR order. 66.9% of clinicians believed that a DNR order indicates limitation of resuscitative measures only on cardiopulmonary arrest, whereas 33.1% considered a DNR order to be the threshold for the limitation of treatments not specifically related to resuscitation. 68.7% of clinicians reported that the care of a patient changes once a DNR order is written. Of those reporting changes in care, 11.2% reported that this happens only if a cardiopulmonary arrest occurs, while 36.7% believed that there is an increased attention to comfort. Finally, 52.1% reported that care changes beyond both resuscitative measures and focusing on comfort, including limitation or withdrawal of diagnostic and therapeutic interventions. Most clinicians reported that resuscitation status discussions happen later in the illness course than is ideal.
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