MedicalResearch.com Interview with: Anne Bellemain-Appaix
Service de Cardiologie-La Fontonne Hospital, Antibes, France and
Gilles Montalescot Professor of Cardiology
Institut de CardiologiePitié-Salpêtrière Hospital
Université Paris 6, France
ACTION Study Group, Paris, France
Medical Research: What is the background for this study?Response: Pretreatment with P2Y12 inhibitors for Non-ST-Elevation Acute Coronary Syndrome (NSTE-ACS) patients, although advised in current guidelines, has been recently questioned in term of benefit/risk ratio (no ischemic benefit and increase in major bleeding). We wanted to answer this question by giving enough power to results in a complete meta-analysis of studies comparing P2Y12 inhibitors pretreatment (defined as its administration before the coronary angiogram) to no pretreatment in NSTE-ACS. (more…)
MedicalResearch.com Interview with:
Eric Wan BS and Miceile Barrett BS
Johns Hopkins University School of Medicine
Baltimore, MD
Medical Research: What is the background for this study? What are the main findings?Answer: Access to surgery is limited in resource-poor settings and low-and-middle income countries (LMICs) due to a lack of human and material resources. In contrast, academic hospitals in high-income countries often generate significant amounts of unused and clean medical supplies that cannot be re-used in the operating rooms of high-income countries. Programs such as Supporting Hospitals Abroad with Resources and Equipment (SHARE) provide an avenue for recovery of these supplies and donation to resource-poor hospitals in LMICs. From data collected from SHARE supplies donated by Johns Hopkins, we found that the nationwide impact for these programs to be $15.4 million among US academic hospitals, which accounts for only 19 categories of commonly recovered supplies. When we tracked our donated supplies to hospitals in Ecuador serving the poor, we found that the cost-effectiveness of these donations was US $2.14 per disability-adjusted life-year prevented.
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MedicalResearch.com Interview with: Esther van Kleef
London School of Hygiene and Tropical Medicine,
London, UK
Medical Research: What are the main findings of the study?Response:Existing evidence reveals a wide variation in estimated excess length of hospital stay (LoS) associated with healthcare-acquired C. difficile infection (HA-CDI), ranging from 2.8 to 16.1 days. Few studies considered the time-dependent nature of healthcare-acquired C. difficile (i.e. patients that spent a longer time in hospital have an increased risk of infection), and none have considered the impact of severity of healthcare-acquired C. difficile on expected delayed discharge. Using a method that adjusted for this so-called time-dependent bias, we found that compared to non-infected patients, the excess length of stay of severe patients (defined by increased white blood cell count, serum creatinine, or temperature, or presence of colitis) was on average, twice (11.6 days; 95% CI: 3.6-19.6) that of non-severe cases (5.3 days; 95% CI: 1.1-9.5). However, severely infected patients did not have a higher daily risk of in-hospital death than non-severe patients. Overall, we estimated that healthcare-acquired C. difficile prolonged hospital stay with an average of ~7 days (95% CI: 3.5-10.9) and increased in-hospital daily death rate with 75% (Hazard Ratio (HR): 1.75; 95% CI: 1. 16 – 2.62).
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MedicalResearch.com Interview with: Tanja Stadler, ETH Zürich
Department of Biosystems Science & Engineering (D-BSSE)
Basel, Switzerland
Medical Research: What are the main findings of the study?Response: We quantified the speed of spread of the ebola epidemic using the genetic information of ebola.
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MedicalResearch.com Interview with:Jeff R. Temple, PhD
Associate Professor and Psychologist
Director, Behavioral Health and Research
Department of Ob/Gyn
UTMB Health Galveston, TX 77555-0587
Medical Research: What are the main findings of the study?Dr. Temple:Through previous research, we know that teen sexting is related to actual sexual behaviors, but we did not have any information on the temporal link between these two behaviors.
In short, we found that teens who sexted had 32% higher odds of being sexually active over the next year relative to youth who did not sext – this was even after controlling for history of prior sexual behavior, ethnicity, gender, and age. We also found that active sexting (actually sending a naked picture to another teen) mediated the relationship between passive sexting (asking for or being asked for a sext) and sexual behaviors. In other words, while sending a sext was predictive of subsequent sexual behavior, asking for/being asked for a sext was only associated with sexual behavior through its relationship with active sexting.
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MedicalResearch.com Interview with:Kathrin S. Utz, PhD
Department of Neurology
University of Erlangen-Nuremberg
Erlangen, German
Medical Research: What are the main findings of the study?Dr. Utz: A transient ischemic attack is caused when there is a temporary disruption in the blood supply to a person’s brain. It causes the person to experience symptoms, similar to those of a stroke, such as speech and visual disturbance and numbness or weakness in the arms and legs. A transient ischemic attack is only temporary and people make a full physical recovery from it. We found, however, that a TIA is not without cost. Specifically, we found that such persons are at a greater risk of going on to develop the psychiatric condition known as posttraumatic stress disorder (PTSD). We found 1 in 3 patients develop it. PTSD, which is perhaps better known as a problem found in survivors of war zones and natural, can develop when a person experiences a frightening event that poses a serious threat. It leads the person to experience symptoms such as worry, nightmares, flashbacks and social isolation. We found that TIA patients who develop PTSD are also more likely to suffer from depression and anxiety symptoms. Taken together these symptoms pose a significant psychological burden for the affected patients and it therefore comes as no surprise that we also found TIA patients with PTSD have a measurably lower sense of quality of life than TIA patients who do not develop PTSD. We could also identify some potential risk-factors for the development of PTSD following a TIA. Younger patients and patients who overestimate their future stroke risk are more likely to develop PTSD. Also important in this context are the strategies that patients typically adopt to deal with stressful situations. Those patients who use certain types of coping strategies, such as denying the problem, blaming themselves for any difficulties or turning to drugs for comfort, face a greater risk of developing PTSD after TIA.
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MedicalResearch.com Interview with: Professor F. J. Raal
FRCP, FRCPC, FCP(SA), Cert Endo, MMED, PhD
Director, Carbohydrate & Lipid Metabolism Research Unit
Professor & Head, Division of Endocrinology & Metabolism
Faculty of Health Sciences, University of the Witwatersrand
Johannesburg Hospital Johannesburg South Africa
Medical Research: What are the main findings of the study?Dr. Raal: Heterozygous familial hypercholesterolaemia (HeFH) is one of the most common inherited disorder in man affects between 1:250 to 1:300 persons worldwide. Thus, there are likely more than 3 million patients with heterozygous familial hypercholesterolaemia in the United States and Europe alone. The RUTHERFORD-2 study was a large world-wide multinational study of the use of the PCSK9-inhibitor, evolocumab, in over 300 patients with heterozygous familial hypercholesterolaemia (HeFH). Evolocumab administered either 140 mg biweekly or 420 mg monthly as a subcutaneous injection, much like an insulin injection, was well tolerated with minimal side effects, and markedly reduced levels of LDL cholesterol or “bad cholesterol” by over 60% compared to placebo.
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MedicalResearch.com Interview with: Nick Lonardo, PharmD
Pharmacy, Clinical Coordinator
Department of Pharmacy Services
Salt Lake City, Utah 84132
Medical Research: What are the main findings of the study?Dr. Lonardo:To our knowledge, this is the first, large, multicenter, retrospective cohort study to show that continuous infusion benzodiazepines are independently associated with increased mortality in mechanically ventilated ICU patients. In addition, benzodiazepines were associated with an increased time of mechanical ventilation and ICU length of stay.
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MedicalResearch.com Interview with: Richard J. Kryscio, PhD, Professor
Sanders-Brown Center on Aging
University of Kentucky
Medical Research: What are the main findings of the study?Dr. Kryscio: We followed 531 elderly over time assessing their cognition annually; of these 105 (about 20%) eventually were diagnosed with a serious cognitive impairment (either a mild cognitive impairment or a dementia) and 77% of the latter declared a subjective memory complaint prior to the diagnosis of the impairment. In brief, declaration of a memory problem put a subject at three times the risk of a future impairment.
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MedicalResearch.com Interview with: Tuomo Tompuri, MD
Clinical Physiology and Nuclear Medicine
Kuopio University Hospital, Finland
Medical Research: What are the main findings of the study?Dr. Tompuri: Measures of the cardiorespiratory fitness should be scaled by lean mass instead of body weight, while aiming to enable comparison between the subjects. Our result is physiologically logical and confirms earlier observations of the topic. Scaling by body weight has been criticized, because body fat, per se, does not increase metabolism during exercise. We did observe that scaling by body weight introduces confounding by adiposity.
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MedicalResearch.com Interview with:Rebecca J. Schmidt, M.S., Ph.D.
Assistant Professor
Department of Public Health Sciences
The MIND Institute School of Medicine
University of California Davis
Davis, California 95616-8638
MedicalResearch: What are the main findings of the study?Dr. Schmidt: Women who had children with autism reported taking iron supplements during pregnancy and breastfeeding less often than women who children who were typically developing. Mothers of children with autism also had lower average iron intake.
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MedicalResearch.com Interview with:Dr Fergus Hamilton
University of Bristol, Centre for Academic Primary Care, School of Social and Community Medicine, Canyngne Hall, Bristol UK.
Medical Research: What are the main findings of the study?Dr. Hamilton:The findings of this study showed a stepwise increase in risk of cancer as calcium levels increase above the normal range, most notably in men. This relationship did occur in women, but was much less strong
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MedicalResearch.com Interview with
Agneta Åkesson
Associate professor, senior lecturer Nutritional Epidemiology
IMM Institute of Environmental Medicine
Karolinska Institutet Stockholm, Sweden
Medical Research: What are the main findings of the study?Dr. Åkesson: Our study indicates that a healthy diet together with low-risk lifestyle practices such as being physically active, not smoking and having a moderate alcohol consumption, and with the absence of abdominal adiposity may prevent the vast majority of myocardial infarctions in men.
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MedicalResearch.com Interview with:Chester G. Chambers PhD
Armstrong Institute for Patient Safety and Quality
Johns Hopkins Carey Business School, Baltimore, Maryland
Medical Research: What are the main findings of the study?
Dr. Chambers: The main findings of this study are that several metrics of system performance can be improved by using simple methods proven to be effective in many production settings.
Specifically, the idea of using “Pre-processing” as an aspect of medical education improves patient flow times, waiting times, system throughput, and system capacity.
When fixed costs are spread across more patients, we are effectively reducing the cost per patient as well.
In this context “Pre-processing” simply refers to the practice of having medical trainees present and review cases with the attending prior to patient clinic visits as opposed to doing it in the midst of the patient visit. This simple idea is common in many areas including surgery but tends to get omitted in other settings involving ambulatory care. Our simple experiment verified that this practice has real value in a wide array of settings.
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MedicalResearch.com: Interview InvitationDr. Csaba P. Kovesdy, MD
Professor of Medicine
University of Tennessee Health Science Center
Chief of Nephrology
Memphis Veterans Affairs Medical Center
Medical Research: What are the main findings of the study?Dr. Kovesdy: We applied the structure of a clinical trial of hypertension management to our cohort of >600,000 patients with prevalent Chronic Kidney Disease (CKD). We first identified patients with baseline uncontrolled hypertension (using the definition applied by the SPRINT trial), then isolated the ones who had a decline in their baseline systolic blood pressure to two different levels (<120 and 120-139 mmHg) in response to a concomitant increase in prescribed antihypertensives, similar to what would happen in a trial examining two different systolic blood pressure targets. We then matched patients in the two groups to end up with identical baseline characteristics, similar to a randomized trial. When we examined the all-cause mortality of these two groups, we found that the group with follow-up systolic blood pressure of <120 had a 70% higher mortality.
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MedicalResearch.com Interview Dongyi (Tony) Du, MD, PhD
Division of Epidemiology
FDA/CDRH/OSB
Medical Research: What are the main findings of the study?Dr. Du: The risk for death on the date of surgery was 60% higher for recipients of mechanical aortic valves than recipients of bioprosthetic aortic valves (OR, 1.61 [95%CI, 1.27-2.04; P < .001]; risk ratio [RR], 1.60). The risk difference decreased to 16% during the 30 days after the date of surgery (OR, 1.18 [95%CI, 1.09-1.28; P < .001]; RR, 1.16). The risk for operative mortality was 19% higher for recipients of mechanical compared with bioprosthetic valves (OR, 1.21 [95%CI, 1.13-1.30; P < .001]; RR, 1.19). The number needed to treat with mechanical valves to observe 1 additional death on the surgery date was 290; to observe 1 additional death within 30 days of surgery, 121.
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MedicalResearch.com Interview with: Lex W Doyle MD BS MSc FRACP
Professor of Neonatal Paediatrics
Department of Obstetrics and Gynaecology
The Royal Women’s Hospital
Parkville, Victoria, Australia
Medical Research: What are the main findings of the study?Dr. Doyle: From collectively pooling data from five large trials carried out around the world over the past 20 years, we know that magnesium sulfate given under strict medical protocols in hospital to women threatening to deliver preterm reduces the risk of cerebral palsy in their children in early childhood. Following from this knowledge, magnesium sulfate is now given routinely to women, under strict medical conditions, who are threatening to deliver very early in Australia, and in other parts of the world, to try to prevent cerebral palsy in their child. What we do not know is if magnesium sulfate used this way has any longer-term effects on the brain or on other important outcomes.
One of the initial studies that contributed to the overall evidence about cerebral palsy was carried out in Australia and New Zealand and completed more than 10 years ago. Over 1000 women and their babies were enrolled in that study and although the rate of cerebral palsy was not substantially reduced by magnesium sulfate in our study, we showed that there were fewer children at 2 years of age who were not walking in the group whose mothers were given magnesium compared with those whose mothers were given placebo. With this knowledge, and given the unknown longer-term benefits or risks, we re-evaluated the children from our study at school-age, between 6-11 years of age. We thoroughly evaluated their brain function, including movement and co-ordination, thinking ability, behaviour, and school progress, as well as general health and well-being. The basic message from our longer-term study is that magnesium sulfate, as used in our trial, does not have any substantial benefits or harms on brain or cognitive function, or any other outcome at school age.
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MedicalResearch.com Interview with:Dr. Dee Fenner, M.D.
Professor of Obstetrics and Gynecology
Director of Gynecology
University of Michigan
MedicalResearch.com Editor’s note: American Medical Systems Inc. (AMS), a subsidiary of Endo International plc (Nasdaq: ENDP) (TSX: ENL), released top-line results from its TRANSFORM study that show the investigational TOPAS™ System improves fecal incontinence in women.
The results show that over a 12 month period, 69% of women suffering from fecal incontinence who were implanted with the TOPAS™ System experienced at least a 50% reduction in weekly incontinence episodes and experienced a durable, consistent effect across the study period. The results were presented in Cape Town, South Africa at the International Society of University Colon & Rectal Surgeon (ISUCRS) Congress.
Dr. Fenner, a primary investigator of the study, kindly answered the questions below:
Medical Research: How common/prevalent is the problem of fecal incontinence in women?Dr. Fenner: Fecal incontinence, also known as accidental bowel leakage (ABL), is estimated to affect nearly 11 million women and 10% of women over the age of 20 in the United States.1,2 Additionally, nearly one in five women over the age of 45 experience ABL at least once a year.3(more…)
MedicalResearch.com Interview with:Sharon G. Curhan, MD, ScM
Channing Division of Network Medicine
Department of Internal Medicine
Brigham and Women's Hospital
Harvard Medical School
Boston, MA 02115
Medical Research: What are the main findings of the study?Dr. Curhan:We followed more than 65,000 women who were participants in the Nurses’ Health Study II over 18 years and found that eating 2 or more servings of fish per week was associated with a lower risk of hearing loss. For example, after adjusting for potential confounders in multivariable analyses, in comparison with women who rarely or never ate fish, women who consumed 2 or more servings of fish per week had a 20% lower risk of hearing loss. Eating any type of fish (tuna, dark fish, light fish or shellfish) tended to be associated with lower risk. Also, we found that higher intake of long-chain omega-3 polyunsaturated fatty acids (PUFAs) was inversely associated with risk. For example, in comparison with women with the lowest intake, women with the highest intake of long-chain omega-3 PUFAs had a 22% lower risk of hearing loss.
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MedicalResearch.com Interview with: Saurabh S. Thosar, Ph.D.,
Postdoctoral Researcher
Oregon Institute for Occupational Health Sciences,
Oregon Health & Science University
Medical Research: What are the main findings of the study?Dr. Thosar:We discovered that 3 hours of sitting leads to an impairment in shear rate and an impairment in femoral artery endothelial function. When systematic breaks are added in the sitting time the shear rate and the endothelial function are preserved.
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MedicalResearch.com: Interview with:Dr. Steve Turner
Child Health, Royal Aberdeen Children's Hospital
Aberdeen,UK
Medical Research: What are the main findings of the study?
Dr. Turner: There is evidence that being small for a given gestational age is associated with a broad range of what could be loosely considered “disadvantageous” outcomes in early childhood, eg increased risk for wheeze, increased blood fat levels, increased blood pressure and low bone mineral density. Many of these outcomes are subclinical – ie unless they were measured no-one would be any the wiser – and what remains to be determined is whether as these individuals grow up these subclinical measurements become important. Follow up may take many years, decades for outcomes such as coronary artery disease and type II diabetes.
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The American College of Chest Physicians released an expert consensus statement, Care of the Critically Ill and Injured During Pandemics and Disasterswhile the global health-care community cares for patients with the Ebola virus.Three of the authors discussed this important statement with MedicalResearch.com.
Asha V. Devereaux, MD, MPH
Sharp Hospital
Coronado, CA
Jeffrey R. Dichter, MD
Allina Health, Minneapolis, MN
and Aurora Health, Milwaukee, WI
Niranjan Kissoon, MBBS, FRCP(C)
BC Children's Hospital and Sunny Hill Health Centre
University of British Columbia, Vancouver, Canada
Medical Research: What are the main ethical concerns and criteria for evaluating who may be eligible for treatment during a pandemic or disaster?
Dr. Asha Devereaux: The main ethical concerns regarding eligibility for treatment during a pandemic will be access to limited or scarce resources.Who should get treatment and who decides will be some significant questions whenever there is a scarcity of healthcare resources. Transparency and the fairness of the ethical framework for decision-making will need to be made public and updated based upon the changing dynamics of resources and disease process.
Dr. Niranjan Kissoon: There is work to be done in this area and engagement of citizens, government, medical community, ethicists and legal experts in the process is important.
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MedicalResearch.com Interview with Steven M. Bradley, MD, MPH
Veterans Affairs, Eastern Colorado Health CareSystem
Denver, Colorado
Medical Research: What are the main findings of the study?Dr. Bradley: In 539 hospitals participating in the CathPCI Registry that performed elective coronary angiography on more than 500,000 patients, 22% of patients were asymptomatic at the time of coronary angiography. We observed marked variation in the hospital rate of angiography performed in asymptomatic patients, ranging from 0.2% to 66.5%, suggesting broad variation in the quality of patient selection for coronary angiography across hospitals. Additionally, hospitals with higher rates of asymptomatic patients at diagnostic angiography also had higher rates of inappropriate PCI, due to greater use of PCI in asymptomatic patients. These findings suggest that patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria. By addressing patient selection upstream of the catheterization laboratory, we may improve on the optimal use of both angiography and PCI.
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Medical Research Interview with: Brian Dannemann, MD, FACP
Senior Director, JNJ Pharmaceutical Research and Development
Titusville, NJ 08560
MedicalResearch: What are the main findings of the study?Dr. Dannemann : The final investigational 120-week results from the TMC207-C208 Phase 2 study demonstrated that bedaquiline (SIRTURO®) showed nearly twice an many patients in the bedaquiline group as in the placebo group were cured on the basis of the World Health Organization (WHO) outcome definitions for Multidrug-Resistant Tuberculosis which was statistically significant (38 of 66 patients [58%] and 21 of 66 patients [32%] respectively; p = 0.003).
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MedicalResearch.com Interview with Esther Ooi & Børge G Nordestgaard, MD, DMSc
Professor, University of Copenhagen
Chief Physician, Herlev Hospital, Copenhagen University Hospital
Dept. Clinical Biochemistry Herlev Ringvej 75, DK-2730 Herlev, Denmark
Medical Research: What are the main findings of the study?Answer:Our findings suggest that low 25(OH)D levels observationally is simply a marker for elevated atherogenic lipoproteins, and thus question a role for vitamin D supplementation in the prevention of cardiovascular disease.
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MedicalResearch.com Interview with: Ying-wei Qiu, MD
Department of Medical imaging
Guangdong No. 2 Provincial People’s Hospital
Guangzhou, China;
Medical Research: What are the main findings of this study?Dr. Ying-wei Qiu: The main findings include:
White matter (WM) integrity is abnormal in the IFO of bilateral temporal-occipital regions and right frontal region, and in the right corona radiata white matter in chronic Codeine-Containing Cough Syrups users.
The abnormal white matter integrity related to the higher impulsivity in codeine-containing cough syrups users.
The abnormal white matter integrity related to duration of Codeine-Containing Cough Syrups abuse in codeine-containing cough syrups users.
MedicalResearch.com Interview with: James T. Becker, Ph.D.
Professor of Psychiatry, Psychology, and Neurology
University of Pittsburgh
Medical Research: What are the main findings of the study?Dr. Becker: We found that people who eat baked or broiled (but not fried) fish at least once every week had significantly larger brain volumes in areas critical for memory and cognition, namely, hippocampus, precuneus, posterior cingulate cortex, and orbital frontal cortex.
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MedicalResearch.com Interview with:Lara B. McKenzie, PhD MA
Center for Injury Research and Policy
The Research Institute at Nationwide Children’s Hospital
Columbus, OH 43205
Medical Research: What are the main findings of the study? Dr. McKenzie: Our main findings were that lacrosse injury rates and patterns are different by sex and by type of athletic activity. Boys’ lacrosse allows for some person-to-person contact, while girls’ lacrosse largely outlaws it. Boys had an overall injury rate of 2.26 per 1000 athletic exposures, and girls had an injury rate of 1.54 per 1000 athletic exposures. The overall injury rate was about 3 times higher in competition than in practice. We also found that sprains and strains were the most common injury diagnosis for boys and girls (boys: 35.6% of injuries; girls: 43.9%), but that concussions were a significant injury diagnosis (boys: 21.9% of injuries; girls: 22.7%).
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MedicalResearch Interview with: Maurizio Gasparini MD
Humanitas Research Hospital
Rozzano, Italy
Medical Research: What are the main findings of the study?Dr. Gasparini: We found that a strategic programming of implantable cardioverter defibrillators which allows the non-sustained arrhythmias to self-terminate is associated with reductions in hospitalizations, length of hospital stay and cost per patient-year and an increase in the time to first hospitalization. These results were mainly driven by reduction in cardiovascular-related events.
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MedicalResearch.com Interview with:Henry M. Spinelli, MD, PC
Plastic & Reconstructive Surgery
875 Fifth Avenue
New York, NY 10065
Medical Research: What are the main findings of the study?
Dr. Spinelli: Briefly, we polled approximately 26,000 plastic surgeons by way of membership in the International Society of Aesthetic Plastic Surgeons (ISAPS), American Society for Aesthetic Plastic Surgery (ASAPS) and American Society of Plastic Surgeons (ASPS) and collated this data and published it in Aesthetic Plastic Surgery (the Blue Journal), the official journal of ISAPS. This preliminary study was initiated given the current and past healthcare and cosmetic medical/surgical care climate both in the United States and worldwide. As a background, when it comes to injectables (botox and fillers) there is not a united consensus on a state by state basis in the USA and from country to country worldwide. Additionally, the regulations and laws governing the administration of botox and injectables is in a constant flux. For instance, the UK allowed beauticians in the past to administer these substances however they are now banned from legal administration of these products. Alabama, only allows physicians (dermatologists and plastic surgeons) to purchase and administer botox and injectables whereas the medical board of California states that physicians can perform the procedure or oversee licensed registered nurses, licensed vocational nurses, or physicians assistants. Similarly, dentists in some states are permitted to administer these agents. It would be a bad idea for any physician working with botox to take Advanced Botox Training to reduce the possibility of medical misdemeanors.
At the present time few studies have directly assessed the capability of various providers to administer cosmetic injections. When people schedule a consultation for plastic surgery, they are often looking for things like a younger face or a nicer body. The answer to the previous question will become more important as the demand for these procedures continues to grow and an increasing number of practitioners and different Plastic Surgeon from a variety of backgrounds enter the field to meet demand. This study aimed to help define the role of various practitioners in an increasingly more competitive environment for injectables and to explore the relationship between patient and injectable provider in order to improve patient satisfaction and outcomes.
When asked to rank patients’ perceptions of various providers according to their expertise in administering Botox and dermal fillers, responders ranked plastic surgeons and dermatologists as most capable (96%) then nurses in plastic surgery and dermatology (3%). Gynecologists (<1%), dentists (<1%) and nurses in other fields (<1%) all received nearly equivalent numbers of “most capable” rankings. When asked to rank patients’ perception of various providers according to their inability to administer Botox and dermal fillers, nurses in other fields were most frequently ranks as least capable (63%) followed by dentists (26%), gynecologists (12%), plastic surgeons and dermatologists (2%) and nurses in plastic surgery and dermatology (1%).
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