TAVR for Bicuspid Vs. Tricuspid Aortic Valve Stenosis

MedicalResearch.com Interview with:
Sung-Han Yoon MD
Clinical Trials, Cardiology, Developmental Biology
Cedars-Sinai Medical Center, Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Transcatheter aortic valve replacement (TAVR) has become the standard treatment in inoperable patients in high surgical risk patients with symptomatic severe aortic stenosis (AS). However, major randomized trials excluded congenital bicuspid AS due to its unique morphological features. The indication of TAVR is expanding into a younger population, in which the frequency of bicuspid AS is higher. Therefore, we will encounter TAVR for bicuspid AS more frequently. However, the experience of TAVR in bicuspid AS is limited to small series. Therefore, we aim to evaluate the clinical outcomes of TAVR in bicuspid AS and compare them to tricuspid AS.

Continue reading

iFR Can Assess Need For Coronary Revascularization Without Adenosine

MedicalResearch.com Interview with:

Dr. Justin Davies PhD Senior Reserch Fellow and Hononary Consultant Cardiologist National Heart and Lung Institute, Imperial College Londo

Dr. Davies

Dr. Justin Davies PhD
Senior Reserch Fellow and Hononary Consultant Cardiologist
National Heart and Lung Institute,
Imperial College London

MedicalResearch.com: What is the background for this study?

Response: We know from the FAME study that compared to angiography alone, FFR guided revascularization improves long-term clinical outcomes for our patients. Despite this, adoption of FFR into everyday clinical practice remains stubbornly low. One major factor for this is the need for adenosine (or other potent vasodilator medications) in order to perform an FFR measurement. Adenosine is expensive, unpleasant for the patient, time consuming and even potentially harmful.

iFR is a newer coronary physiology index that does not require adenosine for its measurement. In the prospective, multi center, blinded DEFINE FLAIR study, 2492 patients were randomly assigned to either FFR guided revascularisation or iFR guided revascularization and followed up for a period of 1 year.
Continue reading

Cardiovascular Procedures That Push the Line: High-Risk or Futility of Care?

MedicalResearch.com Interview with:

Adam Skolnick, MD Cardiologist Associate professor of medicine NYU Langone Medical Center

Dr. Adam Skolnick

Adam Skolnick, MD
Cardiologist
Associate professor of medicine
NYU Langone Medical Center  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: I am privileged to serve on the ACC Program Planning Committee and helped to design this important session that seeks to determine the line between when a cardiovascular procedure is high risk and when it is futile.    I am co-chairing the session with the incoming chair of the section on Geriatric Cardiology for the ACC, Dr. Karen Alexander from Duke.

We are practicing medicine at one of the most extraordinary times when there are so many devices and procedures to prolong and improve quality of life.    It is critical to assess a patient’s goals of care for a given intervention.   In some patients, particularly those who are multiple degenerative chronic conditions, are frail and/or have cognitive impairment it is difficult to know when a given procedure multiple medical conditions will achieve a patient’s goals.   When is a procedure high risk, and when is it simply futile?    This is the fine line upon which many cardiologists often find themselves.

The speakers present case examples of high risk patients considering TAVI, high risk PCI or CABG and mechanical support devices and with interaction from the audience work through when each procedure is high risk and when it is unlikely to achieve a patient’s goals of care.   We also have a dedicated talk on high risk procedures in patients with cognitive impairment, such as advanced dementia.

Continue reading

Patients Who Quit Smoking Had Fewer Adverse Events After Knee Replacement

MedicalResearch.com Interview with:
Amy Wasterlain, MD

Fourth-year orthopaedic surgery resident
NYU Langone Medical Center who led the study with Dr. Richard Iorio 

MedicalResearch.com: What is the background for this study?

Response:  We looked at smoking habits and outcomes for 539 smokers undergoing primary total hip or knee arthroplasty, 73 of whom participated in a pre-operative smoking cessation program. Patients who participated in program were 4.3 times more likely to quit than smokers who tried to quit on their own. Program participants also reduced their tobacco intake dramatically (10.6 fewer cigarettes/day) compared to smokers who didn’t participate (2.3 fewer cigarettes/day), even if they weren’t able to quit completely. Patients who completed the program before undergoing total knee arthroplasty had about 24% fewer adverse events (readmission, venous thromboembolism, stroke, urinary tract infection, pneumonia, and surgical site infection) than smokers who didn’t participate in the program.

Continue reading

Laypeople Perceive Facelift To Give More Youthful, Healthier Appearance

MedicalResearch.com Interview with:
Lisa E. Ishii, MD, MHS
Associate Professor of Otolaryngology – Head and Neck Surgery
John Hopkins Medicine

Lisa Earnest Ishii, M.D. Associate Professor of Otolaryngology - Head and Neck Surgery Johns Hopkins Medicine

Dr. Ishii

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There was a gap in our knowledge about what the average lay person thought about the impact of a facelift.  We had information about what experts thought, and some about what patients themselves thought, but nothing about lay people.
Patients who choose to have a facelift are typically concerned about the opinions of:

1) Themselves when they look in the mirror, and

2) Laypeople they encounter socially in society.

Our study showed for the first time that laypeople find people who have had a facelift to appear more attractive, more youthful, healthier and more successful than they were before their facelift.

Continue reading

Stretta Procedure Improves GERD Symptoms, Reduces Need for PPIs

MedicalResearch.com Interview with:

Dr. Ronnie Fass, MD Professor, School of Medicine Case Western Reserve University

Dr. Ronnie Fass

Dr. Ronnie Fass, MD
Professor, School of Medicine
Case Western Reserve University

MedicalResearch.com: What is the background for this study?

Response: The endoscopic radiofrequency procedure (Stretta) has been used for more than a decade to treat patients with gastroesophageal reflux disease (GERD). Over time, there were several Meta-analyses with variable designs of the Stretta procedure providing conflicting results. Thus, the purpose of the current systematic review and meta-analysis was to determine the efficacy of the Stretta procedure using all currently available controlled and cohort studies.

Continue reading

“Spillover” of Transfusion Practice from Trauma to Non-trauma Patients Without Strong Supporting Evidence

MedicalResearch.com Interview with:

Daniel Dante Yeh, MD FACC Assistant Professor of Surgery Harvard Medical School Course Director General/GI Surgery sub-internship Associate Course Director, Surgery Core Clerkship Associate Director, Surgical Intensive Care Unit Co-Director, Nutrition Support Unit Department of Surgery Division of Trauma, Massachusetts General Hospital Emergency Surgery, and Surgical Critical Care Boston, MA 02114

Dr. Yeh

Daniel Dante Yeh, MD FACC
Assistant Professor of Surgery Harvard Medical School Course Director
General/GI Surgery sub-internship Associate Course Director, Surgery Core Clerkship Associate Director, Surgical Intensive Care Unit Co-Director, Nutrition Support Unit Department of Surgery Division of Trauma,
Massachusetts General Hospital
Emergency Surgery, and Surgical Critical Care Boston, MA 02114

MedicalResearch.com: What is the background for this study? 

Response: High Fresh Frozen Plasma to Red Blood Cells FFP:RBC transfusion ratio is a strategy which has emerged in the trauma literature as the preferred method of resuscitation for massively bleeding injured patients.  However, this strategy has now spread to other patient populations which have never been formally studied.   These populations include elective operations and even non-surgical patients.  Giving excess FFP when it is not needed is not only wasteful, but may be harmful, as other studies have reported that FFP can cause problems with lung function, heart function, and immune function.

Continue reading

Plastic Surgeons Define Ideal Female Lip Dimensions

MedicalResearch.com Interview with:

Brian J. F. Wong, MD, PhD Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology–Head and Neck Surgery Beckman Laser Institute and Medical Clinic Department of Biomedical Engineering University of California, Irvine

Dr. Brian Wong

Brian J. F. Wong, MD, PhD
Division of Facial Plastic and Reconstructive Surgery
Department of Otolaryngology–Head and Neck Surgery
Beckman Laser Institute and Medical Clinic
Department of Biomedical Engineering
University of California, Irvine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Research in facial attractiveness is difficult because of the inherent subjectivity of rating. Most people can look at a face and instinctively tell you whether that face is attractive or not, by subconsciously picking up on biologic cues like fertility, coloration, and proportions.

Continue reading

Alcohol-Based Skin Preps Can Fuel Surgical fFres

MedicalResearch.com Interview with:
Edward L Jones, MD MS

Assistant Professor
Department of Surgery, Denver VA Medical Center and
University of Colorado, Denver, CO 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Operating room fires continue to be an underreported source of sometimes catastrophic injuries to our patients and we could find no recent data evaluating common surgical skin antiseptics as a potential fuel for these flames. Manufacturers continue to recommend waiting at least 3 minutes for “drying” of an alcohol-based prep prior to a surgical start but cite no searchable studies to support this timeframe. We were curious if these alcohol-based preps were flammable and what impact a 3 minute delay had on their flammability. Thus we decided to study them in rigorous fashion.

Continue reading

Is the Benefit of Arthroscopic Meniscus Surgery a Placebo Effect?

MedicalResearch.com Interview with:

Jonas Bloch Thorlund Associate Professor (MSc, PhD) Department of Sports Science and Clinical Biomechanics Research Unit for Musculoskeletal Function and Physiotherapy University of Southern Denmark

Dr. Jonas Thorlund

Jonas Bloch Thorlund
Associate Professor (MSc, PhD)
Department of Sports Science and Clinical Biomechanics
Research Unit for Musculoskeletal Function and Physiotherapy
University of Southern Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Arthroscopic partial meniscectomy is a very common knee surgery. Research evidence has seriously questioned the effect of this type of surgery for degenerative meniscal tears in middle-aged and older patients. Most young patients with traumatic meniscal injury (from sports or similar) also undergo this type of surgery. There is a general understanding that young patients with traumatic tears experience larger improvements in patient reported pain, function and quality of life. However, evidence for this presumption is sparse.

Continue reading

Variable Effects of Vitamin C on Post-Operative Atrial Fibrillation

MedicalResearch.com Interview with:

Dr-Harri-Hemilae.jpg

Dr. Harri Hemilae

Harri Hemilä, MD, PhD
Department of Public Health
University of Helsinki

MedicalResearch.com: What is the background for this study?

Response: I have a long term interest in vitamin C. Previously I have shown that it alleviates exercise-induced bronchoconstriction (EIB) (http://dx.doi.org/10.1186/1710-1492-10-58 ) and shortens the duration of colds ( http://dx.doi.org/10.1371/journal.pmed.0020168 ). Now I had been following the literature and I noted that a number of randomized trials were being published about vitamin C for preventing post-operative atrial fibrillation (POAF). Therefore I reasoned that it is worthwhile to analyze that set of trials

Continue reading

Donated Tissue Provides Surgeons Improved Ways to Repair and Reconnect Damaged or Severed Nerves

MedicalResearch.com Interview with:

Karen Zaderej

Karen Zaderej

Karen Zaderej
CEO, AxoGen

Karen Zaderej joined AxoGen in May 2006. She has served as President, Chief Executive Officer and a member of the Board of Directors of AxoGen, Inc. since May 2010. Prior to her current role, she served as Chief Operating Officer from October 2007 to May 2010 and as Vice President of Marketing and Sales from May 2006 to October 2007. From October 2004 to May 2006, Karen worked for Zaderej Medical Consulting, a consulting firm she founded that helped medical device companies build and execute successful commercialization plans. From 1987 to 2004, Karen worked at Ethicon, Inc., a Johnson & Johnson company, where she held senior positions in marketing, business development, research & development, and manufacturing. Karen is a Director of SEBio, a non-profit supporting the life science industry in the southeastern United States. Karen earned an MBA from the Kellogg Graduate School of Business at Northwestern University and a Bachelor of Science degree in Chemical Engineering from Purdue University.

MedicalResearch.com: Please tell us about yourself and how you became CEO at AxoGen.

Response: I met Jamie Grooms, co-founder of AxoGen, in 2005 and we had one of those meetings that change your life. Jamie is a serial entrepreneur and loves to start businesses. He had tried to make nerves in the past but had been unsuccessful. When he saw new technology at the University of Florida that explained some of the issues in regenerating nerves, he decided to found a company focused on nerve repair. In parallel, I had been in business development and strategic marketing for Johnson & Johnson and we had looked at the nerve repair market. We determined there was a significant unmet need in nerve repair, but we could not find any technology at that time that solved the surgical need. Several years later, I left J&J and started a consulting business focused on market development and commercialization of early stage med tech companies. Jamie and I met, and I found the technology I had been looking for years earlier. We had an exciting conversation about the potential to improve the lives of patients with nerve injuries. I saw the possibility to create an entire new segment in med tech, one dedicated to nerve repair. With that great potential in front of me, I closed my consulting business, moved to Florida, and joined the AxoGen team.

Continue reading