Author Interviews, Diabetes, Surgical Research, Weight Research / 14.10.2013

Dr. Mitchell S. Roslin, MD Lenox Hill Hospital Manhattan Minimally Invasive & Bariatric Surgery 186 E 76th Street, 1st Floor New York, NY 10021.MedicalResearch.com Interview with:

Dr. Mitchell S. Roslin, MD Lenox Hill Hospital Manhattan Minimally Invasive & Bariatric Surgery 186 E 76th Street, 1st Floor New York, NY 10021. MedicalResearch.com: What are the main findings of the study? Dr. Roslin: The cornerstone of medical management for weight loss and to prevent weight gain is to regulate glucose and insulin and prevent wide fluctuation.  Yet, Gastric bypass, widely considered the gold standard operation, accentuates these fluctuations.  The purpose of our study was to compare glucose tolerance of gastric bypass, sleeve gastrectomy and a modified version of duodenal switch that  preserves adequate intestine. We found that all operations improve insulin resistance, but that duodenal switch normalizes the curve, whereas gastric bypass causes wide spikes in insulin and glucose.
Author Interviews, Heart Disease, JAMA, Surgical Research / 09.10.2013

Dr. Mary T Hawn MD Center for Surgical, Medical Acute Care Research and Transitions (C-SMART), Birmingham Veterans Administration Hospital, Birmingham, Alabama Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at BirminghamMedicalResearch.com Interview with Dr. Mary T Hawn MD Center for Surgical, Medical Acute Care Research and Transitions (C-SMART), Birmingham Veterans Administration Hospital, Birmingham, Alabama Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at Birmingham MedicalResearch.com: What are the main findings of the study? Dr. Hawn: The risk of adverse perioperative cardiac events is elevated in patients with recent coronary stenting, but the risk does not differ by stent type and stabilizes for surgery more than 6 months following stenting.
Author Interviews, Genetic Research, Metabolic Syndrome, Nature, Surgical Research, Weight Research / 13.09.2013

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.
Author Interviews, Duke, Heart Disease, Outcomes & Safety, Surgical Research / 05.09.2013

Marco D. Huesch, MBBS, Ph.D., Assistant professor at the USC Sol Price School of Public Policy Adjunct professor with Duke’s School of Medicine and Fuqua School of Business.MedicalResearch.com Interview with: Marco D. Huesch, MBBS, Ph.D. Assistant professor at the USC Sol Price School of Public Policy Adjunct professor with Duke’s School of Medicine and Fuqua School of Business. MedicalResearch.com: What are the main findings of the study? Answer: This study asked whether ‘learning by doing’ works backwards too, as ‘forgetting by not doing’. In an nutshell, the answer is ‘no’ among the Californian cardiac surgeons I examined with short breaks of around a month.
Author Interviews, Case Western, Cleveland Clinic, Cost of Health Care, Pain Research, Surgical Research / 30.08.2013

MedicalResearch.com Interview with: Conor P. Delaney, MD MCh PhD FRCSI FACS FASCRS The Jeffrey L. Ponsky Professor of Surgical Education | Chief, Division of Colorectal Surgery | Vice-Chair, Department of Surgery | Director, CWRU Center for Skills and Simulation | Surgical Director, Digestive Health Institute | University Hospitals Case Medical Center | Case Western Reserve University | 11100 Euclid Avenue Cleveland, OH 44106-5047 MedicalResearch.com: What are the main findings of the study? Answer: Our goal was to see whether the transversus abdominis plane (TAP) block reduced complications and shortened the hospital stay of patients undergoing colorectal operations.  The TAP block is a nerve block injection given at the conclusion of the operation which reduces pain in the operative area.  Results showed that the mean hospital stay dropped to less than 2.5 days after the surgical procedure, significantly lower than the 3.7 days which the University Hospitals Case Medical Center Care pathway had already described for more than 1,000 consecutive patients. In our new study, we employed the TAP block and the Enhanced Recovery Pathway (ERP) on 100 patients.  We found that 27 patients went home the next day and another 35 went home 48 hours after their operations. That is considerably better than the five or six days patients usually stay in the hospital after laparoscopic colorectal procedures, and certainly better than nine days often seen after an open operation.  With a third of patients leaving the day after colorectal resection, we feel these results are significant.
Diabetes, Surgical Research / 30.08.2013

MedicalResearch.com Interview with: Ta-Liang Chen, MD, PhD Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan MedicalResearch.com: What are the main findings of the study? Reply: Diabetes increases postoperative 30-day mortality, complications, and medical expenditures in patients undergoing in-hospital noncardiac surgeries.
Author Interviews, General Medicine, Heart Disease, Mayo Clinic, Surgical Research / 16.08.2013

MedicalResearch.com Interview with: Rakesh M. Suri MD, D.Phil. Mayo Clinic College of Medicine, Rochester, Minnesota MedicalResearch.com: What might clinicians “take home” from this study? Answers: a. The contemporary outcomes of surgical correction of mitral regurgitation are excellent based upon results observed in this large multinational, multi-institutional study, Mitral valve surgery now has a low peri-operative risk of death or complications, and a very high likelihood of saving a patient’s own heart valve (>90% - repair); thereby avoiding the need for replacement with an artificial valve substitute. b. All patients with severe degenerative mitral regurgitation are at risk for heart failure and/or death when surgical correction is delayed.  A safe period of “watchful waiting” in those with severe mitral regurgitation due to flail leaflets, even in the absence of traditional Class I triggers for surgery (symptoms or left ventricular dilation/dysfunction) does not exist. c. Prompt mitral valve surgery within months following the diagnosis of severe degenerative mitral regurgitation, even in those without symptoms, is associated with important and sustained long term benefits including a 40% decrease in death and 60% less heart failure risk, sustained many years following surgical intervention
Author Interviews, Clots - Coagulation, Surgical Research / 16.08.2013

MedicalResearch.com Interview with: Dr. Takahisa Fujikawa, MD, PhD, FACS. Director, Dept of Surgery, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, JAPAN. MedicalResearch.com: What are the main findings of the study? Answer: A total of consecutive 1,075 patients undergoing abdominal laparoscopic surgery between 2005 and 2011, including 715 basic and 360 advanced laparoscopic surgeries, were reviewed. The perioperative management protocol consists of interruption of antiplatelet therapy (APT) one week before surgery and early postoperative re-institution in low thromboembolic risk patients (n=160, iAPT group), whereas preoperative APT was maintained in patients with high thromboembolic risk or emergent situation (n=52, cAPT group). Perioperative and outcome variables of cAPT and iAPT groups, including bleeding and thromboembolic complications, were compared to those of patients without APT (non-APT group, n=863).
  • No case suffering excessive intraoperative bleeding due to continuation of APT was observed. There were 10 postoperative bleeding complications (0.9%) and 3 thromboembolic events (0.3%), but surgery was free of both complications in cAPT group. No significant differences were found between the groups in operative blood loss, blood transfusion rate, and the occurrence of bleeding and thromboembolic complications.
  • Multivariable analyses showed that multiple antiplatelet agents (p=0.015) and intraoperative blood transfusion (p=0.046) were significant prognostic factors for postoperative bleeding complications.  Increased thromboembolic complications were independently associated with high New York Heart Association class (p=0.019) and history of cerebral infarction (p=0.048), but not associated with APT use.
Author Interviews, Cleveland Clinic, Heart Disease, Surgical Research / 17.07.2013

MedicalResearch.com Interview with Dr. Frank Sellke, MD Chief of cardiothoracic surgery and co-director of the Cardiovascular Institute at Rhode Island, The Miriam and Newport hospitals MedicalResearch.com: What are the main findings of the study? Dr. Sellke: The main findings of the study are that outcomes of repair of an ascending aortic dissection are improved under a full moon compared to other phases of the moon. This was with regard to both mortality and length of hospital stay. Interestingly, there was no correlation with season of the year.
Author Interviews, JAMA, Surgical Research / 15.07.2013

Aneel Bhangu, MBChB, MRCS and Douglas M. Bowley, FRCS Royal Centre for Defense Medicine, Birmingham, EnglandMedicalResearch.com Interview with: Aneel Bhangu, MBChB, MRCS and Douglas M. Bowley, FRCS Royal Centre for Defense Medicine, Birmingham, England MedicalResearch.com: What are the main findings of the study?  Answer: Our study was a meta-analysis, which combined the findings from 8 randomized controlled trials that included a total of 623 patients. The key finding was that delayed primary skin closure (DPC) for contaminated and dirty abdominal incisions may reduce the rate of surgical site infection. However, due to high risk of bias from the included studies, including flaws in study design, definitive evidence is lacking. We believe that this meta-analysis represents an exciting development in biomedical publishing; this was a true collaboration between US and UK military surgeons to examine an area of major concern and interest to surgeons everywhere. This work uses experience hard-won on the battlefields of Iraq and Afghanistan, combined with published surgical trials, to inform both future research activity as well as military and civilian surgical practice. This cross-fertilization of ideas is one positive consequence of all the sacrifice and suffering of recent conflicts.
Author Interviews, Frailty, Surgical Research / 09.07.2013

MedicalResearch.com Interview with Kenneth Ogan MD Department of Urology Emory University School of Medicine 1365 Clifton Rd. NE, Building B, Suite 1400 Atlanta, Georgia 30322 MedicalResearch.com: What are the main findings of the study? Dr. Ogan: Surgical risk assessment is traditionally a very subjective process, and an evaluation that more accurately measures a patient’s physiologic reserve would greatly aid in surgical decision making. In this study we sought to further characterize frailty as an objective risk assessment tool in surgical patients. We prospectively measured the five component frailty criteria described by Fried et al.1 (weight loss, exhaustion, low activity, grip strength, and gait speed).  Patients deemed “intermediately frail” and “frail” had twice the likelihood of experiencing any complication in the 30-day post-operative period.
Author Interviews, Hematology, Surgical Research, Transfusions / 08.05.2013

MedicalResearch.com eInterview with Luca Weltert, MD Cardiac Surgery Department of the European Hospital in Rome, Presentation during the Plenary Scientific Session of the 93rd AATS Annual Meeting in Minneapolis. MedicalResearch.com: What are the main findings of the study? Dr. Luca Weltert: This study illustrates the efficacy of Human Recombinant Erythropoietin (HRE) in avoiding blood transfusions in the heart surgery setting. And aside from complicated number, tables and statistics tells that HRE can reduce Blood Transfusions as much as 65%, while at the same time not exposing patients to any substantial added risk.