Surgical Research

16 Nov

Posted at 15:49h in Author Interviews, Dermatology, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_61061" align="alignleft" width="142"]Peter C. Minneci, MDChair of Surgery at Nemours Children’s Health Delaware Valley Dr. Minneci[/caption] Peter C. Minneci, MD Chair of Surgery at Nemours Children’s Health Delaware Valley MedicalResearch.com: What is the background for this study?  Would you briefly explain the symptoms/course of pilonidal disease?  Response: Pilonidal disease is relatively common and affects up to 1% of the population starting in adolescence and up until young adulthood. Pilonidal disease occurs when cysts or sinuses form between the buttocks. It is believed to be an inflammatory reaction to hair or debris that gets caught in the crease of the buttocks. Risk factors for the condition include a sedentary lifestyle, hygiene and obesity. [caption id="attachment_61062" align="alignleft" width="150"] Pilonidal Cyst
DermNet Image[/caption] Pilonidal disease can be intermittent or chronic and recurs about 33% of the time, with 80% of recurrences taking place within a year of initial treatment. These recurrences contribute to a high degree of psychosocial stress in patients, who often miss school or sports and may avoid social activities. Pilonidal cysts may become infected, in which case patients must take antibiotics or undergo surgery.   Standard treatment for pilonidal disease involves removal of hair with razors or creams, as well as recommendations such as keeping the area clean. In recent years, some practitioners have begun using laser epilation as an additional strategy to prevent recurrence by providing more durable hair removal. However, it’s important to point out that this is not covered by insurance. In addition, as a provider, I have found that my patients that do have the means to pay often don’t comply with the number of sessions needed to fully remove the hair due to many different factors including pain and discomfort during the procedure.  

04 Oct

Posted at 22:20h in Author Interviews, Breast Cancer, JAMA, OBGYNE, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_60897" align="alignleft" width="128"]Gabriele Martelli, MDBreast Unit, Surgery Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Italy Dr. Martelli[/caption] Gabriele Martelli, MD Breast Unit, Surgery Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Italy MedicalResearch.com: What is the background for this study? Response: Approximately 8% of breast cancer cases are associated with pathogenic germline variants of the BRCA1 or BRCA2 genes. Women with a pathogenic BRCA1 variant have lifetime risks of breast or ovarian cancer of 45% to 80% and 30% to 60%, respectively. Women with a pathogenic BRCA2 variant have lifetime risks of breast or ovarian cancer of 35% to 60% and 10% to 25%, respectively. BRCA1 breast cancer is often more aggressive than sporadic disease, while BRCA2 breast cancer is often of similar aggressivity to sporadic disease. However, few studies have investigated outcomes of breast-conserving surgery, prophylactic mastectomy, or prophylactic salpingo-oophorectomy in patients with BRCA1/2 breast cancer. We conducted a cohort study to assess outcomes of breast-conserving surgery vs mastectomy, prophylactic mastectomy vs no prophylactic mastectomy, and prophylactic salpingo-oophorectomy vs no prophylactic salpingo-oophorectomy in patients with BRCA1/2 breast cancer.

30 Aug

Posted at 20:16h in Author Interviews, Gender Differences, JAMA, Surgical Research, Vanderbilt
MedicalResearch.com Interview with: [caption id="attachment_60825" align="alignleft" width="143"]Christopher Wallis, MD, PhDAssistant Professor of Urology Department of Surgery University of Toronto and Urologic Oncologist Mount Sinai Hospital  Dr. Wallis[/caption] Christopher Wallis, MD, PhD Assistant Professor of Urology Department of Surgery University of Toronto and Urologic Oncologist Mount Sinai Hospital   MedicalResearch.com:  Could you give a little context - what was the question you were looking at?
  • We have been studying how the primary treating surgeons sociocultural characteristics impact the recovery of patients they are looking after.
  • Specifically, we have been studying the effect of surgeon sex on outcomes such as death, complications and readmission after common and complex surgeries. These are outcomes that are important to patients and the health system.
  • Previously, we showed that patients with a female surgeon had better short term (30 day) outcomes than similar patients having surgery with a man. This study asked the question of whether the sex of a patient’s surgeon affects patients’ longer term outcomes at 90 days and 1 year, after surgery.

24 Aug

Posted at 14:26h in Author Interviews, Columbia, Gender Differences, JAMA, OBGYNE, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_60784" align="alignleft" width="134"]Jason D. Wright, MD, FACOG, FACSSol Goldman Associate Professor Chief, Division of Gynecologic Oncology Vice Chair of Academic Affairs, Department of Obstetrics and Gynecology Columbia University College of Physicians and Surgeons New York, New York 10032 Dr. Wright[/caption] Jason D. Wright, MD, FACOG, FACS Sol Goldman Associate Professor Chief, Division of Gynecologic Oncology Vice Chair of Academic Affairs, Department of Obstetrics and Gynecology Columbia University College of Physicians and Surgeons New York, New York 10032 MedicalResearch.com: What is the background for this study? Response: There is growing recognition that gender-affirming surgery (GAS) is safe and that the procedures are associated with favorable long term outcomes. Prior work has explored the use of inpatient procedures and shown that the rates of GAS have risen, but there is little contemporaneous data to examine more recent inpatient and outpatient use of GAS. This is particularly important as changes in insurance regulations may have increased access for these procedures. We examined temporal trends in performance of inpatient and outpatient GAS and examined age-specific trends in the types of procedures performed over time.

10 Jul

Posted at 15:24h in Anesthesiology, Author Interviews, Cannabis, JAMA, Opiods, Surgical Research, University Texas
MedicalResearch.com Interview with: [caption id="attachment_60589" align="alignleft" width="160"]Paul Potnuru, MDAssistant Professor Anesthesiology, Critical Care and Pain Medicine The John P. and Kathrine G. McGovern Medical School The University of Texas Health Science Center at Houston Dr. Potnuru[/caption] Paul Potnuru, MD Assistant Professor Anesthesiology, Critical Care and Pain Medicine The John P. and Kathrine G. McGovern Medical School The University of Texas Health Science Center at Houston UTHealth MedicalResearch.com: What is the background for this study? Response: The use of cannabis is on the rise in the United States, as it becomes increasingly legally accepted and is viewed as harmless. Furthermore, the potency of cannabis is steadily increasing over time. There is some evidence from previous studies that compared to non-users, cannabis users require more anesthetics, have higher pain after surgery that requires more opioids, and have an increased risk of postoperative nausea and vomiting. Given this context of increased usage and potential risks during surgery, we conducted a study to examine the impact of cannabis use on patients undergoing surgery.

23 Jun

Posted at 13:59h in Surgical Research
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle,
cosmetic surgeryIndividuality is the buzzword on the current aesthetic medicine scene at a time in which the arrival of the remote working phenomenon has sparked an interest in more facial surgery and procedures delivering a more natural effect. The American Society of Plastic Surgeons (ASPS) has reported that there has been a boom in facial feature surgery such as facelifts, blepharoplasties, and rhinoplasties. What’s more, although breast augmentations, liposuctions, and buttock augmentations continue to be in high demand, the results sought are no longer driven by celebrity trends. Instead, they are firmly focused on results that are in harmony with a patient’s physique. Finally, many clients are completely giving the knife a miss and opting for non- or minimally-invasive treatments that deliver great results. Below are the top trends taking over the sector.  You may consider advice from a female plastic surgeon in Houston.

22 May

Posted at 11:07h in Author Interviews, Heart Disease, JACC, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_60443" align="alignleft" width="125"]Aloke V. Finn MDMedical Director/Chief Scientific Officer CVPath Institute Inc. Gaithersburg, MD 20878 Dr. Finn[/caption] Aloke V. Finn MD Medical Director/Chief Scientific Officer CVPath Institute Inc. Gaithersburg, MD 20878   MedicalResearch.com: What is the background for this study? Response:Transcatheter left atrial appendageal closure (LAAC) has become an established therapeutic approach for prevention of stroke in subjects with non-valvular atrial fibrillation who are ineligible for long-term oral anticoagulation.  Device-related thrombus (DRT), developing after LAAO procedures occurs in a small proportion but patients receiving these devices but is associated with critical embolic events such as ischemic stroke. Thrombogenicity and delayed endothelialization of fabric play a role in the development of DRT.  Fluorinated polymers are known to have thromboresistant properties which may favorably modify blood biomaterial interactions of a LAAO device. In this study we compared the thrombogenicity and endothelial coverage (EC) after left atrial appendage occlusion (LAAO) between a novel fluoropolymer-coated Watchman (FP-WM (Watchman FLX PRO) and the conventional uncoated Watchman FLX (WM).

05 Apr

Posted at 11:28h in Surgical Research
One way to achieve natural-looking results with minimal bruising and swelling is to choose a skilled and experienced plastic surgeon who can perform the procedure with precision and care. Additionally, certain surgical techniques, such as using smaller incisions or utilizing advanced technology like lasers or ultrasound, can help reduce trauma to the skin and underlying tissues, leading to less bruising and swelling. Another approach is to follow a customized postoperative plan that includes proper aftercare, such as avoiding certain medications and activities that can increase the risk of bruising or swelling. Finally, maintaining a healthy lifestyle with a balanced diet and regular exercise can also contribute to a faster and smoother recovery process. By taking these steps, you can help ensure natural-looking results with minimal side effects.

03 Mar

Posted at 20:22h in Author Interviews, Gender Differences, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_60128" align="alignleft" width="150"]Mario FL Gaudino, MD, PhD, MSCE, FEBCTS, FACC, FAHAStephen and Suzanne Weiss Professor in Cardiothoracic Surgery (II) Assistant Dean for Clinical Trials Professor of Clinical Epidemiology and Health Services Research at Weill Cornell Graduate School Director of the Joint Clinical Trials Office (JCTO) Director of Translational and Clinical Research, Department of Cardiothoracic Surgery Chair Coronary Artery Task Force, European Association for Cardio-Thoracic Surgery Weill Cornell Medicine | NewYork – Presbyterian Hospital Department of Cardiothoracic Surgery Dr. Gaudino[/caption] Mario FL Gaudino, MD, PhD, MSCE, FEBCTS, FACC, FAHA Stephen and Suzanne Weiss Professor in Cardiothoracic Surgery (II) Assistant Dean for Clinical Trials Professor of Clinical Epidemiology and Health Services Research at Weill Cornell Graduate School Director of the Joint Clinical Trials Office (JCTO) Director of Translational and Clinical Research, Department of Cardiothoracic Surgery Chair Coronary Artery Task Force, European Association for Cardio-Thoracic Surgery Weill Cornell Medicine | NewYork – Presbyterian Hospital Department of Cardiothoracic Surgery MedicalResearch.com: What is the background for this study? Response: It is well-documented that women undergoing CABG have higher mortality and morbidity when compared with men. They are referred to surgery later than men, with more cardiovascular risk factors than men, and present more frequently with heart failure or in non-elective settings. However, overall CABG outcomes have improved over time, and so we sought to evaluate national trends in outcomes specifically in women.

13 Jan

Posted at 18:16h in Author Interviews, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_59920" align="alignleft" width="175"]Casey HribarFourth-year medical student University of North Carolina Casey Hribar[/caption] Casey Hribar Fourth-year medical student University of North Carolina MedicalResearch.com: What is the background for this study? Response: Several great pieces of literature already exist about patient perception of doctors wearing white coats, formal attire, business attire, and the like. But recently, scrubs are garnering favor, especially as a result of the COVID-19 pandemic. While there has been some interest in what is worn over scrubs (jackets, vests, name tags, etc.), to our knowledge, there has not been any investigation into scrub color. Scrubs are a highly variable article of clothing, from fit, to pockets, pattern, and color, and it makes sense that these variations could have their own associated perceptions. Our study served as a way to open up the conversation around scrubs and the potential impact of their color on patients.

13 Sep

Posted at 21:19h in Author Interviews, Pulmonary Disease, Surgical Research
MedicalResearch.com Interview with: Ms. Sara Buttery Research Physiotherapist at Royal Brompton & Harefield NHS Foundation Trust University of the West of England London, England, UK MedicalResearch.com: What is the background for this study? Would you describe the BVLR technique? Response: The CELEB trial is a multicentre randomised controlled trial that was carried out at five centres across the UK, with the objective of investigating if Lung volume reduction surgery (LVRS) is significantly superior to Bronchoscopic lung volume reduction (BLVR) in people who are suitable for both procedures. BLVR is a minimally invasive method of lung volume reduction whereby a fibreoptic camera is passed through the mouth, rather than by an incision in the chest wall as is the case with LVRS. The CELEB trial compared endobronchial valves (EBVs) as a type of BLVR, to LVRS. EBVs are designed to prevent airflow into the treated lobe, but allow air and mucus to exit. EBV treatment can be carried out under general anaesthetic or sedation. The primary outcome for the CELEB trial was the iBODE index score at 12 months post procedure, as a measure of disease severity.

21 Jun

Posted at 10:56h in Author Interviews, Cancer Research, COVID -19 Coronavirus, Lung Cancer, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_59278" align="alignleft" width="130"]Emanuela Taioli, MD, PhD Director, Institute for Translational Epidemiology Professor, Population Health Science and Policy Professor, Thoracic Surgery Icahn School of Medicine at Mount Sinai New York, NY Dr. Taioli[/caption] Emanuela Taioli, MD, PhD Director, Institute for Translational Epidemiology Professor, Population Health Science and Policy Professor, Thoracic Surgery Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com:  What is the background for this study?  Response: NYC experienced a halt on all elective care from March 22 to June 8, 2020, provoking reduced cancer screening rates, and delayed cancer care and treatment. We wanted to quantify the effect of the “pause” on cancer stage at diagnosis using lung cancer as an example of a condition where early diagnosis can dramatically modify survival.

14 Apr

Posted at 19:53h in Author Interviews, Cleveland Clinic, Diabetes, JACC, Surgical Research, Weight Research
MedicalResearch.com Interview with: Amgad Mentias, MD MS FACC FESC Assistant Professor, CCLCM Section of Clinical Cardiology, Heart and Vascular Institute. Cleveland, OH 44195Amgad Mentias, MD MS FACC FESC Assistant Professor, CCLCM Section of Clinical Cardiology, Heart and Vascular Institute. Cleveland, OH 44195  MedicalResearch.com:  What is the background for this study?    Response:  There is evidence that bariatric or weight loss surgery can decrease the risk of heart attack, stroke, and death in young and middle age patients with obesity and diabetes. However, the evidence is less clear for older patients and patients without diabetes. There is also no long-term data on outcomes of bariatric surgery in the Medicare beneficiaries. So, in our study, we aimed to report long-term outcomes of bariatric surgery from a contemporary nationwide cohort from the US, while also looking into outcomes in patients older than 65 years, and patients without type 2 diabetes specifically.

06 Apr

Posted at 21:31h in Author Interviews, Gender Differences, Heart Disease, JACC, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_58987" align="alignleft" width="200"]Left: Mario Gaudino, MD PhD; Right: Antonino Di Franco, MD Left: Mario Gaudino, MD PhD; Right: Antonino Di Franco, MD[/caption] Mario F.L. Gaudino, M.D. PhD Attending Cardiac SurgeonDepartment of Cardiothoracic Surgery Antonino Di Franco, MD Adjunct Clinical Assistant Professor of Cardiothoracic Surgery Weill Cornell Medicine   MedicalResearch.com:  What is the background for this study?  What is the aim of this review?  Response: Biological and socio-cultural differences between men and women are complex and likely account for most of the variations in the epidemiology and treatment outcomes of coronary artery disease (CAD) between the two sexes. Despite the growing recognition of sex-specific determinants of outcomes, representation of women in clinical studies remains low, and sex-specific management strategies are generally not provided in guidelines. We summarized the current evidence on sex-related differences in patients with CAD, focusing on the differential outcomes following medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery.

31 Mar

Posted at 12:25h in Author Interviews, NEJM, OBGYNE, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_58976" align="alignleft" width="200"]Professor Mohamed Abdel-fattah, MD, FRCOG Chair in Gynaecology Consultant Gynaecologist & Sub-specialist Urogynaecologist School Medicine, Medical Sciences and Nutrition University Of Aberdeen Co-Director Aberdeen Centre For Women’s Health Research Lead – MBChB intercalated degree programme Chief Investigator – CATHETER II, FUTURE, and SIMS RCTs Prof. Abdel-Fattah[/caption] Professor Mohamed Abdel-Fattah, MD, FRCOG Chair in Gynaecology Consultant Gynaecologist & Sub-specialist Urogynaecologist School Medicine, Medical Sciences and Nutrition University Of Aberdeen Co-Director Aberdeen Centre For Women’s Health Research Lead – MBChB intercalated degree programme Chief Investigator – CATHETER II, FUTURE, and SIMS RCTs MedicalResearch.com:  Why was this study necessary? Response:At the time of study design, the main surgical option for treating stress urinary incontinence was the insertion of a standard mid-urethral sling, usually using a general anaesthetic. However, single incision mini-slings were introduced to clinical practice without robust assessment. They were considered promising due to several potential advantages including using less mesh more possibility to be performed under local anaesthetic. A number of small studies with short-term follow-up (i.e. low quality evidence) showed mini-slings to have similar success rates to standard mid-urethral slings, but required shorter hospital stay and was less painful immediately after surgery. Several systematic reviews at the time recommended an adequately powered robust randomised trial to compare the clinical and cost-effectiveness of mini-slings to standard mid-urethral slings with adequate term follow-up. 

22 Mar

Posted at 00:02h in Author Interviews, Education, JAMA, Surgical Research, Technology
MedicalResearch.com Interview with: [caption id="attachment_58936" align="alignleft" width="125"]Ali M. Fazlollahi, MSc ,McGill Medicine, Class of 2025 Neurosurgical Simulation and Artificial Intelligence Learning Centre Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital Faculty of Medicine and Health Sciences McGill University, Montreal, Canada Ali M. Fazlollahi[/caption] Ali M. Fazlollahi, MSc, McGill Medicine Class of 2025 Neurosurgical Simulation and Artificial Intelligence Learning Centre Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital Faculty of Medicine and Health Sciences McGill University, Montreal, Canada MedicalResearch.com:  What is the background for this study?  Response: COVID-19 disrupted hands on surgical exposure of medical students and academic centres around the world had to quickly adapt to teaching technical skills remotely. At the same time, advances in artificial intelligence (AI) allowed researchers at the Neurosurgical Simulation and Artificial Intelligence Learning Centre to develop an intelligent tutoring system that evaluates performance and provides high-quality personalized feedback to students. Because this is the first AI system capable of providing surgical instructions in simulation, we sought to evaluate its effectiveness compared with learning from expert human instructors who provided coaching remotely.

27 Oct

Posted at 15:42h in Author Interviews, Brigham & Women's - Harvard, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_58312" align="alignleft" width="200"]Joel S. Weissman, PhD Deputy Director/Chief Scientific Officer Center for Surgery and Public Health Brigham and Women's Hospital/Harvard Medical School Professor of Surgery (Health Policy) Harvard Medical School Dr. Weissman[/caption] Joel S. Weissman, PhD Deputy Director/Chief Scientific Officer Center for Surgery and Public Health Brigham and Women's Hospital/Harvard Medical School Professor of Surgery (Health Policy) Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Over time, the military health system has been shifting care for its soldiers and their families away from big military treatment facilities (MTFs), allowing soldiers and their families to get care from civilian hospitals.  But this has had an unintended consequence.  Unfortunately, it means that military surgeons are getting fewer cases, and they are worried about maintaining their skills as surgeons.  But some surgeries count more than others to help prepare the surgeon for battlefield casualties. 

18 Oct

Posted at 11:56h in Author Interviews, JAMA, Race/Ethnic Diversity, Surgical Research, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_58229" align="alignleft" width="200"]Amresh D. Hanchate, PhD Professor, Department of Social Sciences and Health Policy Director, Program in Health Services Research Division of Public Health Sciences Wake Forest School of Medicine Medical Center Boulevard Winston-Salem, NC  27157-1063 Dr. Hanchate[/caption] Amresh D. Hanchate, PhD Professor, Department of Social Sciences and Health Policy Director, Program in Health Services Research Division of Public Health Sciences Wake Forest School of Medicine Medical Center Boulevard Winston-Salem, NC  27157-1063 MedicalResearch.com: What is the background for this study? Response: There is strong evidence of increase in access to outpatient physicians among low income individuals who gained Medicaid following changes initiated with the Affordable Care Act. But there is little evidence of whether Medicaid expansion has similarly resulted in increased use of elective inpatient procedures. Bariatric surgery is a particularly important service to study, as the number of adults with severe obesity continues to grow in the United States, and this is the most effective available treatment. Additionally, bariatric procedures are primarily performed among the age group targeted by Affordable Care Act expansions (18-64), and there is a lot of evidence that only a small fraction of eligible uninsured patients are having surgery. 

14 Oct

Posted at 12:09h in Surgical Research, Technology
Medicine is ever evolving, but it might surprise you to hear how far we’ve come even since the turn of the century. Advancements in technology have allowed for some amazing upgrades in medicine that could only be imagined in sci-fi movies before, and new developments in drugs have vastly increased the average life expectancy, from 77.74 in 2000 to a high of 81.3 in 2014. Read on to find out more about our top picks for the most influential advancements in medicine. Information technology An often overlooked but greatly impactful aspect of medicine, information technology has allowed for the smooth and faster running of hospitals. Like every other aspect of life, technology has infiltrated hospitals and GPs at a basic and far-reaching level, allowing for safer and more secure running of hospitals as well as aiding diagnosis earlier and minimally invasive procedures to create less pain and quicker healing. Rather than sifting through filing rooms for that one patient, staff can access a patient’s file on cloud storage, where it is free from other prying eyes. Remote consultations allow for neither patient or doctor to travel to do a consultation, and an encyclopedia of symptoms and treatments are available at doctors’ fingertips. Technology has taken the routine and tedious aspects of patient care out of the equation, or at least streamlined it, so that doctors can focus on their patients. Filing, record maintenance and other routine tasks, are all done quickly with the help of apps and cloud storage. Streamlining processes like no exam life insurance allows for doctors to focus on the care of their patients while you offer other evidence like family history and pre-existing conditions. Doctors are working faster, patients get seen quicker, their prescriptions are issued sooner.

21 Sep

Posted at 11:20h in Anesthesiology, Author Interviews, Brigham & Women's - Harvard, Opiods, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_58139" align="alignleft" width="200"]Andres Zorrilla Vaca, MD Resident Physician Brigham and Women’s Hospital Boston, Massachusetts Dr. Zorrilla Vaca[/caption] Andres Zorrilla Vaca, MD Resident Physician Brigham and Women’s Hospital Boston, Massachusetts  MedicalResearch.com: What is the background for this study? Response: The background for this study was Enhanced Recovery After Surgery, also known as ERAS protocols. They basically consisted of a bundle of interventions that are performed preoperatively, intraoperatively and postoperatively with the aim of enhancing patient recovery and reducing complications. This protocol in our institution started with a thorough preoperative counseling which includes, smoking cessation, pain and analgesia education, ERAS program expectations, pulmonary rehabilitation based on pulmonary function tests and incentive spirometry. On the day of surgery, prolonged fasting is avoided and a carbohydrate loading is given orally 2 hours before surgery. Our protocol also included a standardized multimodal analgesic regimen consisting of tramadol ER 300mg p.o. and gabapentin 300mg p.o., intraoperative acetaminophen 1gm i.v., posterior intercostal nerve blockade with liposomal bupivacaine 266mg prior to incision, intraoperative 30mg ketorolac upon wound closure and scheduled postoperative acetaminophen 1g p.o. q 6hrs and ketorolac 15mg i.v. q 6 hrs, as well as additonal interventions recommended by ERAS Society Guidelines. As a general rule, preoperative sedatives (midazolam) are avoided as premedication and prophylaxis against nausea and vomiting (ondansetron, dexamethasone and scopolamine) is administered. Patients are kept euvolemic by using validated goal-directed fluid therapy algorithms (stroke volume variation and cardiac output) and normothermia is maintained throughout the procedure.

07 Sep

Posted at 23:35h in Author Interviews, Cost of Health Care, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_58033" align="alignleft" width="133"]Andrew P. Loehrer, MD, MPH Assistant Professor Department of Surgery, Division of Surgical Oncology Dartmouth-Hitchcock Dr. Loehrer[/caption] Andrew P. Loehrer, MD, MPH Assistant Professor Department of Surgery, Division of Surgical Oncology Dartmouth-Hitchcock MedicalResearch.com: What is the background for this study? Response: Patient cost sharing represents the portion of costs covered by insurance that individuals pay out of pocket, including deductibles, co-payment, and co-insurance. Cost sharing is increasingly common and also increasingly expensive for patients with commercial health insurance across the United States. While designed to increase patient responsibility for health care spending, prior work has shown that higher cost sharing is also associated with decreased use of health care overall, both needed and discretionary. However, little work has been done as to how high cost sharing may affect common and costly conditions like acute appendicitis and acute diverticulitis. 

10 Jun

Posted at 18:36h in Accidents & Violence, Author Interviews, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_57593" align="alignleft" width="110"]Chris Conner, MD/PhD PGY6, Dept Neurosurgery University of Texas, Houston Dr. Conner[/caption] Christopher Conner, MD, PhD Neurosurgery resident McGovern Medical School The University of Texas Health Science Center at Houston MedicalResearch.com: What is the background for this study? Response: There has been a growing understanding in medicine that the incidence of motor vehicle trauma is changing. We have watched as Friday and Saturday night emergencies have declined without a good explanation. Several other studies have investigated this, but the results were not conclusive. We think that is due to a lack of data from the rideshare companies and hospitals directly 

10 Jun

Posted at 17:42h in Author Interviews, Brigham & Women's - Harvard, Primary Care, Surgical Research, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_57605" align="alignleft" width="142"] Dr. Turchin[/caption] Alexander Turchin, MD, MS Director of Informatics Research Division of Endocrinology, Diabetes and Hypertension Associate Professor of Medicine, Harvard Medical School Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: There is an epidemic of obesity in the U.S.: over 40% of adults are obese. Obesity causes numerous complications, ranging from heart attacks to cancer. Bariatric surgery is one of the most effective ways to treat obesity, but very few patients utilize it; it is unclear why. 

22 May

Posted at 13:30h in Anesthesiology, Author Interviews, Cognitive Issues, Heart Disease, JAMA, Surgical Research, UCSF
MedicalResearch.com Interview with: [caption id="attachment_57417" align="alignleft" width="117"]Elizabeth L. Whitlock, MD, MSc John W. Severinghaus Assistant Professor In Residence Anesthesia & Perioperative Care UCSF Medical Center Dr. Whitlock[/caption] Elizabeth L. Whitlock, MD, MSc John W. Severinghaus Assistant Professor In Residence Anesthesia & Perioperative Care UCSF Medical Center MedicalResearch.com: What is the background for this study? Response: We have known for a while that, rarely, some older adults suffer substantial, durable cognitive decline after surgery, particularly after coronary artery bypass grafting (CABG) surgery; a larger proportion experience a decline in cognitive test performance which doesn't necessarily affect function, but which has caused concern among researchers.  This cognitive decline was attributed, in part, to the cardiac bypass pump. ​Many of the studies had methodological limitations which made it difficult to be sure that the cognitive change was due to surgery and not due more generally to heart problems or atherosclerotic disease, which may also imply cerebrovascular atherosclerosis. Using a large database of older adults who undergo regular cognitive testing, we identified individuals who underwent CABG and compared them to those who underwent percutaneous coronary intervention (PCI), a minimally invasive, non-surgical method of opening blocked coronary arteries.  This allowed us to model the rate of memory decline before surgery - which hadn't been done in previous studies - and compare it to the rate of memory decline after surgery in older adults who had serious heart disease (some of whom were treated with CABG, and some treated with PCI).

28 Apr

Posted at 18:29h in Author Interviews, Gender Differences, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_57250" align="alignleft" width="200"]Anthony Almazan MD Candidate Harvard Medical School Anthony Almazan[/caption] Anthony Almazan MD Candidate Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Gender-affirming surgeries are procedures offered to alleviate psychological distress and affirm the gender identities of transgender and gender diverse (TGD) people. Requests for these surgeries have been increasing in the United States over the past decade. However, the mental health benefits of these procedures have remained controversial due to the limited evidence base on this subject.

02 Feb

Posted at 11:19h in Author Interviews, CMAJ, Orthopedics, Rheumatology, Surgical Research
MedicalResearch.com Interview with: Codie Primeau, MSc Physical Therapy Student & Ph.D. Candidate (Combined MPT/Ph.D.) Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sport Medicine Clinic Western University London, ON, Canada MedicalResearch.com: What is the background for this study? Response: High tibial osteotomy (HTO) is a surgery for patients with varus alignment (bowed legs) and earlier-stage knee osteoarthritis. By correcting alignment, HTO shifts load to less diseased parts of the knee. One of the goals of HTO is to delay or even prevent the need for knee replacement surgery later. 

01 Feb

Posted at 11:16h in Author Interviews, Brigham & Women's - Harvard, Cancer Research, COVID -19 Coronavirus, Prostate, Prostate Cancer, Surgical Research, Urology
MedicalResearch.com Interview with: [caption id="attachment_56523" align="alignleft" width="200"]David-Dan Nguyen Research Fellow | Center for Surgery and Public Health, Brigham and Women's Hospital MPH (Health Policy) Student | Harvard T.H. Chan School of Public Health Medical Student | McGill University Mr. Nguyen[/caption] David-Dan Nguyen Research Fellow | Center for Surgery and Public Health, Brigham and Women's Hospital MPH (Health Policy) Student | Harvard T.H. Chan School of Public Health Medical Student | McGill University MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has forced hospitals to delay the definitive treatment of cancers via surgery or radiation therapy. While previous evidence has shown that delaying the treatment of low-risk prostate cancer is not associated with worse outcomes, treatment delays for intermediate-risk and high-risk prostate cancer are more controversial. As such, we sought to determine if delays for these disease states negatively impacted oncological outcomes.

23 Jan

Posted at 18:17h in Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Memory, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_56458" align="alignleft" width="194"]Pascual Sánchez-Juan, MD, PhD Servicio de Neurología Hospital Universitario "Marqués de Valdecilla" Unidad de Deterioro Cognitivo https://www.facebook.com/deteriorocognitivovaldecilla Director científico Biobanco Valdecilla Avda Marqués de Valdecilla s/n  Dr. Sanchez-Juan[/caption] Pascual Sánchez-Juan, MD, PhD Servicio de Neurología Hospital Universitario "Marqués de Valdecilla" Unidad de Deterioro Cognitivo https://www.facebook.com/deteriorocognitivovaldecilla Director científico Biobanco Valdecilla Avda Marqués de Valdecilla s/n  MedicalResearch.com: What is the background for this study? Response: Alzheimer's disease is one of the greatest public health challenges. From the moment the first lesions appear in the brain to the clinical manifestations, up to 20 years can pass. Today we can detect the presence of these initial lesions through biochemical markers such as amyloid-β, which is one of the main proteins accumulated in the brains of Alzheimer's patients. The prevalence of cerebral amyloid-β pathology in cognitively asymptomatic individuals increases with age. It has been estimated that 21.1% of the population at the age of 65 will have a positive amyloid scan or a pathological cerebrospinal fluid (CSF) amyloid-β determination, and which will double by the age of 90. Due to the aging of our societies and advances made in medical care, an increasing number of elderly and more fragile people are considered candidates for major surgery. In preoperative screenings, respiratory and cardiovascular functions are routinely checked; however, it is not commonly assessed how the brain is going to cope with the intervention. In the clinic, the patient’s relatives frequently tell us that the memory problems began after a surgical procedure or a hospital admission. This posed us the following question: is this just a recall bias or has surgery triggered the appearance of the symptoms in a previously affected brain?”

08 Jan

Posted at 11:43h in Author Interviews, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_56358" align="alignleft" width="133"]Dr. Kibbe Dr. Kibbe[/caption] Melina R. Kibbe, MD, FACS, FAHA Colin G. Thomas Jr. Distinguished Professor and Chair Department of Surgery Professor, Department of Biomedical Engineering The University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7050 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Fluoroquinolones are a commonly prescribed antibiotic.  Recent data from Taiwan, Sweden, and Canada suggests that the use of fluoroquinolones increase the short-term risk of aneurysm formation in certain older patient  populations.  As such, the FDA issued a warning in 2018 regarding the use of fluoroquinolone antibiotics suggesting that this class of antibiotics should not be used in patients at increased risk. The FDA defined the high risk population as those with a history of aneurysms or blockages, high blood pressure, certain genetic disorders related to blood vessels, and the elderly.  However, we hypothesized that this risk of taking fluoroquinolones extends to all patient populations and not just high risk patient populations.