Author Interviews, Brigham & Women's - Harvard, JAMA, Surgical Research / 27.10.2021

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. 
Author Interviews, JAMA, Race/Ethnic Diversity, Surgical Research, Weight Research / 18.10.2021

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. 
Surgical Research, Technology / 14.10.2021

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.
Anesthesiology, Author Interviews, Brigham & Women's - Harvard, Opiods, Surgical Research / 21.09.2021

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.
Author Interviews, Cost of Health Care, JAMA, Surgical Research / 07.09.2021

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. 
Accidents & Violence, Author Interviews, JAMA, Surgical Research / 10.06.2021

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 
Author Interviews, Brigham & Women's - Harvard, Primary Care, Surgical Research, Weight Research / 10.06.2021

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. 
Anesthesiology, Author Interviews, Cognitive Issues, Heart Disease, JAMA, Surgical Research, UCSF / 22.05.2021

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).
Author Interviews, Gender Differences, JAMA, Surgical Research / 28.04.2021

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.
Author Interviews, CMAJ, Orthopedics, Rheumatology, Surgical Research / 02.02.2021

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. 
Author Interviews, Brigham & Women's - Harvard, Cancer Research, COVID -19 Coronavirus, Prostate, Prostate Cancer, Surgical Research, Urology / 01.02.2021

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.
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Memory, Surgical Research / 23.01.2021

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?”
Author Interviews, JAMA, Surgical Research / 08.01.2021

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. 
Author Interviews, Heart Disease, JAMA, Pediatrics, Surgical Research / 25.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56023" align="alignleft" width="200"]Michael R. Flaherty, DO Attending, Pediatric Critical Care Medicine Co-Director, Trauma and Injury Prevention Outreach Program, MGH Instructor in Pediatrics, Harvard Medical School Boston, MA 02114 Dr. Flaherty[/caption] Michael R. Flaherty, DO Attending, Pediatric Critical Care Medicine Co-Director, Trauma and Injury Prevention Outreach Program, MGH Instructor in Pediatrics, Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings?   Response: This study was a joint collaboration between Massachusetts General Hospital and Boston Children’s Hospital. The Consumer Product Safety Commission (CPSC) found an increasing incidence of rare earth magnet ingestions by children causing serious injury; Injuries are particularly serious when a child ingests two of these small magnets, or a magnet with another metal object – this can lead to bowel walls becoming attached and kinked, leading to catastrophic bowel injury and/or death. The Consumer Product Safety Commission initiated campaigns to limit sales in 2012 with voluntary recalls and safety standards, as well as public awareness campaigns, legislative advocacy, and lawsuits. In October 2014, the CPSC published their final rule, “Safety Standard for Magnet Sets,” which prohibited the sale of magnets based on a pre-specified size and power scale, essentially eliminating the ability to sell SREMs. This rule was appealed by largest manufacturer of these magnets, Zen Magnets, LLC., and in November 2016 this rule was legally reversed by the U.S. Court of Appeals Tenth Circuit resulting in a resurgence of these magnets on the market.
Author Interviews, Surgical Research / 03.11.2020

MedicalResearch.com Interview with: Dr. Pravesh S. Gadjradj, MD Department of Neurosurgery, Leiden University Medical Center, University Neurosurgical Center Holland Leiden, Netherlands neurosurgery brain surgery ct scan MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Many healthcare professionals throughout the world face issues surrounding medical malpractice at some point in their careers. Unfortunately, a number of these cases turn into medical malpractice lawsuits. As a specialty that treats acute pathology and refractory pain, neurosurgery is at risk for high liability. By the means of a survey among members of the Congress of Neurological Surgeons (CNS), we aimed to illustrate how malpractice lawsuits affect neurosurgeons professionally, emotionally and financially.   MedicalResearch.com: What are the main findings?  Response: Some 490 members of the CNS shared their experiences with us. Among these members, 81% faced a medical malpractice lawsuit. The main concerns expressed about being sued included losing confidence and practicing defensive medicine, personal assets being at risk, and being named in the National Practitioner Data Bank. Of the respondents, 40% stated they were frequently or always concerned about being sued, and 77 % stated their fear had led to a change in how they practice medicine. For 58 %, this change led to the practice of defensive medicine, while for others it led to more extensive documentation (14%) and/or to referring or dropping complex cases (12%). Given the medical malpractice environment, 59% of respondents considered referring complex patient cases, whereas 37% considered leaving the practice of medicine.
AHA Journals, Author Interviews, Heart Disease, Surgical Research / 30.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55798" align="alignleft" width="160"]Stavros G. Drakos, MD, PhD, FACC Professor of Cardiology Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center. Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology Dr. Drakos[/caption] Stavros G. Drakos, MD, PhD, FACC Professor of Cardiology Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center. Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology MedicalResearch.com: What is the background for this study? Response: Heart transplantation and LVADs are first line therapies for advanced chronic heart failure. There were some earlier anecdotal observations and single center small studies from several programs in the US and overseas that left ventricular assist devices (LVADs) significantly reduce the strain on failing hearts and in some cases, using LVADs for limited periods of time has allowed hearts to “rest” and remodel their damaged structures. As a result of these repairs, described as “reverse remodeling,” heart function can improve to the point that the LVAD can be removed. The new study sought to broaden the reach of the research with a multicenter trial involving physicians and scientists at the University of Utah Health, the University of Louisville, University of Pennsylvania, the Albert Einstein College of Medicine/Montefiore Medical Center, the Cleveland Clinic, and the University of Nebraska Medical Center. 
Author Interviews, BMJ, Surgical Research / 15.10.2020

MedicalResearch.com Interview with: Sebastian Straube, BM BCh, MA (Oxon), DPhil Professor and Director, Division of Preventive Medicine, Department of Medicine University of Alberta Zone Section Chief, Occupational Medicine Edmonton Zone, Alberta Health Services Director, Foundation Course in Occupational Medicine surgery-aerosols-covid-19MedicalResearch.com: What is the background for this study?   Response: In view of the COVID-19 pandemic, medical procedures that generate aerosols require a higher grade of personal protective equipment, typically including filtering facepiece respirators (e.g. N95 masks). We wanted to know which procedures were aerosol-generating and would require such enhanced precautions. MedicalResearch.com: How did you approach that question? Response: We conducted a systematic review of the literature and aimed to find those procedures for which there is widespread agreement that they are aerosol-generating. We assembled a team of researchers with expertise in the subject matter as well as in systematic review methodology, and we searched widely for relevant guidelines, policy documents, and academic papers.
Author Interviews, Gender Differences, Surgical Research / 14.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55646" align="alignleft" width="200"]Cassandra M. Kelleher, MD, FACS Dr. Kelleher[/caption] Cassandra M. Kelleher, MD, FACS Surgical Director, Fetal Care Program Surgical Director, NICU Quality and Safety Chair, Pediatric Surgery MGH eCare Clinical Informaticist Pediatric Surgery MassGeneral Hospital for Children Boston, MA MedicalResearch.com: What is the background for this study? Response: Only about one in five surgeons practicing in U.S. is female. Unemployment is virtually nonexistent among surgeons, but many female surgeons, as well as professional women in other fields, experience underemployment—the underuse of skills—according to the Federal Reserve Bank. Women in surgery talk among themselves about how they may be perceived as less confident or competent, and for those reasons they may have less opportunity to do exciting and challenging cases. We wondered if this was true, and if so, why?
Author Interviews, Dermatology, Surgical Research / 29.09.2020

Botox treatment was created to make undesirable physical lines less visible. It is an efficient way to bring the natural facial appeal back to its normal condition. By getting quick and painless Botox injections, you can maintain the appearance you want most. There are a lot of myths surrounding the treatment, but the popularity of Botox is a very real thing.

botox-facial-fillers-wrinkles-skin care The Stars Know

When you hear about Botox, it is usually attached to a celebrity story. This type of treatment is very popular in Hollywood circles, and for good reason. It is an effective way to keep a specific look without major cosmetic surgery. When time is of the essence, Botox has no equal. You can set up an appointment, get the injections, and see results as early as three days. That is a single weekend required to get good looking results without breaking the bank. Hollywood is a business that relies on looks, so the popularity of Botox is no surprise. Its effectiveness on the most beautiful people in the world is the main reason why it’s still trending.
Author Interviews, Cost of Health Care, Emory, Heart Disease, JAMA, Surgical Research / 21.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55443" align="alignleft" width="200"]David H. Howard, PhD Professor, Health Policy and Management Rollins School of Public Health Emory University, Atlanta, Georgia Dr. Howard[/caption] David H. Howard, PhD Professor, Health Policy and Management Rollins School of Public Health Emory University, Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: Application of the False Claims Act (FCA) to medically unnecessary care is controversial, both in the courts and in the Department of Justice. Although there haven’t been many FCA suits against hospitals and physicians for performing unnecessary percutaneous coronary interventions (PCIs), the suits that have occurred have been against some of the highest-volume hospitals and physicians. Some cardiologists have been sentenced to prison.
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, Surgical Research / 09.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55334" align="alignleft" width="136"]Prof Stuart MacKay BSc (Med) MB BS (Hons) FRACS Honorary Clinical Professor Otolaryngology Head and Neck Surgery Clinical Professor at University of Wollongong Graduate School of Medicine Adjunct Professor Faculty of Health Sciences University of Adelaide Prof. MacKay[/caption]   Prof Stuart MacKay BSc (Med) MB BS (Hons) FRACS Honorary Clinical Professor Otolaryngology Head and Neck Surgery Clinical Professor at University of Wollongong Graduate School of Medicine Adjunct Professor Faculty of Health Sciences   MedicalResearch.com: What is the background for this study?
  1. Sleep Apnea is common and impairs daytime function and carries health risk.
  2. Many patients have difficulty with CPAP, the main treatment.
  3. Surgery offers an alternative, and we tested this at a very high level in this clinical study.
MedicalResearch.com: What are the main findings? 
  1. Surgery creates marked improvement in stoppages (apnea) and droppages (hypopnea) in airflow.
  2. Surgery significantly improves patient reports of daytime sleepiness.
  3. Many other outcomes related to quality of life, snoring and general well being improve with surgery.
Author Interviews, Cost of Health Care, Genetic Research, Immunotherapy, Melanoma, Surgical Research / 03.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55291" align="alignleft" width="200"] Dr. Bartlett[/caption] Edmund K Bartlett, M.D. Department of Surgery/Division of Surgical Oncology Memorial Sloan Kettering Cancer Center New York, New York   MedicalResearch.com: What is the background for this study? Response: Indications for adjuvant therapy for resected, high-risk melanoma is a controversial and rapidly-evolving topic in melanoma treatment. Immunotherapy treatments targeting PD-1 have significantly improved survival in advanced-stage disease, but the magnitude of survival benefit in stage III disease--particularly stage IIIA--remains unclear. Recently, 31-GEP (a gene expression profiling assay) has been studied as a risk-stratifying tool to identify patients who are at higher risk for systemic recurrence. Ideally such a tool could identify patients most likely to benefit from immunotherapy treatment in the adjuvant setting (when all visible disease has been removed).
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Emergency Care, JAMA, Surgical Research / 01.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55282" align="alignleft" width="200"]Sarabeth Spitzer, MD Co-Chair of Board, Scrubs Addressing the Firearm Epidemic (SAFE) Department of Surgery, Brigham and Women’s Hospital Dr. Spitzer[/caption] Sarabeth Spitzer, MD Co-Chair of Board, Scrubs Addressing the Firearm Epidemic (SAFE) Department of Surgery, Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Firearm injury is a significant cause of morbidity and mortality in the United States, resulting in almost 40,000 deaths annually in the United States, but very little is known about the epidemiology of nonfatal firearm injuries. Nonfatal firearm injuries can have significant long-term morbidity and are associated with significant cost. We found that there were over 81,000 nonfatal firearm injuries in California over the study period. Over the period, there was a decrease in nonfatal firearm injuries by 38.1%, driven primarily by a decrease in assault injuries.  
Author Interviews, NEJM, OBGYNE, Surgical Research / 29.07.2020

MedicalResearch.com Interview with: Jane Daniels PhD Professor of Clinical Trials, Faculty of Medicine & Health Sciences School of Medicine University of Nottingham MedicalResearch.com: What is the background for this study? MedicalResearch.com: What are the main findings? [caption id="attachment_54976" align="alignleft" width="200"]One example of a large fibroid-Wikipedia image One example of a large fibroid-Wikipedia image[/caption] Response: Uterine fibroids are the most common non-cancerous tumour in women of childbearing age. They are associated with heavy bleeding, lower chances of having children and reduced quality of life. Traditional surgical options were either to remove the fibroids (myomectomy) or completely remove the womb. A newer approach, known as uterine artery embolization, involves blocking the blood supply to the fibroids in the womb. Fibroids may be associated with infertility and problems during pregnancy, including miscarriage and preterm birth. As more women are having children at a later age, fibroids are becoming more of an issue for them and safe and effective fertility sparing treatments are needed. Both treatments improve quality of life, but myomectomy will provide greater benefit to women on average. MedicalResearch.com: What should readers take away from your report? Response: This study is the largest to date comparing women treated with either myomectomy or uterine-artery embolization for their fibroids. It was completed in hospitals across the UK, and included a substantial number of women of African-Caribbean ethnicity, who are more likely have bothersome fibroids, so we can be confident that the findings are important and relevant. Women, including those desiring a future pregnancy, should be provided with the evidence generated by the FEMME trial to enable to make a fully informed decision regarding their fibroid treatment.
Author Interviews, Surgical Research / 29.07.2020

Rhinoplasty is a common plastic surgery procedure for people who want to alter the look of their nose. There are several versions of the procedure, including one that augments the nose by adding an implant. nose-plastic-surgery Some surgeons prefer to use human cartilage from the septum, ears, or ribs. But, other surgeons prefer to use synthetic implants made of either Gore-Tex or silicone. Before you get a nose job from the best rhinoplasty surgeons, it is important to know which material is best for you. Before you choose Gore-Tex or silicone, you should take time to talk to your surgeon and work together to pick the material that will give you the look you want. An augmentation rhinoplasty takes about 90 minutes, but the change to your face will last a lifetime.
  1. What is a silicone implant?
The silicone implant is easy to insert and easy to shape. It can also be removed if there are any problems. Surgeons like them as they offer a more noticeable lift to the bridge of the nose. Silicone implants need very small incisions, if they are done from the outside.
  1. What is a Gore-Tex implant?
Gore-Tex is porous, so it gives a less noticeable lift to the bridge as it merges with the tissues in the nose. Surgeons like to use Gore-Tex because it provides a natural look. Because Gore-Tex integrates with nasal tissue, it is more difficult to remove than a silicone implant.
Author Interviews, Surgical Research, Telemedicine / 17.07.2020

MedicalResearch.com Interview with: [caption id="attachment_54875" align="alignleft" width="200"]Leonardo Mattos, PhD Head of Biomedical Robotics Lab Advanced Robotics Department Istituto Italiano di Tecnologia Genova, Italy Dr. Mattos[/caption] Leonardo Mattos, PhD Head of Biomedical Robotics Lab Advanced Robotics Department Istituto Italiano di Tecnologia Genova, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been working on robotic microsurgery for several years, and have developed robotic technology for it that is getting ready for use on humans. Then, 5G started to become a reality here in Italy, and we wanted to test if it could be used to enable remote telesurgery. So we joined forces with Vodafone Italia to realize this study and proof of concept demonstration. Telesurgery has been a dream for over 20 years, and has been demonstrated already back in 2001. However, the wide scale adoption of the technology has been limited by many factors, including the limited availability of surgical robots and the lack of a telecommunication network that is fast and reliable enough for such operation. Recent technological progress is changing this scenario, with surgical robots being used in hospitals around the world and high-performance telecommunications system becoming widely available. This study shows that telesurgery is now feasible using the newest 5G telecommunication networks, enabling us to consider a large scale adoption of the technology. 
Author Interviews, Heart Disease, JAMA, Surgical Research / 14.07.2020

MedicalResearch.com Interview with: [caption id="attachment_54851" align="alignleft" width="127"]Mario Fl Gaudino MD Professor of Cardiothoracic Surgery Department of Cardiothoracic Surgery Weill Cornell Medicine  Dr. Gaudino[/caption] Mario Fl Gaudino MD Professor of Cardiothoracic Surgery Department of Cardiothoracic Surgery Weill Cornell Medicine  MedicalResearch.com: What is the background for this study? Response: The radial artery is currently used in less than 10% of CABG procedures in the US.  MedicalResearch.com: What are the main findings? Response: The JAMA paper provides convincing evidence that the use of the radial artery rather than the saphenous vein to complement the internal thoracic artery for CABG is associated with improved long-term outcomes. 
Author Interviews, Diabetes, Surgical Research, Weight Research / 03.07.2020

MedicalResearch.com Interview with: [caption id="attachment_54762" align="alignleft" width="138"]MedicalResearch.com Interview with: Carlos KH Wong, PhD, MPhil, BSc Department of Family Medicine and Primary Care LKS Faculty of Medicine The University of Hong Kong Dr. Wong[/caption] Carlos KH Wong, PhD, MPhil, BSc Department of Family Medicine and Primary Care LKS Faculty of Medicine The University of Hong Kong MedicalResearch.com: What is the background for this study? Response: The background is that bariatric surgery has been widely indicated for the management of obesity and related comorbidities. However, there are uncertainties pertaining to the risks of post-bariatric severe hypoglycaemia (SH), cardiovascular diseases (CVDs), end-stage kidney diseases (ESKDs) and all-cause mortality in obese patients with Type 2 diabetes mellitus (T2DM), especially among Asian populations. 
Author Interviews, Heart Disease, JAMA, Opiods, Surgical Research, University of Pennsylvania / 20.06.2020

MedicalResearch.com Interview with: [caption id="attachment_54628" align="alignleft" width="150"]MedicalResearch.com Interview with: Chase Brown, MD Associate Fellow, Leonard Davis Institute of Health Economics Integrated Cardiac Surgery Resident Hospital of the University of Pennsylvania Dr. Brown[/caption] Chase Brown, MD Associate Fellow, Leonard Davis Institute of Health Economics Integrated Cardiac Surgery Resident Hospital of the University of Pennsylvania [caption id="attachment_54629" align="alignleft" width="111"]Nimesh D. Desai, MD, PhD Director, Thoracic Aortic Surgery Research Program Associate Professor of Surgery Hospital of the University of Pennsylvania Dr. Desai[/caption] Nimesh D. Desai, MD, PhD Director, Thoracic Aortic Surgery Research Program Associate Professor of Surgery Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Dr. Chase Brown:  Opioid use in the United States is a public health emergency. We know that opioids prescribed after general surgery operations to patients who never received them within the year prior to their surgery are at increased risk for continuing to take opioids months later. However, this has not been studied in patients undergoing cardiac surgery, who often times have more severe post-operative pain. Our goal in this study was to determine how many patients after cardiac surgery and are opioid naive are continuing to take opioids within 90-180 days after their surgery.  
Author Interviews, Dermatology, Stem Cells, Surgical Research / 01.06.2020

MedicalResearch.com Interview with: [caption id="attachment_54363" align="alignleft" width="200"]Charles-de-SáM.D., Ph.D. Rio de Janeiro, Brazil Dr. Charles-de-Sá[/caption] Charles-de-SáM.D., Ph.D. Rio de Janeiro, Brazil MedicalResearch.com: What is the background for this study? Response: Our clinical trial was based on our clinical skin observations in areas submitted to a lipotransfer previously, an ordinary practice in plastic surgery. These clinical observations lead us to investigate what will be the key element played in these findings. Our scientific support investigation addressed the Dardick1and Zuk, P2 studies, that demonstrated fibroblastic-like cells in adipose tissue with regenerative ability. Our clinical trial proposal is to investigate the adipose-derived stem cell (ADSC) role in the photoaged skin. The direct endpoint of the study was to assess the histological benefits provided by the subdermal ADSC injection. Mesenchymal stem cells were obtained from lipoaspirates, expanded in vitro, and introduced into the facial skin of 20 patients submitted after three to four months to a face-lifting surgery. In the retrieved skin, immunocytochemical and ultrastructural analysis quantified elastic matrix components, cathepsin-K, metalloprotease MMP-12, and the macrophage M2 markers: CD68, CD206 and heme-oxygenase-1.An overview of the trial steps is described in the infographic.