Author Interviews, Dermatology, JAMA, Surgical Research / 16.11.2023

MedicalResearch.com Interview with: 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. 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.   (more…)
Author Interviews, Biomarkers, BMJ, Ovarian Cancer / 03.11.2014

Ben Van Calster PhD Department of Development and Regeneration KU Leuven, Herestraat Leuven, BelgiumMedicalResearch.com Interview with: Ben Van Calster PhD Department of Development and Regeneration KU Leuven, Herestraat Leuven, Belgium   MedicalResearch: What is the background for this study? What are the main findings? Dr. Van Calster: Ovarian cancer is a very common type of cancer among women, with over 200,000 new cases per year worldwide. It is the most lethal of gynecological malignancies. Research has shown that the referral of patients with ovarian cancer to specialized gynecological oncologists in high volume centers improves survival. However, audits in Europe and the United States also show that only a minority of women with ovarian cancer are appropriately triaged to receive specialist care. In addition, different types of malignancies are not treated in the same way. Hence optimal personalized management of an ovarian tumor hinges on the detailed preoperative diagnosis of its nature. Unfortunately, current prediction models focused on the discrimination between benign and malignant tumors without further specification of the likely type of malignancy. Various prediction models and rules have been developed to help predict whether an ovarian mass is benign or malignant. A recent systematic review meta-analysis has shown that the IOTA model LR2 and simple rules perform better than any other previous test. However none of these tests give anything other than a dichotomous outcome – i.e. cancer or non-cancer. In practice the position is more nuanced. The ADNEX model estimates the likelihood that a tumor is benign, borderline malignant, stage I cancer, stage II-IV cancer, or secondary metastatic cancer. This model is the first that is able to differentiate between benign and these four subtypes of malignancy. To do so, ADNEX uses three clinical predictors (age, serum CA-125 level, and type of center), and six ultrasound characteristics of the tumor (maximum diameter of lesion, proportion of solid tissue, more than 10 cyst locules, number of papillary projections, acoustic shadows, and ascites). The model is based on data from almost 6,000 women recruited at 24 centers in 10 countries. (more…)