Author Interviews, HIV, Infections, Vanderbilt / 02.10.2021

MedicalResearch.com Interview with: Rachael Pellegrino, MD Vanderbilt University Medical Center MedicalResearch.com: What is the background for this study? Response: We know that HIV care and outcomes have dramatically improved over the last 20 years, but disparities still exist at each step of the HIV care continuum, which can ultimately lead to differences in mortality rates. In addition to assessing trends and disparities in mortality, we wanted to look at differences in premature mortality, which has not been widely studied in the HIV population in the US. This concept serves to emphasize and quantify the time lost by death at an early age as an important measurement of the impact of diseases and can expose disparities that are not apparent in the mortality rates alone. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections / 02.10.2021

MedicalResearch.com Interview with: Chanu Rhee, MD, MPH Harvard Medical School and Harvard Pilgrim Health Institute Boston, MA MedicalResearch.com: What is the background for this study? Response: Sepsis is a leading cause of death, disability, and healthcare costs.  This has triggered regulators and hospitals to invest heavily in improving sepsis recognition and care.  Most notably, the Centers for Medicare & Medicaid Services (CMS) implemented the Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) by the in October 2015.  SEP-1 requires hospitals to report compliance with a 3 and 6 hour sepsis care bundle, which includes initial and repeat lactate measurements, blood culture orders, broad-spectrum antibiotic, specific quantities of fluid boluses for hypotension, vasopressors for persistent hypotension, and documentation of a repeat volume and perfusion assessment for patients with septic shock. While SEP-1 has helped raise awareness of sepsis and catalyzed sepsis quality improvement initiatives around the country, concerns have been raised about its potential unintended consequences -- particularly around increasing unnecessary broad spectrum antibiotic use -- and the strength of evidence supporting the measure.  In this study, we used detailed clinical data from a diverse cohort of hospitals to assess whether SEP-1 implementation was associated with changes in key processes of care and mortality in patients with suspected sepsis.  (more…)
Author Interviews, HPV, Vaccine Studies / 01.10.2021

MedicalResearch.com Interview with: Holly Frost, MD Assistant Professor Pediatrics University of Colorado Anschutz School of Medicine Thersia Sebastian, MD Pediatrics, Denver Health  MedicalResearch.com: What is the background for this study? Response: Among children with acute otitis media (AOM) S.pneumoniae, H.influenzae, and M.catarrhalis are the predominant bacterial otopathogens. Historically, the gold standard for diagnosing otopathogens has been through middle ear fluid (MEF) culture. The challenge with MEF culture is that it is time-consuming and requires expert training often only done by specialists, thereby limiting its diagnostic utility to guide routine clinical care. Recent studies have shown that there is a high correlation between nasopharyngeal (NP) and MEF organisms during AOM. It is easier to collect NP swabs and less training is required. Thus, NP samples could serve as a surrogate for detection of otopathogens, potentially making identification of otopathogens practical and feasible in a typical practice environment compared to a MEF collection. Identification of otopathogens could be critical in treatment management of AOM, especially in the era of antimicrobial stewardship efforts to overall reduce unnecessary antibiotic use. Our goal was to compare the sensitivity and specificity of NP PCR to NP culture for common bacteria that cause ear infections.  (more…)