medical research Tag
17 Oct Proton Therapy May Decrease Overall Costs While Improving Quality of Cancer Care
MedicalResearch.com Interview with:
Steven J. Frank, M.D.
Associate Professor of Radiation Oncology
Medical Director of the Proton Therapy Center
The University of Texas MD Anderson Cancer Center
MedicalResearch.com Editor’s Note:
A recent research published in Oncology Payers, discusses the quality of life benefits and cost-savings of intensity modulated proton therapy (IMPT or proton therapy) with traditional x-ray therapy for advanced stage head and neck cancer. The senior author of the paper, Dr. Steven Frank, highlights two oropharyngeal cancer patients, one of whom received proton therapy and the other x-ray treatments. Both patients received chemotherapy.
The study showed that although the upfront costs of proton therapy were three times that of standard x-ray treatments, the proton therapy patient was spared the necessity of a feeding tube, nutritional and supportive care and weight loss that accompanied the x-ray treatments. By the end of the treatment period, the total care costs for the proton therapy patient were 20% lower than the x-ray treatment plan.
To evaluate the costs, Dr. Frank has been employing a costing tool used elsewhere at MD Anderson called Time-driven Activity-based Costing that places the emphasis on the value of medical care, both monetary and in terms of quality of life. Dr. Frank plans to enroll 360 patients over the next five years as well as to open the study to other cancer centers. He notes that the results will be especially valuable as health insurance companies look to further bundled insurance payments.
Dr. Frank was kind enough to answer several questions regarding his work for the MedicalResearch.com audience.
Medical Research: From a patient's perspective, what are the main differences between traditional x-ray therapy and proton therapy for cancer treatment?
Dr. Frank: In proton therapy, the radiation hits the cancer, while with traditional x-ray the radiation hits the cancer and the normal tissues in the head and neck, causing more side effects during and after treatment. The main advantage is that proton therapy eliminates unnecessary radiation. As radiation oncologists, our primary goal is to effectively kill cancer while sparing the patient the side effects of excessive radiation. Proton therapy achieves this for many patients with a variety of cancers, including lymphoma, lung, head and neck, prostate, esophageal and pediatric cancers.
17 Oct High Fat Diets Worse for Male Brains
MedicalResearch.com Interview with:
Deborah Clegg, PhD
Research Scientist, Diabetes and Obesity Research Institute
Associate Professor, Department of Biomedical Science
Cedars-Sinai Medical Center
Los Angeles, CA 90048
Medical Research: What are the main findings of the study?
Dr. Clegg: The main findings are that males and females differ with respect to how they process and respond to diets high in fat!!!! Males following consumption of a diet that is 42% of the calories coming from saturated fat (it would be analogous to eating a big mac and having a coke), gained the same amount of weight as did the females BUT the males had increased markers of inflammation in their brains and the females did not. With the elevated markers of inflammation, the males had dysregulation in glucose homeostasis and alteration in cardiovascular function – yet the females did not!!
17 Oct Melanoma: Combination BRAF and MEK Inhibitors Has Better Safety Profile
MedicalResearch.com Interview with:
Martina Sanlorenzo, MD
Department of Dermatology
Mt. Zion Cancer Research Bldg.
San Francisco, CA 94143-0808
Medical Research: What are the main findings of the study?
Dr. Sanlorenzo: In the treatment of BRAF mutant melanoma, the combination of BRAF inhibitor and MEK inhibitor has a better cutaneous safety profile compared with BRAF inhibitor monotherapy. Combination regimen shows fewer cutaneous adverse events and longer cutaneous adverse event-free interval. In particular, the development of squamous cell carcinoma or keratoacanthoma was significantly less frequent.
17 Oct Coumarin Users at Higher Risk For Cerebral Microbleeds
MedicalResearch.com: Interview Invitation S. Akoudad, MD Msc PhD candidate Dep. Epidemiology, Radiology, Neurology Erasmus MC, Rotterdam , the Netherlands Medical Research: What are the main findings of the study? Dr. Vernooij: We found that compared to never users, coumarin users had a higher prevalence of deep or infratentorial microbleeds and probably also a higher incidence of any microbleeds. A higher maximum international normalized ratio (INR) was associated with deep or infratentorial microbleeds, and among coumarin users, a greater variability in INR was associated with a higher prevalence of microbleeds.17 Oct ADHD Genetic Risks Also Predict Milder Attention and Language Difficulties
MedicalResearch.com Interview with: Joanna Martin, PhD student MRC Centre for Neuropsychiatric Genetics and Genomics Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff Medical Research: What are the main findings of the study? Response: In this study, we found that genetic risks which are collectively important for ADHD diagnosis also predict higher levels of traits of hyperactivity/impulsiveness, inattention and pragmatic language difficulties in childhood in the general population.16 Oct Role of Steroids Post Tonsillectomy Explored
MedicalResearch.com Interview with: Sayaka Suzuki, MD Department of Clinical Epidemiology and Health Economics, School of Public Health, Faculty of Medicine, Department of Otolaryngology–Head and Neck Surgery, University of Tokyo, Tokyo, Japan Medical Research: What are the main findings of the study? Dr. Suzuki: We found a slight increase in the risk of severe bleeding requiring surgery for hemostasis in children who were administrated intravenous steroid on the day of tonsillectomy. Physicians should carefully make a decision to use steroids, taking into account patients' choice under being well informed on the risks and benefits of steroid use.16 Oct Serious Reportable Events Reduced By Standardized Safe Surgery Program
Medical Research.com Interview with:
Terrence Loftus, MD, MBA, FACS
Medical Director, Surgical Service & Clinical Resources
Banner Health
Phoenix, Arizona 85006
Medical Research: What are the main findings of the study?
Dr. Loftus: This study demonstrated that a standardized safe surgery program effectively and systematically implemented across a diverse healthcare system resulted in a significant reduction in serious reportable events (SREs), thereby improving the quality of patient care and leading to significant cost avoidance. For the purposes of the study, SREs were defined as any reported retained surgical item, wrong site, wrong patient or wrong procedure event. Following implementation of the Safe Surgery Program there was a 52% reduction in the SRE rate in the operating rooms and L&D areas in our system. The most dramatic change and greatest area of improvement was in wrong site events which demonstrated a 70% reduction for this type of serious reportable events.
This was achieved through a Safe Surgery Program which consisted of three main components.
- The first component was patient focused procedures. These are steps designed to prevent wrong site, wrong patient or wrong procedure events.
- The second component was sponge, sharp and instrument count procedures. These are steps designed to prevent retained surgical items.
- The final component was monthly observational audits that were performed to assess program compliance.
16 Oct Losing Ability To Smell Raises Risk of Household Hazardous Events
MedicalResearch.com Interview with:
Richard M. Costanzo, PhD.
Professor of Physiology and Biophysics and
Special Assistant to the Vice President for Research
Virginia Commonwealth University
Medical Research: What are the main findings of the study?
Dr. Costanzo: In this study we found that individuals with varying degrees olfactory impairment have an increased risk of experiencing a hazardous event. Those with complete loss (anosmia) were three times more likely to experience an event than those with normal olfactory function. Factors such as age,sex, and race were found to affect an individual’s risk.
16 Oct Malpractice Reform Did Not Change ER Doctor Habits or ER Costs
MedicalResearch.com Interview with:
Daniel A. Waxman, MD, PhD
Department of Emergency Medicine
David Geffen School of Medicine
University of California, Los Angeles
RAND Corporation Santa Monica, California
Medical Research: What are the main findings of the study?
Dr. Waxman: About 10 years ago, three states (Texas, Georgia, and South Carolina) passed laws which made it much harder for doctors to be sued for malpractice related to emergency room care. The goal of our research was to determine whether the lower risk of being sued translated into less costly care by emergency physicians. To figure this out, we looked at the billing records of nearly 4 million Medicare patients and compared care before and after the laws took effect, and between states that passed reform and neighboring states that didn’t change their laws. We found that these substantial legal protections didn’t cause ER doctors to admit fewer patients to the hospital, to order fewer CT or MRI scans, or to spend less for the overall ER visit.
16 Oct Melanoma Cells Make Steering Signals To Enter Bloodstream
MedicalResearch.com Interview with:
Professor Robert Insall
CR-UK Beatson Institute for Cancer Research
Glasgow UK
Medical Research: What are the main findings of the study?
Prof. Insall: The principal message is that melanoma cells make their own steering signals, and thus drive themselves out of the tumour and into the bloodstream. This comes in two parts:
(a) The principal steering signal when we assay melanoma spread in vitro is lysophosphatidic acid, LPA. LPA steers cells with really remarkable accuracy; blocking LPA receptors stops them from spreading without hurting their health or ability to move.
(b) Where does the LPA gradient come from? They make it themselves. There seems to be lots of LPA around; they break down the LPA near them, leading to a gradient that's low near the cells and high further away. This is the gradient that steers the tumour cells.
15 Oct Lycopene Associated With Decreased Risk of Renal Cell Carcinoma
MedicalResearch.com Interview with:
Cathryn Bock, PhD
Associate Professor, Oncology Department
Karmanos Cancer Institute
Wayne State University School of Medicine
Detroit, MI 48201
Medical Research: What are the main findings of the study?
Dr. Bock: This study examined the association between dietary antioxidant micronutrients and risk of renal cell carcinoma (RCC) among a cohort of 96,196 postmenopausal women from the Women’s Health Initiative (WHI). During follow-up (median follow-up time was 12 years), there were 240 cases of confirmed renal cell carcinoma in the cohort. Dietary lycopene intake, measured at baseline, was associated with a decreased risk of renal cell carcinoma (RCC). Women with the highest quartile of lycopene intake (>6427.7 mcg/day) had approximately 40% lower risk of RCC compared to those women in the lowest quartile of lycopene intake (<2727.6 mcg/day). There were no statistically significant associations observed between intake of beta-carotene, alpha-carotene, beta-cryptoxanthin, lutein + xeazanthin, vitamin C, or vitamin E and renal cell carcinoma.
15 Oct Smoking Continues To Be Major Source Of Preventable Disease In US
MedicalResearch.com Interview with:
Dr. Brian Rostron PhD, MPH
Center for Tobacco Products
US Food and Drug Administration
Silver Spring, Maryland
Medical Research: What are the main findings of the study?
Dr. Rostron: We estimated that Americans in 2009 had had 14 million major medical conditions such as heart attack, stroke, lung cancer, and COPD that were attributable to smoking. COPD was the leading cause of smoking-attributable morbidity, with over 7.5 million cases of COPD attributable to smoking.
15 Oct Vancomycin Still Highly Effective Against Staphylococcus Aureus Bloodstream Infections
MedicalResearch.com Interview with:
Andre Kalil, M.D., M.P.H.
Professor of Medicine
Director, Transplant ID Program
University of Nebraska Nebraska Medical Center
Omaha, NE 68198-5400
Medical Research: What are the main findings of the study?
Dr. Kalil: In recent years, physicians treating staph infections with vancomycin have seen an increase in the minimum inhibitory concentration (MIC), the lowest concentration of an antimicrobial agent that inhibits the growth of a microorganism. This condition is referred to as vancomycin “MIC creep.” It is an indicator that the bacteria might be developing a reduced susceptibility to vancomycin. There also have been reports suggesting that elevations in vancomycin MIC values may be associated with increased treatment failure and death.
To determine the effectiveness of vancomycin and other newer antibiotics used to treat Staphylococcus aureus, the UNMC team analyzed nearly 8,300 episodes of Staphylococcus aureus bloodstream infections from patients around the U.S. and in several other countries. The adjusted absolute risk of mortality among patients with Staphylococcus aureus bloodstream infections with high-vancomycin MIC was not statistically different from patients with Staphylococcus aureus bloodstream infections with low-vancomycin MIC.
15 Oct Anxiety Disorders Common in Patients With Coronary Heart Disease
MedicalResearch.com Interview with: Phil Tully PhD Early Career Research Fellow, Discipline of Medicine University of Adelaide Australia and Abteilung für Rehabilitationspsychologie und Psychotherapie Institut für Psychologie, Universität Freiburg Freiburg Germany Medical Research: What are the main findings of the study? Response: The systematic review indicated that anxiety disorders ascertained by clinical interview are highly prevalent in patients with verified coronary heart disease. Also, approximately 50% of anxiety disorders were comorbid with depression. There was however some uncertainty in prevalence estimates with high level heterogeneity observed between studies. It was also evident that studies measuring generalized anxiety disorder in outpatient samples reported an increased prognostic risk for major adverse cardiac events in the longer term, when adjusted for confounding factors, however there was limited data. There were no randomized controlled trials targeting anxiety disorders in this population.15 Oct Body Contouring Surgery Helps Bariatric Surgery Patients Keep Weight Off
MedicalResearch.com Interview with: Donna Tepper, M.D. Henry Ford Hospital Medical Research: What are the main findings of the study? Dr. Tepper: We looked at 94 patients who underwent bariatric surgery at Henry Ford from 2003 through 2013. Of those, 47 subsequently had body recontouring procedures, such as body lift, abdominoplasty (tummy tuck), arm lift, thigh lift, face lift. We recorded the patients’ body mass index prior to bariatric surgery, and then again at 6 months, 1, 2.5, 4, and 5 years. Of the patients who underwent contouring surgery, the average decrease in BMI was 18.24 at 2.5 years, compared to a statistically significant 12.45 at 2.5 years for those who did not have further surgery. This is statistically significant. This 3 point change in BMI is an 18-21 pound difference depending on patient height. Furthermore, the BMI in the body contouring group continues to be lower at 4 and 5 years from bariatric surgery compared to the bariatric surgery alone group.15 Oct Sports Improve Quality of Life For Kidney Transplant Patients
MedicalResearch.com Interview with: Elvira Cicognani PhD Department of Psychology School of Psychology and Education, University of Bologna Piazza Aldo Moro, 90 - Cesena, Italy - Viale Berti Pichat, 5 - Bologna, Italy Medical Research: What are the main findings of the study? Dr. Cicognani: The study is part of a larger project of the Italian National Transplant Center (Centro Nazionale Trapianti, CNT), started in 2008, in collaboration with Istituto Superiore di Sanità, Centro Studi Isokinetic, University of Bologna, Cimurri Impresa e Sport and Patients’ associations. The general aim is to encourage transplant patients to practice physical activity and even sport activity, in view of its benefits in enhancing recovery and quality of life after transplantation. In this study we assessed Health-related quality of life on 118 active kidney transplant patients practicing different sports at low to moderate intensity and compared them with those of 79 sedentary kidney transplant patients and with 120 active healthy control subjects. Active transplant patients reported higher levels of quality of life than sedentary patients on most dimensions of quality of life and similar to active healthy controls. In brief, practicing sports may allow patients to achieve a level of quality of life similar to the general population of active individuals.15 Oct Restaurants Continue To Reduce Calories in Menu Items
MedicalResearch.com Interview Invitation
Sara N. Bleich, Ph.D.
Associate Professor
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD 21205
Medical Research: What are the main findings of the study?
Dr. Bleich: Large chain restaurants appear to be voluntarily reducing the calories in their newly introduced menu items which contain an average of 60 fewer calories than items only on the menu in the prior year. This decline is primarily driven by new lower calorie salads and sandwiches.
15 Oct Apolipoprotein E Research May Open New Door to Alzheimer Research
MedicalResearch.comInterview with: Mary Malloy, M.D. Co-director of the Adult Lipid Clinic and the director of the Pediatric Lipid Clinic UCSF Medical Center Medical Research: What are the main findings of the study? Dr. Malloy: We studied an individual whom we found to be homozygous for a rare loss of function mutation in apolipoprotein E. Because apolipoprotein E is necessary for clearance of lipoproteins from plasma, he has very high levels of cholesterol and triglycerides in blood, and unusual and very severe xanthomas. He had no evidence of neurocognitive or retinal defects.15 Oct Relatives Key To Quality of Dying in Hospitals
MedicalResearch.com Interview with:
F.E. (Erica) Witkamp RN MSc
Senior lecturer University of Applied Sciences
Erasmus MC and Erasmus MC Cancer Institute
Rotterdam, The Netherlands.
Medical Research: What are the main findings of the study?
Response: We investigated the experiences of 249 bereaved relatives (response 51%) of patients who had died in the hospital, after a hospitalization of at least six hours. The main outcome measure was their global score of the quality of dying (QOD) on a 0-10 scale, with zero being “very poor” and ten “almost perfect”. Further, we assessed multiple experiences in the last days of life, such as symptom burden, preparedness for life closure, awareness of impending death, and care in the last days of life. We analyzed which of these factors was related to the quality of dying score, and subsequently whether the related factors represented specific domains of the dying phase.
Relatives rated the overall score of QOD on average at 6.3 (sd 2.7) with a range from 0-10.
During the last day(s) of life, 26% of the patients, and 49% of the relatives had been fully aware of imminent death. In the end 39% of the patients and 50% of the relatives had said goodbye; 77% of the patients had died in the presence of a relative.
According to relatives patients had suffered moderately to severely from on average 7 out of 22 symptoms.
In 53% relatives reported that in the last 24 hours symptoms had sufficiently been alleviated; efforts to control symptoms had been sufficient in 75%. In 64% relatives had been informed by the physician about the imminence of death, and in 70% they were satisfied about their involvement in decision making. In 55% relatives had experienced sufficient attention to individual preferences and wishes, and in 70% hospital facilities had been sufficient. Patients had been sufficiently affirmed as a person in 63%.
15 Oct Controlling Insulin Release With Photoswitchable Sulfonylurea
MedicalResearch.com: Interview with:
Dr. David Hodson PhD
Faculty of Medicine, Department of Medicine
Imperial College London
Medical Research: What is the background for this research?
Dr. Hodson: Type 2 diabetes represents a huge socioeconomic challenge. As well as causing significant morbidity due to chronically elevated glucose levels, this disease is also a drain on healthcare budgets (~$20billion in the UK per year). While current treatments are effective, they are sometimes associated with side effects, usually due to off-target actions on organs such as the heart and brain. In addition, the ability to regulate blood glucose levels more tightly may decrease complications stemming from type diabetes (e.g. nerve, kidney and retina damage). As a proof-of-principle that the spatiotemporal precision of light can be harnessed to finely guide and control drug activity, we therefore decided to produce a light-activated anti-diabetic.
15 Oct Olive Oil and Mediterranean Diet May Improve Metabolic Syndrome
MedicalResearch.com Interview with:
Jordi Salas-Salvadó Professor of Nutrition
Human Nutrition Unit Department of Biochemistry & Biotechnology
IISPV School of Medicine.
Rovira i Virgili University CIBERobn, Instituto Carlos III
Medical Research: What are the main findings of the study?
Response: In this large, multicenter, randomized clinical trial conducted in Mediterranean individuals at high cardiovascular risk, Mediterranean-diet supplemented with extra-virgin olive oil was associated to a lower increase in the prevalence of metabolic syndrome compared to the advice on a control low-fat diet. However, no beneficial effect of Mediterranean-diet on the incidence of metabolic syndrome among participants free of this condition at baseline was observed. Therefore, the lower increase in prevalence was especially due to the reversion of metabolic syndrome in those individuals with metabolic syndrome at baseline.
15 Oct Using Coronary Fractional Flow Reserve To Predict Clinical Outcomes
MedicalResearch.com Interview with
Nils P. Johnson, M.D., M.S.
Assistant Professor - Cardiovascular Medicine
Department of Internal Medicine
University of Texas Health Science Center
Houston Texas
Medical Research: What are the main findings of the study?
Dr. Johnson: Our study had 3 main findings.
- First, the numeric fractional flow reserve (FFR) value related continuously to risk, such that clinical events increased as FFR decreased and revascularization showed larger net benefit for lower baseline FFR values.
- Second, fractional flow reserve measured immediately after stenting also showed an inverse relationship with prognosis, likely due to its relationship with diffuse disease.
- Third, an fractional flow reserve-assisted strategy led to revascularization roughly half as often as an anatomy-based strategy, but with 20% fewer adverse events and 10% better angina relief.
15 Oct Sudden Cardiac Death Risk Increased By Proximity To Major Highway
MedicalResearch.com Interview with:
Jaime Hart, ScD
Instructor in Medicine
Channing Division of Network Medicine
Medical Research: What are the main findings of the study?
Response: The main findings are, that among 107,130 women in the Nurses' Health Study, even after adjusting for a number of traditional cardiovascular risk factors, those women living within 50 meters of a major roadway had a 38% increased risk of sudden cardiac death and 24% increased risk of fatal coronary heart disease, compared to women living 500 meters or more away.
13 Oct Patients with Atrial Fibrillation Recurrence More Likely To Have Kidney Function Decline
MedicalResearch.com Interview with:
Dr Jelena Kornej
Department of Electrophysiology
Heart Center Leipzig Leipzig Germany;
Medical Research: What are the main findings of the study?
Dr. Komej: Both atrial fibrillation (AF) and renal impairment are known to coexist and associated with increased morbidity and mortality. However, there is only limited data on changes of renal function after AF catheter ablation and predictors thereof. This is the largest study analyzing the effects of atrial fibrillation catheter ablation on renal function and changes thereof in a contemporary population during mid-term follow-up. We found that lower baseline eGFR was associated with higher CHADS2 and CHA2DS2-VASc scores and that both scores were independently associated with eGFR changes after atrial fibrillation catheter ablation as were atrial fibrillation recurrences.
13 Oct BPA Exposure During Pregnancy Linked With Childhood Wheezing
MedicalResearch.com Interview with:
Adam Spanier, MD, PhD, MPH, FAAP
Associate Professor of Pediatrics
Division Head, General Pediatrics & Developmental and Behavioral Pediatrics
Medical Director, Pediatrics at Midtown Department of Pediatrics
University of Maryland Midtown Campus Baltimore, MD 21201
Medical Research: What are the main findings of the study?
Dr. Spanier: Bisphenol A (BPA) is a chemical that is present in many consumer products (lining of canned foods, some plastics, some receipt paper, etc).
We found that higher maternal Bisphenol A levels during pregnancy were associated with increased odds of persistent wheezing in children and a decrease in lung function at age four. Child BPA levels were not associated with these poor lung health outcomes.
13 Oct Women May Have More Cardiac Ischemia Than Men In Response To Mental Stress
MedicalResearch.com Interview with:
Zainab Samad, M.D., M.H.S.
Assistant Professor of Medicine
Duke University Medical Center
Durham, North Carolina
Medical Research: What are the main findings of the study?
Dr. Samad: This was a sub study of REMIT, an NHLBI funded study. Our research team headed by Dr. Wei Jiang conducted the REMIT study between 2006-2011 at the Duke Heart Center. We found that women and men differ significantly in their physiological and psychological responses to mental stress. We explored sex differences across various domains felt to have implications towards cardiovascular disease pathophysiology and prognosis. We found that women had greater negative emotion, less positive emotion, while men had greater blood pressure increases in response to mental stress. On the contrary, women showed greater platelet reactivity compared to men in response to mental stress. A greater frequency of women had cardiac ischemia in response to mental stress compared to men.
13 Oct Abnormal Lipid Levels Linked To Greater Risk of Prostate Cancer Recurrence
MedicalResearch.com Interview with:
Emma H. Allott PhD
Division of Urology, Department of Surgery, Duke University School of Medicine
Cancer Prevention, Detection, and Control Program, Duke Cancer Institute Division of Urology
Veterans Affairs Medical Center Durham Durham, North Carolina.
Medical Research: What are the main findings of the study?
Dr. Allott: Relative to normal triglyceride levels, high triglycerides (≥150 mg/dl) were associated with 35% increased risk of prostate cancer recurrence. In addition, we found that each 10 mg/dl increase in total serum cholesterol above the abnormal cut-off value of 200 mg/dl was associated with a 9% increased risk of prostate cancer recurrence, while each 10 mg/dl increase in HDL (high density lipoprotein; “good” cholesterol) below the abnormal cut-off value of 40 mg/dl was associated with a 39% increased risk of prostate cancer recurrence. These findings suggest that normalization, or even partial normalization, of serum lipid levels among men with dyslipidemia may reduce the risk of prostate cancer recurrence.
13 Oct Resistant C. Diff Infections Treatable With Pill Form of Fecal Bacterial Transplant
MedicalResearch.com Interview with:
Dr. Ilan Youngster, MD, MMSc
Division of Infectious Diseases, Massachusetts General Hospital,
Harvard Medical School,
Division of Infectious Diseases, Boston Children’s Hospital
Boston, Massachusetts
Medical Research: What are the main findings of the study?
Dr. Youngster: The main finding is that oral administration seems to be as safe and effective as more traditional routes of delivery like colonoscopy or nasogastric tube. This is important as it allows Fecal microbiota transplantation (FMT) to be performed without the need of invasive procedures, making it safer, cheaper and more accessible to patients.