Author Interviews, Mayo Clinic, Surgical Research / 11.08.2014

Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Minn.MedicalResearch.com Interview with: Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Minn.   Medical Research: What are the main findings of the study?   Dr. Bingener-Casey: “About half of patients seeking emergency care for gallbladder problems were immediately admitted and underwent urgent cholecystectomy, the other half went home. The half that went home was younger and had lower WBC counts, lower neutrophils and less people with elevated temperature than the patients immediately admitted. Of the half that went home, 31% returned at least once to the ED within 30 days and 20% were admitted to undergo urgent cholecystectomy after the return visit, 55% percent of those within 7 days of the initial ED visit. Patients who failed the elective treatment plan had similar WBC counts but were more likely to have an ASA >3, slightly higher creatinine and higher average maximum VAS pain score. Patients who were less than 40 years old or older than 60 years were more likely to fail the elective pathway.” (more…)
JAMA, Ophthalmology / 11.08.2014

Helen A. Mintz-Hittner, M.D., F.A.C.S. Alfred W. Lasher, III, Professor of Ophthalmology Department of Ophthalmology and Visual Science The University of Texas Health Science Center at Houston-Medical School Cizik Eye ClinicMedicalResearch.com Interview with: Helen A. Mintz-Hittner, M.D., F.A.C.S. Alfred W. Lasher, III, Professor of Ophthalmology Department of Ophthalmology and Visual Science The University of Texas Health Science Center at Houston-Medical School Cizik Eye Clinic Medical Research: What are the main findings of the study? Dr. Mintz-Hittner:
  • For retinopathy of prematurity (ROP), at age 2 ½ years, intravitreal bevacizumab (IVB) injections cause less myopia (nearsightedness) in diopters (D) compared to conventional laser therapy (CLT):f
  • or Zone I: -1.51 D versus -8.44 D (7 diopters difference: p = 0.001. for Posterior Zone II: -0.58 D versus -5.83 D (5 diopters difference: p = 0.001.
(more…)
Author Interviews, Stem Cells, Stroke / 11.08.2014

MedicalResearch.com Interview with: Dr Soma Banerjee M.D. Department of Stroke Medicine Imperial College Healthcare National Health Services Trust St. Mary’s Hospital Campus, Praed Street, London Medical Research: What are the main findings of the study? Dr. Banerjee: This stem cell trial is the first of its kind in humans to show that selected bone marrow stem cells (CD34+ cells) from the patients' own bone marrow, can be administered to patients with severe strokes, within an early timescale after their stroke. This pilot study of 5 patients showed that it was both safe and feasible to administer these cells to patients within a week of the event. This was primarily a safety study, but clinical measures of recovery were also assessed, and these showed improvements in disability scores and scores of neurological impairment, in all 5 patients. (more…)
Alzheimer's - Dementia, Author Interviews, Emergency Care / 11.08.2014

Dr. Caroline E Stephens PhD Department of Community Health Systems University of California, San FranciscoMedicalResearch.com Interview with: Dr. Caroline E Stephens PhD Department of Community Health Systems University of California, San Francisco Medical Research: What are the main findings of the study? Dr. Stephens: In our national random sample of nursing home residents, we found that mild cognitive impairment (CI) predicted higher rates of ED visits compared to no CI, but interestingly, ED visit rates decreased as severity of cognitive impairment increased.  However, after nursing home residents were evaluated in the ED, severity of CI was not significantly associated with higher odds of hospitalization. Another important finding was that the proportion of nursing home residents using feeding tubes more than tripled in advanced or end-stage dementia, from 9.9% to 33.8%.  Moreover, tube-fed nursing home residents had 73% higher rates of total ED visits, but once evaluated in the ED, they were no more likely to be hospitalized than those without feeding tubes.  This finding is particularly striking given the numerous existing studies that have questioned the utility and appropriateness of using feeding tubes in people with advanced dementia. (more…)
Author Interviews, Breast Cancer / 10.08.2014

Dr. Judith Malmgren PhD Affiliate Assistant Professor, Epidemiology University of Washington School of Public Health Seattle, WA 98177MedicalResearch.com Interview with: Dr. Judith Malmgren PhD Affiliate Assistant Professor, Epidemiology University of Washington School of Public Health Seattle, WA 98177 Medical Research: What are the main findings of the study? Dr. Malmgren: We found a significant shift to lower stage breast cancer at diagnosis with an observed increase in mammography detected breast cancer over time and a significant decrease in later stage cancers found by the patient or her doctor. Mammography detected breast cancers were more often treated with lumpectomy and radiation and less likely to require mastectomy or adjuvant chemotherapy. We also observed better 5 year invasive breast cancer specific survival among the mammography detected patients as opposed to the patient or physician detected breast cancer cases. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity / 10.08.2014

MedicalResearch.com Interview with: Sahil Khera, MD and Dhaval Kolte, MD, PhD Department of Medicine, Division of Cardiology New York Medical College, NY Medical Research: What are the main findings of the study? Answer: We used the publicly available Nationwide Inpatient Sample (NIS) databases for our study. We analyzed data on 6.5 million patients with heart attack (all types) from 2002 to 2011 in United States. Out of these 3.98 million were admitted with a diagnosis of non-ST elevation myocardial infarction (NSTEMI). Our objective was to describe how the care for patients with NSTEMI has changed over the past 10 years and whether this has resulted in better patient outcomes. We looked at the proportion of patients with NSTEMI who underwent cardiac catheterization each year. We also studied how many patients died in the hospital, how long was the hospital stay, and what was the total cost of hospitalization for this condition. Lastly, we determined if the changes in treatment and outcomes over the years were similar for different age- groups, men and women, and for different racial/ethnic groups. In this analysis, we looked at cardiac catheterization trends after NSTEMI for both within 24 hours and within 48 hours. This is the first study of its kind to analyze two different time frames of early catheterization simultaneously. Although there was an increase in the proportion of patients with NSTEMI with increase in utilization of early cardiac catheterization and decrease in in-hospital death and length of stay, age-, sex-, and race/ethnicity-specific differences in the management and outcomes of NSTEMI were observed, and further studies are needed to develop strategies to ensure more equitable care for patients with this type of heart attack. (more…)
Author Interviews, Rheumatology, Tobacco Research / 10.08.2014

Dr. Bente Glintborg: Copenhagen Centre for Arthritis Research Centre for Rheumatology and Spine Diseases Copenhagen University Hospital Glostrup Copenhagen, DenmarkMedicalResearch.com: Interview Invitation Dr. Bente Glintborg: Copenhagen Centre for Arthritis Research Centre for Rheumatology and Spine Diseases Copenhagen University Hospital Glostrup Copenhagen, Denmark Medical Research: What are the main findings of the study? Dr. Glintborg: Current smoking had a negative impact among patients with psoriatic arthritis treated with TNFi. This was especially observed among male patients and among patients treated with infliximab and etanercept. Current smokers had a shorter treatment duration (=poorer treatment adherence rate) compared to non-smokers. And current smokers had poorer treatment response (measured as ACR20, ACR50 and ACR70 responses and EULAR good response) compared to non smokers. Especially among male smokers the EULAR good response and ACR20 response rates were nearly half of the rates among male non-smokers. The response rates among women did not seem to be affcted by smoking status. Current smokers had poorer self reported outcome measures (HAQ and VAS global and VAS fatigue) when they started treatment with TNFi. (more…)
Author Interviews, Erasmus, Lancet, Prostate Cancer / 10.08.2014

Professor Fritz H Schröder Department of Urology, Erasmus University Medical Center Rotterdam, NetherlandsMedicalResearch.com Interview with: Professor Fritz H Schröder Department of Urology, Erasmus University Medical Center Rotterdam, Netherlands Medical Research: What are the main findings of the study? Professor Schröder: I consider as the main finding that we could report a continuing effect of PSA driven screening on prostate cancer mortality for men aged 55 – 69 years in the screen arm of our study after 13 years of follow-up. The absolute reduction in the risk of death from prostate cancer amounts to 1.28 per 1000 men randomized to the screening arm. This translated into numbers to be invited to screening and numbers needed to be diagnosed to save one prostate cancer death of 781 and 27. These figures show an increasing effect with increasing time of follow-up. The relative risk reduction related to the control arm has remained unchanged with respect to the 11 year follow-up period. For men who actually participated and were screened the relative risk reduction amounted to 27%, the figure most applicable to men who consider to be tested. (more…)
Author Interviews, Hand Washing, Infections / 09.08.2014

Dr. Gianni D'Egidio HBSc, MD, MEng Academic Division of Internal Medicine Ottawa Hospital, CanadaMedicalResearch.com Interview with: Dr. Gianni D'Egidio HBSc, MD, MEng Academic Division of Internal Medicine Ottawa Hospital, Canada Medical Research: What are the main findings of the study? Dr. D'Egidio: Baseline hand hygiene compliance at our main entrance in our study was 12.4%.  We believe one of the main reasons for such an appalling low compliance was that individuals were distracted.  Visitors entering are often preoccupied with acquiring information to help them navigate a large and confusing environment given the multitude of signs, lights, announcements and other people.  Also, the majority of individuals entering have objects occupying their hands; keys, hand-held devices, coffee mugs, and during cold weather, gloves.  All this together contributes to poor compliance at our front entrance. We hypothesized that a conspicuous flashing red light at 3 Hz (3 flashed per second) attached to alcohol hand dispensers located at our front entrance would attract an individual’s attention and hopefully increase compliance.  We measured hand hygiene compliance for 1-week periods from 07:30-08:30 before and after the implementation of our flashing lights.  We found that compliance increased by more than double to 25.3% (p<0.0001). (more…)
Author Interviews, General Medicine, Mental Health Research, Nutrition / 09.08.2014

James T. Becker, Ph.D. Professor of Psychiatry, Psychology, and NeurologyMedicalResearch.com Interview with: James T. Becker, Ph.D. Professor of Psychiatry, Psychology, and Neurology University of Pittsburgh Medical Research: What are the main findings of the study? Dr. Becker: We found that people who eat baked or broiled (but not fried) fish at least once every week had significantly larger brain volumes in areas critical for memory and cognition, namely, hippocampus, precuneus, posterior cingulate cortex, and orbital frontal cortex. (more…)
AHA Journals, Author Interviews, Cognitive Issues, Stroke / 09.08.2014

Kumar Bharat Rajan, PhD Assistant Professor Department of Internal Medicine Section of Population Sciences Chicago IL 60612MedicalResearch.com Interview with: Kumar Bharat Rajan, PhD Assistant Professor Department of Internal Medicine Section of Population Sciences Chicago IL 60612 Medical Research: What are the main findings of the paper? Dr. Rajan: Lower levels of cognitive functioning was associated with incident stroke and the change in cognitive functioning was increased after incident stroke. Cognitive functioning was an independent marker of mortality even after accounting for incident stroke. (more…)
Author Interviews, BMJ, OBGYNE / 08.08.2014

MedicalResearch.com Interview with: Steven Ball Telethon Kids Institute University of Western Australia West Perth, WA 6872, Australia Medical Research: What are the main findings of the study? Answer: Our study suggests that the amount of time between pregnancies has less of an effect on birth outcomes than previously thought. Relative to pregnancies that started 18-23 months after a previous birth, pregnancies that followed shorter spacing had very little increased risk of preterm birth, low birth weight or small-for-gestational-age.  Longer pregnancy spacing showed increased risk of low birth weight and small-for-gestational-age, but not of preterm birth. (more…)
Author Interviews, Cancer Research, CMAJ / 08.08.2014

Tetyana Kendzerska MD, PhD Postdoctoral Fellow Institute for Clinical Evaluative Science, Sunnybrook Health Sciences Center, Toronto, ONMedicalResearch.com Interview with: Dr. Tetyana Kendzerska Institute for Clinical Evaluative Science Women's College Research Institute Women's College Hospital Department of Medicine University of Toronto Medical Research: What are the main findings of the study? Dr. Kendzerska: In a large cohort with varying degrees of obstructive sleep apnea (OSA), severity of obstructive sleep apnea was not found to be independently associated with either prevalent or incident cancer, except in one subgroup analysis in smoking-related cancer. (more…)
AHA Journals, Author Interviews, Biomarkers, Heart Disease / 08.08.2014

MedicalResearch.com Interview with: Rakesh K. Mishra, MD San Francisco Veterans Affairs Medical Center San Francisco, CA 94121. Medical Research: What are the main findings of the study? Dr. Mishra: Increased levels of both BNP and NT-proBNP are associated with elevated risk of adverse cardiovascular events in patients with stable coronary artery disease. However, when added to existing clinical models of risk, NT-proBNP is superior to BNP for risk reclassification. (more…)
Author Interviews, BMJ, Nutrition / 08.08.2014

Brie Turner-McGrievy, Ph.D., M.S., R.D. Assistant Professor University of South Carolina Arnold School of Public Health Department of Health Promotion, Education, and Behavior Discovery Columbia, SC 29208MedicalResearch.com Interview with: Brie Turner-McGrievy, Ph.D., M.S., R.D. Assistant Professor, University of South Carolina Arnold School of Public Health Department of Health Promotion, Education, and Behavior Discovery Columbia, SC 29208  Medical Research: What are the main findings of the study? Dr. Turner-McGrievy: This study assessed how closely crowdsourced ratings of foods and beverages contained in 450 pictures from the Eatery mobile app as rated by peer users using a simple “healthiness” scale were related to the ratings of the same pictures by trained observers. Our trained observers used a rating scale based on the U.S. Dietary Guidelines to assess the healthiness of the foods and beverages in each picture. Crowdsourcing uses the input of several users to provide feedback and information. We found that all three trained raters’ scores was highly correlated with the peer healthiness score for all the photos. In addition, we found that peer ratings were in the expected direction for both foods/beverages the Dietary Guidelines say to increase and ones to limit. Photos with fruit, vegetables, whole grains, and legumes, nuts, and seeds were all associated with higher peer healthiness scores and processed, food from fast food restaurants, refined grains, red meat, cheese, savory snacks, sweets/desserts, and sugar sweetened beverages were associated with lower peer healthiness scores. (more…)
General Medicine / 07.08.2014

Lara B. McKenzie, PhD MA Center for Injury Research and Policy The Research Institute at Nationwide Children’s Hospital Columbus, OH 43205MedicalResearch.com Interview with: Lara B. McKenzie, PhD MA Center for Injury Research and Policy The Research Institute at Nationwide Children’s Hospital Columbus, OH 43205 Medical Research: What are the main findings of the study?  Dr. McKenzie: Our main findings were that lacrosse injury rates and patterns are different by sex and by type of athletic activity. Boys’ lacrosse allows for some person-to-person contact, while girls’ lacrosse largely outlaws it. Boys had an overall injury rate of 2.26 per 1000 athletic exposures, and girls had an injury rate of 1.54 per 1000 athletic exposures. The overall injury rate was about 3 times higher in competition than in practice. We also found that sprains and strains were the most common injury diagnosis for boys and girls (boys: 35.6% of injuries; girls: 43.9%), but that concussions were a significant injury diagnosis (boys: 21.9% of injuries; girls: 22.7%). (more…)
Author Interviews, Infections, mBio, NEJM / 07.08.2014

Claudio Soto, PhD Professor of Neurology Director Mitchell Center for Alzheimer's disease and related Brain Disorders University of Texas Medical School at HoustonMedicalResearch.com Interview with: Claudio Soto, PhD Professor of Neurology Director Mitchell Center for Alzheimer's disease and related Brain Disorders University of Texas Medical School at Houston Medical Research: What are the main findings of the study? Dr. Soto: In this study we describe for the first time the highly sensitive detection of prions in human urine, specifically in samples from patients affected by the variant form of Creutzfeldt-Jakob disease (vCJD), which is the disease produced by infection with prions associated with bovine spongiform encephalopathy, also known as mad cow disease. For detection we used the protein misfolding cyclic amplification (PMCA) technique which amplifies the amount of abnormal prion protein in a cyclical manner conceptually analogous to the polymerize chain reaction. We detected prions in 13 of the 14 vCJD cases analyzed, and the only negative was a sample coming from a patient under treatment with a experimental drug injected directly into the brain. No false positive were observed in the more than 200 cases analyzed.  The concentration of abnormal prion protein in urine was estimated at 1x10^-16 g/ml, or 3x10^-21 moles/ml, which extrapolates to ~40-100 particles per ml of urine. (more…)
Diabetes, Diabetologia, Exercise - Fitness / 07.08.2014

Kristian KarstoftMD The Centre of Inflammation and Metabolism and The Centre for Physical Activity ResearchDepartment of Infectious Diseases and CMRC, Rigshospitalet Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkMedicalResearch.com Interview with: Kristian Karstoft MD The Centre of Inflammation and Metabolism and The Centre for Physical Activity ResearchDepartment of Infectious Diseases and CMRC, Rigshospitalet Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark Medical Research: What are the main findings of the study? Dr. Karstoft: Four months of Interval-walking training (IWT; five sessions/week, one hour/session) in individuals with type 2 diabetes mellitus maintained insulin secretion, improved insulin sensitivity index and disposition index in opposition to energy-expenditure and time-duration matched continuous walking training (CWT). (more…)
Author Interviews, Breast Cancer, Genetic Research, NEJM / 07.08.2014

Dr Marc Tischkowitz MD PhD University Lecturer (Associate Professor) and Honorary Consultant Physician in Medical Genetics Department of Medical Genetics, University of CambridgeMedicalResearch.com Interview with: Dr Marc Tischkowitz MD PhD University Lecturer (Associate Professor) and Honorary Consultant  Physician in Medical Genetics Department of Medical Genetics, University of Cambridge Medical Research: What are the main findings of the study? Dr. Tischkowitz: The PALB2 gene was first identified in 2006 and linked to breast cancer in 2007 but until now we have not had good breast cancer risk estimates for women who have inherited PALB2 mutations. This study was started in 2009 by an group of research institutions (The PALB2 Interest Group) in Canada, US, Europe (UK, Belgium, Greece, Italy, Finland) and Australia. We studied 362 individuals with PALB2 mutations from 154 families. We found that awomen with a PALB2 mutation will on average have a 35% risk of developing breast cancer by the age of 70, rising to 58% if there is a strong family history. Our study will help clinicians to better advise and manage such women. There are several new aspects.
  • It is by far the largest study to date and provides the most accurate risk estimates for PALB2 mutation carriers.
  • It shows that the breast cancer risk is modified by the family history. (more…)
Author Interviews, JAMA, Surgical Research / 06.08.2014

MedicalResearch.com Interview Cristina B. Geltzeiler, MD Knight Cancer Institute Oregon Health & Science University Portland, OR 97239-3098 Medical Research: What are the main findings of the study? Dr. Geltzeiler: The main findings of the study are that implementing an Enhanced Recovery After Surgery (ERAS) program at a community hospital can be successfully implemented and can allow patients to recover quicker from their surgery with ongoing safety. (more…)
Addiction, Author Interviews, JAMA / 06.08.2014

Dr. Richard Saitz MD MPH Department of Community Health Sciences Boston University School of Public Health Boston, Massachusetts MedicalResearch.com Interview with: Dr. Richard Saitz MD MPH Department of Community Health Sciences Boston University School of Public Health Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Saitz: We found that brief counseling interventions had no efficacy for reducing the frequency of illicit drug use or drug use consequences among primary care patients identified by screening as using drugs. (more…)
Author Interviews, Exercise - Fitness / 06.08.2014

James Fisher BSc (Hons) MSc PGCLT(HE) Senior Lecturer Sports Conditioning and Fitness IFBB Certified Weight Training Prescription Specialist Centre for Health, Exercise and Sport Science Faculty of Business, Sport and Enterprise Southampton Solent University, SouthamptonMedicalResearch.com Interview with: James Fisher  BSc (Hons)  MSc  PGCLT(HE) Senior Lecturer Sports Conditioning and Fitness IFBB Certified Weight Training Prescription Specialist Centre for Health, Exercise and Sport Science Faculty of Business, Sport and Enterprise Southampton Solent University, Southampton Medical Research: What are the main findings of the study? Answer: The study reports that pre-conceived ideas about exercise order, and rest intervals are not substantiated by evidence, and that advanced training routines such as pre-exhaustion appear to induce no greater strength adaptations than simpler training methods. Ultimately, that a single set of each exercise performed at a repetition duration which maintains muscular tension is all that is necessary to induce significant increases in strength in even trained persons. (more…)
Author Interviews, Cancer Research, Herpes Viruses, Vaccine Studies / 06.08.2014

Sara Tartof, PhD, MPH Post-doctoral research fellow Kaiser Permanente Southern California Department of Research & Evaluation.MedicalResearch.com Interview with: Sara Tartof, PhD, MPH Post-doctoral research fellow Kaiser Permanente Southern California Department of Research & Evaluation. Medical Research: What are the main findings of the study? Dr. Tartof: Our study found that the herpes zoster vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy. In particular, we found that those patients who were previously vaccinated with the vaccine were 42 percent less likely to develop shingles following chemotherapy treatment. We also found that none of our vaccinated patients underwent hospitalization for shingles, while six unvaccinated patients were hospitalized with the disease. (more…)
Author Interviews, General Medicine, Heart Disease, JAMA / 06.08.2014

Maurizio Gasparini, MDMedicalResearch Interview with: Maurizio Gasparini MD Humanitas Research Hospital Rozzano, Italy Medical Research: What are the main findings of the study? Dr. Gasparini: We found that a strategic programming of implantable cardioverter defibrillators which allows the non-sustained arrhythmias to self-terminate is associated with reductions in hospitalizations, length of hospital stay and cost per patient-year and an increase in the time to first hospitalization. These results were mainly driven by reduction in cardiovascular-related events. (more…)
Author Interviews, Hepatitis - Liver Disease / 06.08.2014

MedicalJagpreet Chhatwal, Ph.D. Assistant Professor Department of Health Services Research Houston, TX 77098Research.com Interview with Jagpreet Chhatwal, Ph.D. Assistant Professor Department of Health Services Research Houston, TX 77098 Medical Research: What are the main findings of the study? Dr. Chhatwal: The recent updates in hepatitis C virus (HCV) screening policy and ongoing therapeutic advances can make hepatitis C a rare disease in the US by 2036. However, more aggressive screening strategies are needed to further reduce the burden of disease. For example, 1-time universal screening further identify 487,000 chronic hepatitis C virus cases in the next 10 years, and can make hepatitis C a rare disease in the next 12 years. (more…)
Allergies, Author Interviews, Dermatology, JAMA / 06.08.2014

upcoming JAMA publication: Shuen-Iu Hung, PhD, for the Taiwan SCAR consortium Associate Professor, Department of Pharmacology, National Yang-Ming University, Taipei, 112 TaiwanMedicalResearch.com Interview with: Shuen-Iu Hung, PhD, for the Taiwan SCAR consortium Associate Professor, Department of Pharmacology, National Yang-Ming University, Taipei, 112 Taiwan   Medical Research: What are the main findings of the study? Reply: Phenytoin, a widely prescribed antiepileptic drug, can cause severe cutaneous adverse reactions (SCAR) (e.g., Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) ), which carry high mortality and morbidity. The genomic basis of phenytoin-induced SCAR has not been known. This study identifies CYP2C variants, including CYP2C9*3 known to reduce drug clearance, as the key genetic factors associated with phenytoin-related severe cutaneous adverse reactions. These findings have potential to improve the safety profile of phenytoin in clinical practice and offer the possibility of prospective testing for preventing phenytoin-related SCAR. (more…)
Author Interviews, Health Care Systems, Orthopedics / 05.08.2014

M. Susan Ridgely, JD Senior Policy Analyst RAND Corporation Santa Monica, CaliforniaMedicalResearch.com: Interview with: M. Susan Ridgely, JD Senior Policy Analyst RAND Corporation Santa Monica, California   Medical Research: What are the main findings of the study? Answer: We evaluated a three-year effort, coordinated by the Integrated Healthcare Association, to determine whether bundled payment could be an effective payment model for California. The pilot focused on bundled payment for orthopedic procedures for commercially insured adults under age 65. Bundled payment is a much-touted strategy that pays doctors and hospitals one fee for performing a procedure or caring for an illness. The strategy is seen as one of the most-promising ways to curb health care spending. Unfortunately, the project failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden and concerns about financial risk. At the outset of the project, participants included six of the state’s largest health plans, eight hospitals and an independent practice association. Eventually, two insurers dropped out because they believed the bundled payment model in this project would not lead to a redesign of care or lower costs. Another decided that bundled payment was incompatible with its primary type of business (health maintenance organization). Just two hospitals eventually signed contracts with the three remaining health plans to use bundled payments. Hospitals that dropped out cited concerns about the time and effort involved. The project was hurt by a lack of consensus about what types of cases to include and which services belonged in the bundle. In the end, most stakeholders agreed that the bundle definitions were probably too narrow to capture enough procedures to make bundled payment viable. (more…)
Blood Pressure - Hypertension, JACC, JAMA, Kidney Disease / 05.08.2014

Dr. John J. Sim Division of Nephrology and Hypertension Kaiser Permanente Los Angeles Medical Center, Los Angeles,MedicalResearch.com Interview with: Dr. John J. Sim Division of Nephrology and Hypertension Kaiser Permanente Los Angeles Medical Center, Los Angeles, Medical Research: What are the main findings of the study? Dr. Sim: Among a large diverse population of treated hypertensive people, those who achieved systolic blood pressures (SBP) in the ranges of 130-139mm Hg had the lowest risk for death and end stage renal disease (kidney failure).  Not surprisingly, those with SBP above 139 had incrementally greater risk, but somewhat surprising was that those with SBP under 130 also had a greater risk for death and kidney failure. (more…)
Author Interviews, Dermatology, General Medicine, Surgical Research / 05.08.2014

Henry M. Spinelli, MD, PC Plastic & Reconstructive Surgery 875 Fifth Avenue New York, NY 10065MedicalResearch.com Interview with: Henry M. Spinelli, MD, PC Plastic & Reconstructive Surgery 875 Fifth Avenue New York, NY 10065 Medical Research: What are the main findings of the study? Dr. Spinelli: Briefly, we polled approximately 26,000 plastic surgeons by way of membership in the International Society of Aesthetic Plastic Surgeons (ISAPS), American Society for Aesthetic Plastic Surgery (ASAPS) and American Society of Plastic Surgeons (ASPS) and collated this data and published it in Aesthetic Plastic Surgery (the Blue Journal), the official journal of ISAPS. This preliminary study was initiated given the current and past healthcare and cosmetic medical/surgical care climate both in the United States and worldwide. As a background, when it comes to injectables (botox and fillers) there is not a united consensus on a state by state basis in the USA and from country to country worldwide. Additionally, the regulations and laws governing the administration of botox and injectables is in a constant flux. For instance, the UK allowed beauticians in the past to administer these substances however they are now banned from legal administration of these products. Alabama, only allows physicians (dermatologists and plastic surgeons) to purchase and administer botox and injectables whereas the medical board of California states that physicians can perform the procedure or oversee licensed registered nurses, licensed vocational nurses, or physicians assistants. Similarly, dentists in some states are permitted to administer these agents. It would be a bad idea for any physician working with botox to take Advanced Botox Training to reduce the possibility of medical misdemeanors. At the present time few studies have directly assessed the capability of various providers to administer cosmetic injections. When people schedule a consultation for plastic surgery, they are often looking for things like a younger face or a nicer body. The answer to the previous question will become more important as the demand for these procedures continues to grow and an increasing number of practitioners and different Plastic Surgeon from a variety of backgrounds enter the field to meet demand. This study aimed to help define the role of various practitioners in an increasingly more competitive environment for injectables and to explore the relationship between patient and injectable provider in order to improve patient satisfaction and outcomes. When asked to rank patients’ perceptions of various providers according to their expertise in administering Botox and dermal fillers, responders ranked plastic surgeons and dermatologists as most capable (96%) then nurses in plastic surgery and dermatology (3%). Gynecologists (<1%), dentists (<1%) and nurses in other fields (<1%) all received nearly equivalent numbers of “most capable” rankings. When asked to rank patients’ perception of various providers according to their inability to administer Botox and dermal fillers, nurses in other fields were most frequently ranks as least capable (63%) followed by dentists (26%), gynecologists (12%), plastic surgeons and dermatologists (2%) and nurses in plastic surgery and dermatology (1%). (more…)