Category: Harvard affiliates

Celiac disease is not reduced by breast feeding or delaying the introduction of gluten

October 19, 2014- Interviewed by Steven E. Greer, MD

Alessio Fasano, MD of Harvard discusses his 10-year-long study in children testing whether the delayed introduction of gluten into the diet reduced the eventual incidence of celiac disease. Dr. Fasano is most responsible for raising awareness of gluten intolerance after his 2003 NEJM and Archives of Internal Medicine papers were published.

Cutting through the hype surrounding gluten

October 19, 2014- Interviewed by Steven E. Greer, MD

Did you know that one out of three Americans think that they are “gluten intolerant”. Of those 100 Million people, only 13 Million really have a medical problem caused by gluten.

Alessio Fasano, MD, director of the Center for Celiac Research and Treatment at MassGeneral Hospital for Children, is the man who started all of the gluten hype back in 2003 with a paper in the Archives of Internal Medicine. Hoping to reduce some of the current “gluten hysteria,” he has written a book explaining what gluten is, who can and can’t eat it, and why. We interviewed him.

A proposal to make the Social History more robust and proactive

October 2, 2014 Interviewed by Steven E. Greer, MD

Joseph Rhatigan, MD of Harvard Medical School published a paper in the NEJM proposing was to enhance the current social history section of the H&P. He explains how factors currently ignored by doctors, such as income and living conditions, are important to the compliance of the patient. The new ACA law might also make it financially rewarding for doctors to pay more attention to these issues.

The bionic pancreas data

July 2, 2014- Interviewed by Steven E. Greer, MD

The New England Journal of Medicine recently published the early clinical data on the “bionic pancreas” being developed by engineers at Boston University and medical doctors at Massachusetts General hospital. We interviewed Ed Damiano, PhD, the lead biomedical engineer, and Steven Russell, MD PhD, the lead endocrinologist. In Part 1, they review the clinical data.

The research was funded by the NIH and not a medical device or drug company. The researchers selected the components based on merit. They chose the Dexcom G4 Platinum continuous glucose sensor and a Tandem Diabetes t:slim pump, and used software that ran on a standard Apple iPhone 4S.

In Part 2, the team discusses the details of the pivotal study, that could be concluded by 2016, allowing for an FDA approval by 2017. Industry partners yet to be determined would be involved. However, the final marketed product will not require any particular smartphone to be used by the patient.

 

Atul Gawande’s surgical checklist fails in real world study

March 15, 2014- By Steven E. Greer, MD

In 2009, Atul Gawande, MD, MPH and his large international team published in the New England Journal of Medicine (NEJM) an observational study that showed a significant reduction of death and “complications” after non-cardiac surgery. The World Health Organization (WHO) created the checklist used in the NEJM paper. After this non-randomized, non-controlled, observational study was published, entire nations adopted the surgical checklist system.

Now, in 2014, a population study drawing from Ontario surgical patient data, published in the NEJM, showed no significant benefit from the widespread adoption of the same WHO surgical safety checklist that Dr. Gawande popularized. This study was also observational, but it was stronger than the 2009 Gawande study in that it included the entire population within a region.

What went wrong? Read more »

Single-pill combo regimens for HIV

July 28, 2014- Interviewed by Steven E. Greer, MD

Rajesh Tim Gandhi, MD of the Massachusetts General Hospital discusses the NEJM review paper he co-wrote with his sister, Monica Gandhi, MD, discussing the current state of therapy for HIV-infected patients. He then addresses limitations of the existing drugs and how future medications can improve.

How did a small academic lab succeed where big medical device companies failed?

July 5, 2014- Interviewed by Steven E. Greer, MD

The New England Journal of Medicine recently published the early clinical data on the “bionic pancreas” being developed by engineers at Boston University and medical doctors at Massachusetts General hospital. We interviewed Ed Damiano, PhD, the lead biomedical engineer, and Steven Russell, MD PhD, the lead endocrinologist.

In Part 3, we asked them how their small lab funded only by the NIH succeeded at developing the bionic pancreas when large companies, such as Roche, Medtronic, Abbott, and JNJ all failed.

 

The Medicaid Roundtable

Part 1: Medicaid primer

Part 2: State spending on Medicaid

Part 3: Impact of Medicaid expansion to hospitals, states, and mortality

Part 4: Efforts by individual states to reform Medicaid away from fee-for-service

Part 5: Will other states adopt bundled payment plans for Medicaid and stop fee-for-service?

Part 6: What does the ACA ObamaCare law mean for Medicaid?

Part 7: Will individual state reforms of Medicaid lead to a more global reform of American healthcare?

Part 8: Impact the healthcare companies

Part 9: The outcome of the election and Medicaid/ACA law

Has the ACA law begun to reduce the uninsured, and at what cost?

July 27, 2014- Interviewed by Steven E. Greer, MD

Ben Sommers, MD PhD, from the Harvard School of Public Health has a new article in the NEJM that attempts to quantify the total number of uninsured people in the country, and map it out temporally to show whether the newly implemented Obamacare law is working as intended.

Preventing HIV infection

July 28, 2014- Interviewed by Steven E. Greer, MD

Rajesh Tim Gandhi, MD of the Massachusetts General Hospital discusses the NEJM review paper he co-wrote with his sister, Monica Gandhi, MD, discussing the current state of therapy for HIV-infected patients. He then addresses the ways to prevent HIV infection either after or before exposure.

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