New Study Details the Risk of Blockages, Bleeding and Death Among Patients Who Receive Stents: Five Things to Know

Researchers wanted to better understand the long-term risk of blockages, bleeding events and death among patients who received a cardiac stent. Here are five things to know about the new study recently published in JAMA Cardiology:

  1. A stent is a small, wire mesh tube (pictured below) that can strengthen a weak artery or open a narrow or blocked artery. Patients who have received a cardiac stent are at greater risk for blockages in blood flow to the heart or brain (called ischemic events) as a result of their heart disease or from clotting inside the stent. The use of aspirin combined with other similar drugs (called dual antiplatelet therapy) to prevent these incidents in the first year after receiving a stent has become standard practice. However, while dual antiplatelet therapy decreases risk of ischemic events, it also increases risk of fatal bleeding or bleeding in vital organs (called bleeding events) when continued longer than one year.Stent
  2. This new study, led by Eric Secemsky, MD, MSc, a fellow in the Massachusetts General Hospital Division of Cardiology, looked at data from over 11,000 participants who underwent dual antiplatelet therapy for one year following the placement of a stent and had no ischemic or bleeding events. The participants were then randomized to either continue with the dual therapy for 18 months, or to receive aspirin plus placebo instead.
  3. Researchers found that taking both medications for a total of 30 months decreased ischemic risk (1.6% drop in ischemic events) while also increasing bleeding risk (0.9% increase in bleeding events). Overall, having either an ischemic or bleeding event severely increased risk of death – an 18-fold risk increase after any bleeding event and a 13-fold risk increase after any ischemic event.
  4. In a previous study, Secemsky developed a risk score that can help determine whether or not dual antiplatelet therapy should continue past the one-year mark. This tool, which is utilized by the American College of Cardiology, can help clinicians decide what treatment to prescribe. You can find it on the ACC website.
  5. With the understanding that both ischemic and bleeding events are associated with high risk of mortality, future efforts will focus on individualizing treatment and identifying patients who are likely to experience more benefit than harm from dual therapy.

Eric Secemsky, MD, MSc, a fellow in the Massachusetts General Hospital Division of Cardiology, is lead author on this study. Click here to learn more.

Smartphone Device Accurately Screens for Male Infertility

Image_6_Smartphone_Men's_InfertilityResearchers at Massachusetts General Hospital and Brigham and Women’s Hospital have developed a smartphone-based semen analyzer that can be used to test for male infertility in the privacy of your own home. The device can accurately analyze most semen samples in less than five seconds.

The Challenge
Male infertility affects almost half of the 45 million couples worldwide who have trouble conceiving, but current standard methods for diagnosing male infertility can be expensive, labor-intensive and require testing in a clinical setting. Cultural and social stigma, and lack of access in resource-limited countries may prevent men from seeking an evaluation.  To overcome these barriers, researchers wanted to come up with a solution to make male infertility testing as simple and affordable as home pregnancy tests.

The Solution
The analyzer consists of a disposable device onto which a semen sample can be loaded, a miniature weight scale to gauge sperm count, and an optical accessory that can quickly analyze the sperm. The entire kit costs less than less than $5. The team also designed a user-friendly smartphone application to guide users through each step of the testing process.

The Results
To evaluate the device, the research team collected and studied 350 semen samples from the Massachusetts General Hospital Fertility Center. Using the World Health Organizations guidelines for sperm concentration and motility, the screening kit was able to detect abnormal semen samples with 98 percent accuracy. The team also evaluated how well both trained and untrained users performed the test using the smartphone-based device.

What’s Next
“The ability to bring point-of-care sperm testing to the consumer, or health facilities with limited resources, is a true game changer,” said John Petrozza, MD, a co-author of the study and director of the Mass General Fertility Center.

The device is currently in a prototyping stage. The team plans to perform additional tests before filing with the FDA for approval.

John Petrozza, MD, Director of the Massachusetts General Hospital Fertility Center is a co-author of the study. Charles Bormann, PhD, of the Division of Reproductive Endocrinology and Infertility is also an author. Learn more about the study here.

Early Warning System May Save Lives from Sepsis

Filbin-Heldt-Grand-Challenge-bannerMassachusetts General Hospital clinicians and a Massachusetts Institute of Technology biomedical engineering team are developing a computer-based early warning system to alert clinicians when a patient might have a deadly condition called sepsis. This MGH-MIT collaborative project has helped shorten by half the time it takes clinicians to start patients with sepsis on lifesaving antibiotics.

You can learn more about this collaboration here.

Research Awards and Honors: March 2017

Massachusetts General Hospital’s talented and dedicated researchers are working to push the boundaries of science and medicine every day. In this series we highlight a few individuals who have recently received awards or honors for their achievements:

 CorcoranRyan Corcoran, MD, PhD, of the Division of Hematology and Oncology, has been elected to the American Society for Clinical Investigation (ASCI), one of the greatest honors for a young physician scientist. The ASCI is an honor society of physician-scientists, those who translate findings in the laboratory to the advancement of clinical practice. Founded in 1908, the society is home to nearly 3,000 members who are in the upper ranks of academic medicine and industry.

My research focuses on developing therapies against the specific molecular changes driving gastrointestinal cancers and in identifying and overcoming the mechanisms by which tumors become resistant to therapy, in order to improve treatment outcomes.

Being inducted into ASCI is a great honor, and our team will continue to work toward its goal of leveraging science-driven clinical investigation to improve treatment options for patients with gastrointestinal cancers.

 

SinghalVibha Singhal, MD, of the Pediatric Endocrine Unit, has received the Janet McArthur Award for Excellence in Clinical Research by Women in Endocrinology. This is one of just two Young Investigator Awards awarded annually by the organization recognizing the most outstanding abstracts accepted for presentation at the Annual Meeting of the Endocrine Society.

My research involves evaluating the impact of body composition on bone health in adolescents and young adults ranging from low weight patients with anorexia to severely obese patients. I have worked with populations suffering from anorexia nervosa, female athletes who have decreased energy availability, irregular menses and osteoporosis and I’m now primarily focused on severe obesity. I aim to dissect the physiological impact of increased fat around abdominal organs (visceral), under the skin (subcutaneous) or in the bone (marrow) on bone strength and ultimately fracture risk.

I am honored to receive the Janet McArthur Award for Excellence in Clinical Research by Women in Endocrinology. It is a privilege to stand with other accomplished young endocrinologists dedicated to making a difference in human health. It is also a testament to the great mentorship and resources available at MGH.


Congratulations Drs. Corcoran and Singhal!

Proposed NIH Budget Cuts Could Devastate the Research Landscape

From scientists and physicians to senior leadership, members of research community at Massachusetts General Hospital are expressing deep concerns about President Donald Trump’s proposed budget for Fiscal 2018, which calls for a $5.6 billion cut in funding for medical research via the National Institutes of Health (NIH).

Harry W. Orf, PhD, Mass General’s senior vice president for research, recently spoke to the Boston radio news station WBUR about the impact of the proposed cut, which represents one-fifth, or 20% of the NIH’s overall operating budget.

“In a word, it would be devastating to have a cut this deep, particularly at a time when the budget has not increased for the past decade,” Orf told WBUR. “A 20 percent cut to research funding through the NIH at this point would be really devastating not just to the hospital, but to the entire research community and the nation.”

Clinicians and researchers from Mass General are also planning to speak out against the cuts by joining the March for Science on Saturday, April 22, from 2-4 pm on the Boston Common. There will be a meetup on the Bulfinch lawn prior to the event and all members of the Mass General community are welcome to join in, says organizer Regina LaRocque, MD, MPH.

LaRocque is part of Physicians for Policy Action, a group of Partners-affiliated physicians who have mobilized in response to recent developments in federal healthcare, immigration and research policy.

As the largest hospital-based research enterprise in the United States, the Mass General Research Institute would be particularly hard-hit by the proposed cuts. Of the Research Institute’s $850 million budget in 2016, almost half ($365M) comes from NIH-funded, merit-based research grants and awards.

A 20% cut in NIH funding would mean many Principal Investigators—the faculty leaders of research labs—would have to lay off staff members and derail promising research studies. Essentially a fifth of Mass General’s researchers, grant applications, and discoveries would be in jeopardy, Orf said.

At the national level, the cuts would reduce the number of research projects funded each year at a time when demand is already exceeding supply. “Right now, the NIH, on a national average, funds 17 percent of the grant applications that come in, even though more than twice that number are deemed worthy of funding,” Orf explained. “With a 20 percent cut, you’re going to be funding one out of every eight grants that come in.”

The effects of such a reduction would have reverberations throughout the medical field, Orf said. “Think about all the advances that have taken place in healthcare in the last hundred years. All of those medical advances begin with fundamental research and translational research, which are supported by the NIH.”

“When that gets hurt, then the pipeline for the fundamental discoveries that eventually lead to new products, new therapeutics and new diagnostics for patients—that pipeline is getting squeezed.”

The NIH cuts would have a particularly big impact on Massachusetts, which is home to a large cluster of academic research institutions that rely on NIH funding, including Brigham and Women’s Hospital, Harvard Medical School, Children’s Hospital, University of Massachusetts Medical School (Worcester), Beth Israel Deaconess Medical Center, the Dana Faber Cancer Institute, the Harvard School of Public Health, MIT and many more.

Patient care will also be impacted, Orf said, explaining that with growing pressure to keep healthcare costs down, there is an urgent need to develop new technologies and approaches that make medicine more affordable.

“If we stop the fundamental research that’s progressing in those areas, it’s going to make it even harder to get healthcare costs down going forward.”

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Little Known Form of Dementia Can Spark Creative Expression

As patients with frontotemporal dementia, a little-known form of dementia, lose their language capabilities, they develop a keen interest in visual arts. “It can be a source of pleasure and hope and optimism in an otherwise pretty devastating state of affairs,” says Massachusetts General Hospital researcher Dr. Bradford C. Dickerson. Dickerson is studying patients with this disease to identify possible treatments as well as better understand how the brain functions.

Read more about frontotemporal dementia and Dr. Dickerson’s work in this fascinating article from STAT.

Children’s Sleep Habits Could Improve Their Ability to Focus, Make Friends and Solve Problems Later on in Childhood: Five Things to Know

A recent study by the MassGeneral Hospital for Children found that children ages 3 to 7 who don’t get enough sleep are more likely to have problems with attention, emotional control and relationship building later on in childhood. Here are five things to know about the study…

Young boy sleeping on bed with teddy bear

  1. The recommended amount of sleep for children is 11 hours or more at ages 3 to 4 year; and 10 hours or more at ages 5 to 7 years.
  2. A recent study from MassGeneral Hospital for Children reports that children ages 3 to 7 who don’t get enough sleep are more likely to have problems with attention, emotional control and peer relationships in mid-childhood (ages 7-10). The study found significant differences in the surveys responses of parents and teachers depending on how much sleep the 7-year-old children regularly received at younger ages.
  3. Analyzed data came from Project Viva, a long-term study that looks at the health impacts of several factors during pregnancy and after birth.  Information was gathered from mothers via interviews and questionnaires conducted at varying time points between when children were ages 6 months and 7 years old. Mothers and teachers were also sent surveys evaluating factors such as emotional symptoms and problems with conduct or peer relationships, when children were around 7.
  4. Among the 1,046 children enrolled in the study, those living in homes with lower household incomes and whose mothers had lower education levels were more likely to sleep less than nine hours at ages 5 to 7. Other factors associated with insufficient sleep include more television viewing and a higher body mass index. Sleep deficiencies also tend to be more prevalent in African American children. Sleep levels during infancy often predict levels at later ages, supporting the importance of promoting a good quantity and quality of sleep from the youngest ages.
  5. “Our previous studies have examined the role of insufficient sleep on chronic health problems – including obesity– in both mothers and children,” explains Elsie Taveras, MD, MPH, chief of General Pediatrics at MassGeneral Hospital for Children, who led the study.  “The results of this new study indicate that one way in which poor sleep may lead to these chronic disease outcomes is by its effects on inhibition, impulsivity and other behaviors that may lead to excess consumption of high-calorie foods. It will be important to study the longer-term effects of poor sleep on health and development as children enter adolescence.”

You can read more about this study here. And in honor of #WorldSleepDay today, check out this great article from the American Academy of Sleep Medicine that offers tips on helping your child get a better night’s rest.