Research Spotlight

Peters, W. R. and S. Ramamoorthy (2020). “Delivery of Colorectal Surgical Care in 2018: Results From the 2018 ASCRS Compensation Survey.” Dis Colon Rectum 63(7): 887-889.

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The average colon and rectal surgeon had 12.9 years of clinical colon and rectal surgery experience (ie, years since completion of colon and rectal surgery residency) and 14.5 years of general surgery experience (ie, years since completion of a general surgery residency). The majority (71% of respondents) were men. Nearly all reporting colon and rectal surgeons (90.2%) were currently board certified in colon and rectal surgery. The greatest proportion of colon and rectal physicians (45%, n = 296) were employed by an academic entity (academic health system, university/medical school, or faculty practice plan), and 21% reported that they were employed by a community hospital/health system. Only 28% of physicians indicated that they were in a private practice or independent medical group. Approximately 58% of the colon and rectal surgeons worked in practices that also employed advanced practice providers, with 90.3% of these surgeons providing some level of advanced practice provider supervision. [No abstract available; excerpt from article.].

O’Shaughnessy, J. (2020). “Treatment options for patients with HR+/HER2- advanced breast cancer during the COVID-19 pandemic: dose reduction of ribociclib does not diminish efficacy.” Breast Cancer Res Treat 182(1): 243-244.

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The COVID-19 pandemic poses unprecedented challenges to the field of oncology. I read with great interest the recent recommendations outlined by Deitz et al. for patients with breast cancer during the COVID-19 pandemic [1]. For patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer, it is recommended that use of targeted oral therapies be weighed against the risk of adverse events and that dose reductions can minimize treatment-related toxicities. This was followed by the statement “dose reduction of palbociclib does not diminish efficacy.” [no abstract available; excerpt from Comment.].

Van Nguyen, H., M. Van Hoang, A. T. M. Dao, H. L. Nguyen, T. Van Nguyen, P. T. Nguyen, L. Q. Khuong, P. M. Le and S. Gilmour (2020). “An adaptive model of health system organization and responses helped Vietnam to successfully halt the Covid-19 pandemic: What lessons can be learned from a resource-constrained country.” Int J Health Plann Manage Jun 18. [Epub ahead of print.].

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Coping with the COVID-19 pandemic has been painful and no single model for such a purpose is perfect. However, sharing experiences is the best way for countries to learn real-time lessons and adapt to this rapidly changing pandemic. This commentary shares with the international community how an adaptive model of health system organization and responses helped Vietnam to break transmission of coronavirus. We find that an effective model is adaptive to time and context, and mobilizes and engages the wider society. We identify merging of different health system units into Center for Diseases Controls as a health system organization that saved massive resources. The early establishment of a formal committee responding to the pandemic helped unify every public health strategy. The mobilization of different stakeholders and communities added resources and facilitated a synchronous implementation of response strategies, even where those strategies involved significant personal or financial sacrifice. National training on Covid-19 treatment for healthcare professionals across the entire hospital system was useful to expand the health service availability. Quickly published response guidelines helped to activate every level of the health system and involve every sector of society. A strategy of keeping high alert and preemptive action is also essential for coping with the pandemic.

Kumano, K., S. Vasu, Y. Liu, S. T. Lo, A. Mulgaonkar, J. Pennington, C. M. Darden, X. Sun, M. C. Lawrence and B. Naziruddin (2020). “Grafting Islets to a Dissected Peritoneal Pouch to Improve Transplant Survival and Function.” Transplantation Jun 11. [Epub ahead of print.].

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BACKGROUND: Although the liver is the primary site for clinical islet transplantation, it poses several restrictions, especially limited tissue volume due to portal vein pressure. We evaluated the preperitoneal space as an extrahepatic islet transplant site to deliver high tissue volumes and sustain long-term graft function. METHODS: A peritoneal pouch was formed by dissecting the parietal peritoneum from the transversalis fascia of mice. Syngeneic C57BL/6 donor islets were transplanted into the peritoneal pouch of diabetic mouse recipients. Blood glucose were monitored for islet function, and miR-375 were analyzed for islet damage. Islet graft morphology and vascularization were evaluated by immunohistochemistry. Positron emission tomography/computed tomography (F-FDG PET/CT) was used to image islet grafts. RESULTS: Transplantation of 300 syngeneic islets into the peritoneal pouch of recipients reversed hyperglycemia for >60 days. Serum miR-375 was significantly lower in the peritoneal pouch group than in the peritoneal cavity group. Peritoneal pouch islet grafts showed high neovascularization and sustained insulin and glucagon expression up to 80 days posttransplantation. A peritoneal pouch graft with high tissue volume (1000 islets) could be visualized by PET/CT imaging. Human islets transplanted into the peritoneal pouch of diabetic nude mice also reversed hyperglycemia successfully. CONCLUSIONS: Islets transplanted into a dissected peritoneal pouch show high efficiency to reverse diabetes and sustain islet graft function. The preperitoneal site has the advantages of capacity for high tissue volume, enriched revascularization and minimal inflammatory damage. It can also serve as an extrahepatic site for transplanting large volume of islets necessitated in islet autotransplantation.

Gu, C., K. Upchurch, J. Mamaril-Davis, M. Wiest, B. Lanier, M. Millard, J. Turner, H. Joo and S. Oh (2020). “Obesity influences the outcomes of anti-IgE (omalizumab) therapy of asthma.” Clin Exp Allergy Jun 5. [Epub ahead of print.].

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Asthma is a chronic lung disease characterized by airflow obstruction, bronchial hyper-reactivity and inflammation of the airways. Immunoglobulin E (IgE) plays an important role in the pathogenesis of asthma. Blocking IgE binding to its high affinity FcεR1 with anti-IgE (omalizumab, Xolair®) can provide moderate-to-severe asthma patients with certain levels of clinical benefit by reducing asthma exacerbations, symptoms, and oral corticosteroid doses, as well as improving quality of life.