• share
• favorite_border

A special series of articles addressing the ethical and regulatory challenges to pragmatic clinical trials appears this week on the website of the journal Clinical Trials. The 12 articles were sponsored by the NIH Health Care Systems Research Collaboratory with additional support from the Patient-Centered Outcomes Research Institute, and include authors drawn from the fields of clinical research and patient advocacy, as well as clinicians, bioethicists, and regulatory experts.

• share
• favorite_border

A genetic test that helps predict whether some women’s breast cancer will recur might influence how chemotherapy is used, according to a study from Duke Medicine. The study found that low-risk patients who had the test appeared to opt for more treatment, and high-risk patients who were tested got less.

• share
• favorite_border

To help teams keep infections to a minimum and players at their best, the Duke Infection Control Outreach Network has worked with the NFL and the NFL Players Association to develop a comprehensive reference manual for infection prevention, taking into account the highly contagious dynamics within a professional football team environment.

• share
• favorite_border

Picky eating among children is a common but burdensome problem that can result in poor nutrition for kids, family conflict, and frustrated parents. Although many families see picky eating as a phase, a new study from Duke Medicine finds moderate and severe picky eating often coincides with serious childhood issues.

• share
• favorite_border

A recent HIV vaccine trial testing the HIV envelope as an immunogen was unsuccessful for protection against HIV infection. A new study has found that this vaccine selectively recruited antibodies reactive with both the HIV envelope and common intestinal microbes — a phenomenon previously reported by the same investigators to occur in the setting of acute HIV infection.

• share
• favorite_border

Sudden cardiac arrest kills an estimated 200,000 people a year in the United States, but many of those lives could be saved if ordinary bystanders simply performed CPR, a new study led by Duke Medicine shows. The early application of cardio-pulmonary resuscitation (CPR) by an average person nearby, combined with defibrillation by firefighters or police before the arrival of emergency medical services (EMS), was the one intervention that substantially increased survival from cardiac arrest, according to findings reported by Duke researchers and colleagues in the July 21 issue of the Journal of the American Medical Association.

• share
• favorite_border

Children with even mild or passing bouts of depression, anxiety and/or behavioral issues were more inclined to have serious problems that complicated their ability to lead successful lives as adults, according to research from Duke Medicine.

• share
• favorite_border

The benefits of exercise are well known, but physical fitness becomes increasingly difficult as people age or develop ailments, creating a downward spiral into poor health. Now researchers at Duke Medicine report there may be a way to improve exercise tolerance and, by extension, its positive effects.

• share
• favorite_border

Although being overweight with a high body-mass index (BMI) has long been associated with a higher risk for colorectal cancer, thinner patients might not fare as well after treatment for advanced cancer, according to a new study from Duke Medicine.

• share
• favorite_border

Experts have identified new strategies for using electronic health records (EHRs) to treat patients with chronic kidney disease. These recommendations may help clinicians and hospitals better manage individual patients with chronic conditions and identify groups of patients most likely to benefit from different treatment strategies.

• share
• favorite_border

Heart attack patients age 65 and older who have reduced heart function might still benefit from implanted defibrillators, according to a Duke Medicine study published in the Journal of the American Medical Association. But fewer than 1 in 10 eligible patients actually get a defibrillator within a year of their heart attacks, the study found.

• share
• favorite_border

Patients with atrial fibrillation who stopped taking blood thinners before they had elective surgery had no higher risk of developing blood clots and less risk of major bleeding compared to patients who were given a “bridge” therapy, according to research led by Duke Medicine.

• share
• favorite_border

Researchers at the Duke Cancer Institute and the Duke Clinical Research Institute have found that younger thyroid cancer patients with lymph node involvement are also at increased risk of dying, contrary to current beliefs and staging prognostic tools that classify young patients as having low-risk disease.

• share
• favorite_border

At a time when lipid management in the United States is undergoing transition in response to new guideline recommendations and expanding lipid-lowering therapy options, the Duke Clinical Research Institute (DCRI) today announced a new study to better understand contemporary lipid management as well as the beliefs and attitudes of patient and providers regarding cholesterol, cardiovascular risk assessment, and options for lipid treatments.

• share
• favorite_border

A clinical trial of the glucose-control drug sitagliptin among patients with type 2 diabetes and established cardiovascular disease has found it did not raise the risk of major adverse cardiovascular events.

• share
• favorite_border

How most babies are protected from acquiring HIV from their infected mothers has been a matter of scientific controversy. Now researchers at Duke Medicine provide new data identifying an antibody response that had long been discounted as inadequate to confer protection.

• share
• favorite_border

Scientists at Duke Medicine have produced a 3-D map of the human brain stem at an unprecedented level of detail using MRI technology. In a study to be published June 3 in Human Brain Mapping, the researchers unveil an ultra high-resolution brain stem model that could better guide brain surgeons treating conditions such as tremors and Parkinson’s disease with deep brain stimulation (DBS).

• share
• favorite_border

A modified poliovirus therapy that is showing promising results for patients with glioblastoma brain tumors works best at a low dosage, according to the research team at Duke’s Preston Robert Tisch Brain Tumor Center where the investigational therapy is being pioneered.

• share
• favorite_border

Duke Medicine researchers have found that bladder cells have a highly effective way to combat E. coli bacteria that cause urinary tract infections (UTIs).

• share
• favorite_border

A head-to-head comparison of two biologic therapies used to treat a subset of patients with advanced kidney cancers provides much-needed clarity on the preferred treatment for the first line of attack.

• share
• favorite_border

Smokers who are able to quit might actually be hard-wired for success, according to a study from Duke Medicine. The study, published in Neuropsychopharmacology, showed greater connectivity among certain brain regions in people who successfully quit smoking compared to those who tried and failed.

• share
• favorite_border

A 12-week dose of an investigational three-drug hepatitis C combination cured the virus in 93 percent of patients with liver cirrhosis who hadn’t previously been treated, according to a study in the May 5, 2015, issue of The Journal of the American Medical Association.

• share
• favorite_border

The Duke Clinical Research Institute is launching an ambitious new project that is intended to answer a question of considerable clinical importance, while also changing the way pragmatic clinical trials are conducted. The Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-term Effectiveness (ADAPTABLE) study will assess whether low- or standard-dose aspirin is better for preventing heart attacks and stroke in patients with coronary artery disease.

• share
• favorite_border

Frailty among older people with cardiovascular disease appears to be more predictive than age for gauging their risk of heart attack, stroke and death, according to an international study that included researchers at Duke Medicine.

• share
• favorite_border

Repeated alcohol exposure during adolescence results in long-lasting changes in the region of the brain that controls learning and memory, according to a research team at Duke Medicine that used a rodent model as a surrogate for humans.

• share
• favorite_border

Divorced women suffer heart attacks at higher rates than women who are continuously married, a new study from Duke Medicine has found. A woman who has been through two or more divorces is nearly twice as likely to have a heart attack when compared to their stably-married female peers, according to the findings.

• share
• favorite_border

Researchers found enhanced rather than suppressed immune function in animals with increased biodiversity. Publishing online in the April 8, 2015, issue of PLOS ONE, the findings add to the growing understanding of the complex environment in the digestive tract and its role in maintaining health.

• share
• favorite_border

An estimated 9 percent of adults in the U.S. have a history of impulsive, angry behavior and have access to guns, according to a study published this month in Behavioral Sciences and the Law. The study also found that an estimated 1.5 percent of adults report impulsive anger and carry firearms outside their homes.

• share
• favorite_border

One in nine patients released from the emergency department after treatment for a kidney stone will face a repeat visit, according to findings by Duke Medicine researchers.

• share
• favorite_border

One way many cancers grow resistant to treatment is by generating a web of blood vessels that are so jumbled they fail to provide adequate oxygen to the tumor. With oxygen starvation, the tumor gains a sort of cloaking device that protects it from the toxic effects of chemotherapy drugs and radiation, which are designed to seek out well-oxygenated tissue. Researchers have long tested various approaches to improving blood flow to the tumor in the hopes of restoring potency to treatments. Not much has shown promise. Until researchers investigated exercise.

• share
• favorite_border

A new type of CT scan initially costs slightly less than the traditional stress test to diagnose blocked coronary arteries in patients with chest pain, but its lower cost did not translate into medical care savings over time, according to an analysis by Duke Medicine researchers.

• share
• favorite_border

Patients with chest pain have similar rates of heart attacks and other major cardiac events within two years whether they were evaluated with a new type of CT scan or the traditional stress test, according to results presented today by Duke Medicine researchers at a meeting of the American College of Cardiology.

• share
• favorite_border

The newest guidelines for the use of cholesterol-lowering statins in people at risk of heart disease may be too generic, excluding middle-aged adults who could benefit from the drugs, and over-prescribing in older adults, according to a new study from the Duke Clinical Research Institute.

• share
• favorite_border

Despite legal and ethical mandates for disclosure, results from most clinical trials of medical products are not reported promptly on a registry specifically created to make results of human studies publicly available, according to Duke Medicine researchers.

• share
• favorite_border

An innovative approach using a tetanus booster to prime the immune system enhances the effect of a vaccine therapy for lethal brain tumors, dramatically improving patient survival, according to a study led by Duke Cancer Institute researchers.

• share
• favorite_border

Federal efforts to curb Medicare costs for unclogging blood vessels in the limbs slowed the growing use of the treatments, but also coincided with a marked increase in doctors using a more expensive approach, according to an analysis by Duke Medicine researchers.

• share
• favorite_border

Treatment for painful episodes of blood vessel obstruction in sickle cell anemia is currently limited to controlling pain, but an investigational therapy might be able to interfere with the underlying cause of these events, known as vaso-occlusion crises, researchers at Duke Medicine report.

• share
• favorite_border

Nearly all women and people over 65 in the U.S. with atrial fibrillation are advised to take blood thinners under new guidelines based on an analysis from the Duke Clinical Research Institute.

• share
• favorite_border

Using a portable, non-invasive imaging device, a team of Duke Medicine doctors have identified swelling in the back of the eyes of premature infants that correlates with poorer neurodevelopment as the babies grow.

• share
• favorite_border

• share
• favorite_border

Duke Medicine researchers have shown how gene mutations may cause common forms of cartilage tumors. In a study published in the Feb. 16, 2015, issue of the Proceedings of the National Academy of Sciences, Duke researchers and their colleagues revealed that mutations in the isocitrate dehydrogenase (IDH) gene contribute to the formation of benign tumors in cartilage that can be a precursor to malignancies.

• share
• favorite_border

• share
• favorite_border

For at least 40 years, scientists who study how the body metabolizes sugar have accepted one point: there are four enzymes that kick-start the body’s process of getting energy from food. But this biochemical foursome may not deserve all of the credit. According to research by scientists at Duke and Northwestern universities, the hexokinase team actually has a fifth player.

• share
• favorite_border

Most young adults might assume they have years before needing to worry about their cholesterol. But new findings from researchers at the Duke Clinical Research Institute suggest that even slightly high cholesterol levels in otherwise healthy adults between the ages of 35 and 55 can have long-term impacts on their heart health, with every decade of high cholesterol increasing their chances of heart disease by 39 percent.

• share
• favorite_border

The antibody response from an HIV vaccine trial in Thailand was made possible by a genetic trait carried over in humans from an ancient ancestry with monkeys and apes, according to a study led by Duke Medicine researchers.

• share
• favorite_border

A team of researchers led by Duke Cancer Institute has identified key events that prompt certain cancer cells to develop resistance to otherwise lethal therapies.

• share
• favorite_border

Doctors who treat cancer are vigilant when it comes to the physical side effects of the therapies they prescribe, but financial stress from accumulating medical bills can also weigh on patients’ health — even those who have finished their treatments and are cancer-free.

• share
• favorite_border

Women over the age of 70 who have certain early-stage breast cancers overwhelmingly receive radiation therapy despite published evidence that the treatment has limited benefit, researchers at Duke Medicine report.

• share
• favorite_border

A blocked artery causes a deadly kind of heart attack known as STEMI, and a rapid response to clear the blockage saves lives. But in more than half of cases studied recently by Duke Medicine researchers, one or both of the patient’s other arteries were also obstructed, raising questions about whether and when additional procedures might be undertaken.

• share
• favorite_border