Expanded Autonomic Testing Helps to Pinpoint Causes of Orthostatic Intolerance

drawing of a tilt table, used for diagnosing and treating Orthostatic IntoleranceUsing expanded, state-of-the-art capabilities in autonomic testing, Peter Novak, MD, PhD, chief of the Division of Autonomic Neurology at Brigham and Women’s Hospital, is driving better understanding of hard-to-diagnose patients with orthostatic intolerance.
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New Strategy Fights Tumor Resilience in Glioblastoma

glioblastoma, mircoRNA imagingTo address the challenge of glioblastoma (GBM) recurrence and treatment resistance, a research team from Brigham and Women’s Hospital has reported success using a novel method to co-opt the tumor cells’ molecular machinery. The result makes the tumor more vulnerable to treatment. By delivering molecules that modify gene expression in the tumor, investigators have shown a significant survival benefit in a mouse model of GBM.
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Hepatitis C-Infected Hearts and Lungs Safely Transplanted

As the number of patients in need of heart or lung transplants continues to exceed the number of donor organs that are viable and available, many patients die while waiting for a transplant. Through the DONATE HCV Trial, a team at Brigham and Women’s Hospital is expanding the donor pool by enabling transplantation from hepatitis C-infected donors.

In a recent publication in the New England Journal of Medicine, a multidisciplinary team of experts from Brigham and Women’s Hospital reported a 100 percent success rate for transplant recipients who received lungs or a heart infected with hepatitis C (HCV).

Six months after transplantation, patients remained hepatitis C free and had functioning transplanted organs. The trial showed that a four-week antiviral treatment regimen started immediately following organ transplantation prevented HCV infection in all patients and led to excellent outcomes. Given the success of the trial, enrollment continues.

The DONATE HCV Trial is the largest clinical trial to date for HCV thoracic organ transplantation. “If even half the other centers in the United States were to adopt the Brigham protocol, we would, in fact, shorten the time to transplantation by nearly half,” says Mandeep Mehra, MD, medical director of the Heart & Vascular Center at Brigham and Women’s Hospital. The team has enrolled 69 participants to date.

In the above video, hear more from the investigators pioneering this trial, including:

Enhancing the Care of Frail Older Adults With Complex Needs Through Home Visits

In this bird's eye view, a female doctor sits on a living room couch with a senior female patient. She holds a clipboard as the patient gestures and speaks. There is a doctor's bag and medical equipment on the coffee table.As a primary care physician at Brigham and Women’s Hospital, Laura N. Frain, MD, MPH, saw firsthand the challenges of caring for older adults, particularly those living with frailty, cognitive impairment/dementia and multiple geriatric syndromes within the primary care system. Now, as a geriatrician in the Brigham’s Division of Aging, she leads collaborations with primary care to develop and implement new models for co-managing outpatient geriatric patients.
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Pushing the Boundaries of Robotic-Assisted Colorectal Surgery

3D illustration of surgical robot on white backgroundIn 2017, nearly 700,000 robotic-assisted procedures were performed in the United States. Robotic surgery is fast becoming the preferred method for procedures in gynecological, thoracic, urologic, colon and rectal surgery. Today, a wide range of colorectal problems can be treated with robotic surgery.
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A Biopsychosocial Treatment Model for Inflammatory Bowel Disease

Closeup showing a hand checking off goals that were accomplished.Absent of a cure for inflammatory bowel disease (IBD), physicians at Brigham and Women’s Hospital have pioneered a broader approach to improving the health of patients with ulcerative colitis and Crohn’s by focusing on lifestyle, health education and psychosocial aspects of disease.
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Leading the Country in the Care of Patients with Hereditary GI Cancers

Blood samples in laboratory (coagulation test)Over the past two decades, the Dana-Farber/Brigham and Women’s Cancer Center  (DF/BWCC) has become a national leader in the care of patients with hereditary gastrointestinal cancers, from Lynch syndrome to polyposis syndromes.
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Venous Thromboembolism Prophylaxis Program and Innovations Advance Quality of Care in Radical Cystectomy

Mature couple walking together with water bottles. Copy space.Complications and high readmission rates are a persistent challenge following radical cystectomy for the treatment of bladder cancer. The complex, intrabdominal operation, which  includes replacement of the bladder or creation of a stoma, and often includes removal of reproductive organs as well, is associated with a high rate of morbidity. Patients undergoing the procedure often have additional risk factors for venous thromboembolism (VTE), such as pre-operative chemotherapy, older age and a history of smoking, and VTE is estimated to occur in 5.5 to 8.5 percent of patients and cost more than $10,000 per event. In a comprehensive effort to reduce risk of VTE, reduce length of stay and improve other measures of quality of care, Brigham and Women’s Hospital urologists have implemented a perioperative VTE prophylaxis program and analyzed its results, reporting key quality of care improvements. In addition, in collaboration with nurses, anesthesiologists, pharmacists and other members of patients’ care teams, clinicians in the Division of Urology are exploring innovative initiatives to continue to make strides in improving patient care.
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Urology and Oncology Work Together to Advance Treatments for High-Risk Prostate Cancer

Doctor consulting male patient, working on diagnostic examination on men's health disease or mental illness, while writing on prescription record information document in clinic or hospital officeUrologists and oncologists at Dana-Farber/Brigham and Women’s Cancer Center have laid the groundwork for what would be the first Phase III international, randomized trial of a new treatment for patients with high-risk prostate cancer in more than a decade. The treatment involves using novel, potent neoadjuvant hormone therapy for six months prior to prostatectomy surgery, an approach that has been shown to improve both tumor pathology and long-term remission.
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Developing a Novel, Off-the-Shelf Vocal Cord Augmentation System

Silk-HA delivery deviceFor decades, the medical and scientific community has looked for ways to repair damaged vocal cords through injectable agents. Current best practices involve the use of carboxymethylcellulose, hyaluronic acid or calcium hydroxylapatite (CaHA). However, these injectable agents do not provide permanent effects and typically carry the additional burden of requiring two people to perform the medialization procedure, thus adding to their cost.
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