Salem

Researchers are investigating how chemotherapy affects thinking abilities and brain function in older women with breast cancer. The study focuses on a condition often called "chemo-brain," which refers to changes in cognition and brain structure caused by chemotherapy. The goal is to identify who is most at risk for these cognitive side effects by examining brain images and thinking skills before and after treatment. Participants include older women newly diagnosed with invasive breast cancer, some receiving chemotherapy and some not, along with healthy volunteers. The study involves memory and thinking tests, along with brain imaging using MRI and PET scans to observe changes related to chemotherapy. These assessments occur at multiple points to track the effects over time. Participants will undergo cognitive and functional testing as well as brain scans before chemotherapy, immediately after finishing chemotherapy, and six months later. Researchers will measure changes in cognitive performance scores and monitor brain structure and function. The study also includes safety measures and requires participants to have a good overall health status to complete the assessments and follow-up visits.

Researchers are evaluating surgical and minimally invasive treatments for lumbar spinal stenosis (LSS) by comparing Medicare patients who received the MILD procedure against those who had interspinous process decompression (IPD). The study focuses on outcomes such as the rate of harms related to the initial procedure and the frequency of additional surgical or minimally invasive interventions within 24 months after treatment. Enrollment includes patients treated from January 1, 2017, onward, with continuation until the sponsor decides to stop. The MILD procedure involves percutaneous image-guided lumbar decompression, performed under fluoroscopy through a dorsal approach to partially remove tissue and bone at the affected spinal level. The control group receives the IPD procedure for LSS. Both groups are monitored for a 24-month period post-index procedure using Medicare claims data to track reoperations and any harms. Participants contribute data through Medicare claims without needing prior enrollment or consent, as the study is exempt from IRB oversight. Researchers collect and analyze information on procedure-related harms and subsequent interventions over two years. This approach allows evaluation of long-term safety and effectiveness outcomes for patients treated with either MILD or IPD.

Older adults undergoing colorectal surgery face significant risks after hospital discharge, including a nearly 25% chance of readmission within 30 days due to issues like medication errors, surgical complications, and worsening chronic diseases. This research evaluates whether a specialized care transition intervention can improve outcomes and reduce readmissions for these patients. The study combines principles of geriatric co-management and care transition models to address the complex needs of older colorectal surgery patients. The intervention being studied is the OSCAR-S Care Transition Model, which integrates geriatrics co-management with postoperative surgical care. Patients in the intervention group will receive support from a surgery nurse coach through in-person visits and phone calls over four weeks after discharge. This approach focuses on medication management, maintaining personal health records, ensuring timely follow-up care, and educating patients about warning signs of worsening conditions. Participants will be monitored for 30 days after discharge to track readmissions or death. The study will assess the feasibility and effectiveness of this integrated care model by collecting data on patient outcomes and healthcare interactions. The goal is to improve the transition from hospital to home and reduce complications during this vulnerable period after surgery.

This research aims to evaluate a new screening method using artificial intelligence (AI) to detect glaucoma, a chronic eye disease that can cause irreversible vision loss. The study focuses on people with diabetes as they have a higher risk of developing glaucoma. By adding glaucoma screening to existing diabetic eye disease screenings, the study hopes to catch glaucoma early and reduce the chance of blindness. Participants will have a photograph taken of the back of their eye (fundus) as part of their diabetic eye screening. Their eye pressure will also be measured using a special device called an Icare tonometer. If glaucoma is suspected, participants may undergo a side vision test using a virtual reality headset. This screening program combines AI analysis of eye images with eye pressure checks and visual field testing to improve detection. During the study, participants will have their fundus images and eye pressure measured, with visual field tests added if needed. The study will track how well this combined AI-based screening finds glaucoma cases one year after initial screening. Researchers hope this approach will provide a cost-effective way to improve glaucoma detection in community health settings and support early treatment to protect vision.