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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
    Click to Tweet

     

    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • May 17, 2018

    By Mark L. Gonzalez, MD

    Today’s surgeons can use minimally invasive techniques for many conditions that require surgery. For example, knee replacements can be performed with smaller incisions than in years past, and some skull-base tumors can be removed through the nostrils.

    Glaucoma patients now have the opportunity to undergo minimally invasive surgery for their disease. Minimally invasive glaucoma surgeries, or MIGS, offer faster recovery, less pain and fewer complications than traditional surgery.

    In order to understand how these procedures work, it’s important to understand what glaucoma is and how it affects the eyes. I tell my patients that surgical treatment for glaucoma is similar to draining a kitchen sink with a faucet that never shuts off. If the drain backs up, the sink overflows. The goal is to keep the excess fluid moving steadily out of the eyes.

    LISTEN to me describe minimally invasive glaucoma surgery in this Medical Intel segment on WTOP Radio.

    What is glaucoma?

    Glaucoma is an excess of fluid in the eye. When we’re talking about “fluid in the eye,” we’re talking about the fluid in the actual eyeball. This is something people get confused about all the time. Glaucoma has nothing to do with tear production on the surface of the eye or the feeling of having excessive wetness on the surface of the eyes.

    The ciliary body, an internal part of the eye, makes fluid. Another internal part of the eye, the trabecular meshwork, drains the fluid back into the venous system. The trabecular meshwork is similar to a small sponge. Eye fluid doesn’t simply run through the spongy tissue. Rather, it seeps through the meshwork steadily. People with glaucoma have more resistance in the trabecular meshwork, which causes the fluid to drain through much less efficiently. When the fluid doesn’t drain properly, excess pressure builds up in the eyes and can cause vision problems or vision loss over time.

    There is not yet a cure for glaucoma. We have two options to manage the disease: decreasing the amount of fluid that is produced or improving the drainage system. MIGS can address both sides of this equation.

    People with mild to moderate glaucoma may be candidates for MIGS procedures. Patients who already have advanced glaucoma usually require traditional surgery. Though minimally invasive surgeries pose less risk to patients, most glaucoma doctors would agree they don’t reduce eye pressure as well as trabeculectomy, the traditional and more complex glaucoma surgery.

    How minimally invasive glaucoma surgery reduces risk to patients

    The vast majority of glaucoma patients are controlled with medication and do not need surgery. However, when surgery is needed, we’ve traditionally relied on trabeculectomy as well as tube shunts to reduce intraocular pressure. Though these surgical procedures are effective, they are more complex than may be necessary for many patients.

    In traditional trabeculectomy, we make an external drain where the fluid exits the interior eye underneath the conjunctiva, which is the membrane/skin that covers the front of the eye. This provides access for fluid to move from the inside of the eye to the outside, but the conjunctiva is incredibly thin and fragile. Risks involved with traditional trabeculectomy include eye infections, such as endophthalmitis, scarring, extreme low eye pressure, and failure of the surgery, which can happen right away or over time.

    Though severe cases of glaucoma may ultimately require trabeculectomy, MIGS can be a safe option to treat people for whom medication is no longer enough but whose glaucoma isn’t severe enough for traditional surgery.

    MIGS are procedures done internal to the eye aimed at reducing intraocular pressure via extremely small incisions. These may involve implantation of a device, removal of the trabecular tissue or laser application. All of these techniques serve to bridge the gap between medication therapy and the need for trabeculectomy. These surgeries are exciting to ophthalmologists like me because they give us a lower-risk option to treat patients. We can perform some of these surgeries from inside of the eye, reducing the risk of infection and the duration of recovery.

    Types of MIGS procedures

    We often perform a MIGS at the same time as a patient’s cataract surgery We are able to perform these procedures through the same small incisions used for cataract surgery (2.4mm), thus reducing the trauma to the eye.

    We currently have three ways to perform MIGS:

    • Eye stent, in which we place a tube in the eye to help fluid drain directly out of the eye and bypass the trabecular meshwork.
    • Kahook blade, in which we remove a portion of the trabecular meshwork to increase the efficiency of fluid drainage.
    • Endocyclophotocoagulation (ECP), in which we go behind the iris (the colored portion of the eye) to destroy some of the cells that produce eye fluid.

    If your doctor recommends glaucoma surgery, ask about the risks and benefits of the procedure, as well as whether minimally invasive surgery is an option for you. Though risks such as infection or inflammation are possible, these risks are far lower with MIGS than with traditional glaucoma surgery.

    There’s always a risk that you may need another procedure down the road or that you may eventually require trabeculectomy if your condition worsens. But for many patients, minimally invasive glaucoma surgeries allow us to delay larger, riskier procedures until they’re absolutely necessary.

    Call 202-877-3627 or click below to make an appointment at the MedStar Eye Institute.

    Request an Appointment


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  • May 15, 2018

    By Ross Krasnow ,MD

    Years ago, before we had advanced and routine imaging, a kidney mass was only discovered when it had become very large, caused pain or caused blood in the urine. Oftentimes, patients’ kidney cancer had already spread beyond the kidney when we discovered these masses.

    Today, we often detect kidney cancer by chance, when a patient has a CT scan or an ultrasound for another purpose, such as gallstones, indigestion or back pain. The imaging scan then will show a small renal mass that is localized, or confined to the kidney. At that point, the patient doesn’t have any symptoms from the cancer and the disease can be successfully managed and treated. Advances in treatments offer patients less invasive treatments and more successful outcomes.

    LISTEN: Dr. Krasnow discusses treatment options for localized kidney cancer in this Medical Intel podcast.

    What treatment options are available for localized kidney cancer?

    Localized kidney cancers typically are not aggressive, so we have a variety of treatments that are effective and minimally invasive. The treatment option a doctor recommends will depend on the patient’s health and the characteristics of the kidney mass.

    Active surveillance

    Sometimes the best treatment is to actively monitor small, nonaggressive kidney masses with regular exams and tests every three to six months. If the tumor doesn’t grow or spread, we may extend the exams out to once per year.

    Active surveillance is a safe, non-invasive option for patients who:

    • Are older
    • Have other medical problems, such as diabetes, heart conditions, renal failure, or a single kidney
    • Prefer to avoid surgery
    • Have a small mass

    During active surveillance, we focus on general lifestyle improvements to reduce the risk of the cancer spreading. For example, I advise patients to quit smoking, lose weight, and work on controlling diabetes and overall wellness.

    Radiofrequency ablation and cryoablation

    If, after biopsy, we suspect a mass is cancerous, two of the least invasive treatment options are radiofrequency ablation and cryoablation. Ablation means the removal or destruction of tissues. In radiofrequency ablation, our colleagues in radiology put a needle into the area and burn the mass away. In cryoablation, they freeze the mass through the needle. These are good options for tumors that are small, and ablation will not damage nearby tissues or organs.

    Radical surgery

    In this traditional open surgery, we make a large incision in the front or the side of the patient. We remove the entire tumor and surrounding lymph nodes. For a smaller mass, we remove the cancerous part of the kidney while leaving the rest of the healthy kidney behind.

    We try to avoid this traditional open surgery if the size of the kidney mass or other considerations don’t make it necessary. That’s because, to get to the kidney, we have to make a very large incision, go through many layers of tissue and muscle and then reconstruct them after the tumor is removed. This risks more blood loss, longer hospital stay, a longer recovery, and other complications. In recovery, patients may have difficulty walking or breathing afterward because of how sore they are after the surgery. Today, open surgery is reserved for extremely large masses or evidence of local invasion.

    Traditional laparoscopy

    For a complete removal of the kidney, laparoscopy without robotic assistance is preferred over traditional open surgery, because there is less pain and a faster recovery. This is reserved for large masses that are not amenable to ablative techniques or partial kidney removal.

    Robotic laparoscopy

    We’ve made great progress in tumor removal with minimally invasive robotic laparoscopy. In robotic surgery, we manipulate robotic arms with instruments at a console to guide miniaturized surgical instruments to perform the operation inside the patient’s body. This newer technology allows for tiny keyhole incisions—between 0.5 and 1 centimeter each—either from the front or the back. Using the robotic surgery, we can remove the part of the kidney that is cancerous, while leaving the healthy kidney behind, a technique called “robotic partial nephrectomy”. We can also manage many locally advanced renal masses, such as those with evidence of vascular invasion robotically. Robotic surgery and traditional laparoscopy offer significant benefits to patients, such as:

    • Better cosmetic results
    • Less pain
    • Quicker recovery
    • Restart their diet earlier—even the next day
    • Resume work and normal activities quicker
    • Shorter hospital stays—usually one or two days after surgery

    Related reading: Latest Robotic Technology Brings New Benefits to Patients

    We encourage patients to walk but avoid heavy straining, heavy lifting, running, swimming or strenuous exercise until they’re approved for those activities. The last option for localized cancer is when we can’t spare the kidney. Traditionally, that would have required open surgery. Now, we often can do advanced-stage surgery using the robotic platform.

    Immunotherapy

    One of the natural functions of your immune system is to identify and fight cells that are infected and remove cells that are abnormal. Cancer can escape these immune system defenses by changing receptors on immune cells—it basically turns off the immune response.

    Immunotherapy uses agents in your own body to improve or restore immune system function. These agents, called pd1 inhibitors or pdl1 inhibitors, can turn your immune response back on so that your body can fight the cancer again. This has been a revolution for kidney cancer specifically. Prior to the use of these agents, if a targeted therapy wasn’t working, there weren’t many other options. Now, immunotherapy is an alternative therapy for patients whose cancer seems to be spreading and for whom the first line of defense didn’t work.

    Immunotherapy is a good option for patients who have kidney cancer that has already spread. There are also immunotherapy clinical trials available at MedStar Washington Hospital Center for aggressive tumors that have been removed where the risk of recurrence is high.

    #Immunotherapy is a good option for some people with recurring #kidneycancer or for cancer that has spread. via @MedStarWHC bit.ly/2GjXHkt

    Click to Tweet

    A note about the future of robotic laparoscopy

    I think the future of this procedure is twofold:

    1. The technology keeps progressing rapidly and we’re anticipating the next advancement, called the single-incision platform, which reduces the number of incisions we need for robotic surgery from four to one. Newer robots will be able to center that one incision in a single spot, such as through a belly button, leaving virtually no scar after surgery.
    2. We have started to treat more aggressive tumors in a minimally invasive fashion—even very large tumors that have extended into blood vessels. We are a research institute with clinical trials, so we are focused on advancements in technology and technique, and we are committed to treat every stage of kidney cancer.

    I understand kidney cancer is scary for patients no matter how early we detect it. But with the advances we’ve made in recent years, we have more tools available to us than ever before to catch these cancers early and treat them easier and more successfully for our patients.

     

    Call 202-877-3627 or click below to make an appointment with a urologic oncologist.

    Request an Appointment

  • May 11, 2018

    By MedStar Health

    It’s no wonder Eiman Nabi, MD, characterizes herself as a“global baby.” Born in India, she grew up in the Middle East, close to her petroleum engineer father’s work assignments. She began her medical education in Qatar and finished up at Weill Cornell Medical College in New York City. It was then on to Virginia Commonwealth University in Richmond for a three-year residency in internal medicine, followed by a fellowship in gastroenterology, hepatology and nutrition.

    The Choice to Pursue Medicine

    Dr. Nabi’s career choice, however, was far less circuitous, thanks to the encouragement of her grandmother.

    "I was always good in math and science,” Dr. Nabi says, “but having her say that I could become a physician made it seem the right thing for me to do. I would study her medications when I was younger, so in a way, she helped me get an early start on my training.”

    Dr. Nabi was equally inspired by her medical school colleagues to choose gastroenterology as a specialty.

    “It’s a very balanced field that offers so many ways to help people, from screening for colon cancer to treating GERD and other reflux diseases,” she says. “And here at MedStar Washington Hospital Center, we have the technology and equipment available to perform many highly specialized procedures.”

    Specialized Treatments in Gastroenterology

    In addition to upper endoscopy, sigmoidoscopy and colonoscopy procedures, for example, Dr. Nabi can use video capsule endoscopy to evaluate small bowel lesions—“useful for patients who have anemia,” she says. Dr. Nabi also performs hemorrhoidal banding to help patients with rectal bleeding, while high-resolution esophageal manometry and pH study aid in identifying sources of problems with swallowing and reflux.

    Outside the Hospital

    Having experienced multiple cultures, Dr. Nabi considers metropolitan Washington ideal for her professional and personal interests. She and her husband enjoy sampling the variety of restaurant cuisines found throughout the area (Afghan kebobs are her favorite), as well as cheering on the area’s sports teams.

    “Washington is a nice balance between the environments of New York and Richmond, and convenient to members of both our families,” Dr. Nabi says. “I guess that makes me an ‘East Coast person.’”

  • May 10, 2018

    By MedStar Health

    Because of her profound hearing loss, Edna Whitted would pass notes back and forth in church with her granddaughter in order to understand what was being said. Now, the 90-year-old Upper Marlboro, Md., resident can hear every word the minister relays thanks to a recent cochlear implant.

    "You don’t have to suffer with severe hearing loss,” says Selena E. Briggs, MD, an otologist/neurotologist and lateral skull base surgeon in the Department of Otolaryngology at MedStar Washington Hospital Center who treated Whitted. “Cochlear implants are the next step after hearing aids no longer help.”

    That was indeed the case for Whitted, who for nearly five years could not hear due to a 92 and 88 percent hearing loss in her left and right ears, respectively.

    “Before she could never be part of the conversation,” says Amelia Stewart, Whitted’s granddaughter. “She would get really upset because she couldn’t be part of it.”

    A Safe, Simple Solution to Sensorineural Hearing Loss

    Sensorineural hearing loss–or presbycusis–is a natural part of aging, explains Dr. Briggs. Hearing aids are a natural first step in assisting with progressive hearing loss, however, should those no longer offer any improvement, implants are an option.

    A cochlear implant is a small, surgically implanted electronic device that provides sound to a person who is deaf or severely hard of hearing. Unlike hearing aids, which amplify sounds, cochlear implants provide signals to the brain by stimulating the auditory nerve. The brain then recognizes these signals as sounds.

    "It’s a safe and easy procedure,” says Dr. Briggs. “People love having them and it’s simply life-changing for them.”

    Dr. Briggs notes there is no age limit to having a cochlear implant and the implants are designed to last a lifetime. They are also covered by insurance and Medicare. The implants have two parts, an external piece that sits behind the ear and an internal part that is placed under the skin and secured to the skull. The procedure takes 1-2 hours and can be done on an outpatient basis.

    Life Changing Effects of Cochlear Implants

    In addition to improving hearing, cochlear implants also relieve tinnitus, or the perception of noise or ringing in the ears, in 75 percent of patients.

    "People don’t realize the things they have been missing,” says Dr. Briggs. “Cochlear implants can help older adults stay active and engaged. I have never had a single patient say they regretted getting one.”

    That holds true for Whitted, who received her left-sided implant two months shy of a surprise 90th birthday party. “This has improved my grandmother’s quality of life so much,” says Stewart. “You can tell how happy she really is, and at her birthday party, we sang ‘Happy Birthday,’ and she heard every word, loud and clear.”

    If you or a loved one is experiencing severe hearing loss and is interested in learning more about cochlear implants call 202-877-3627 or click below to make an appointment.

    Request an Appointment

  • May 08, 2018

    By MedStar Health

    Much of heart care focuses on the “what”—the diagnosis, treatments and outcomes. But just as important to consider is the “who,” as in who is providing your care. When it comes to advanced heart disease, we’ve found that a team approach to heart care can make a world of difference in patient outcomes and satisfaction.

    When my patients meet our dedicated heart team, I tell them that they’re joining a family—their heart team family—who will help manage their condition for the rest of their lives in coordination with their local family doctor or cardiologist. Each member of your heart team has a unique role, and we collaborate to provide care that focuses on each patient’s overall well-being, not just their heart condition.

    LISTEN: Dr. Thourani discusses heart teams in the Medical Intel podcast.

    Assembling your heart team

    The concept of a dedicated team for heart care has changed quite a bit in the last 10 to 15 years. While team-based treatment has been part of cancer care and organ transplants for some time, it’s a more recent addition to heart care. Early heart teams were mainly for heart failure patients and consisted of a cardiologist and a surgeon. Today, we use a team-based approach for a wide variety of heart conditions, including coronary artery, aortic, and heart valve diseases. The core members of a patient’s heart team are typically a:

    • Noninvasive cardiologist, who focuses on diagnosing heart problems and treating them without invasive procedures
    • Invasive cardiologist, who focuses on minimally invasive or transcatheter procedures
    • Echocardiographer, who uses ultrasound to examine the heart
    • Cardiac surgeon, who focuses on minimally invasive or standard open surgical procedures
    • Advanced practice clinician (APC), such as a nurse practitioner or physician assistant

    We also bring in additional team members, depending on a patient’s special needs or circumstances. We’re fortunate to have access to world-class experts in all aspects of health care, so we can call on colleagues within minutes to see patients. Some of the experts with whom we may consult include:

    • Nephrologists to address kidney problems that may be related to a heart condition, such as renal artery disease
    • Neurologists to help care for patients who have suffered a stroke or who have dementia
    • Pulmonologists to address respiratory issues or chronic obstructive pulmonary disease

    Related reading: The need for fast stroke care–and why some patients don’t get it

    This team approach, bringing in experts from many medical disciplines, means you have access to multiple doctors’ experience and expertise. We all discuss your case and consider care plans based on your particular needs, whether they’re the traditional standard of care or new, innovative therapies. We have relationships with the Food and Drug Administration (FDA) and the National Institutes of Health (NIH), so we can offer treatment options that are available only at a few select centers nationwide.

    Getting comfortable with your heart team

    In my experience, patients love having a dedicated team for their heart care. It’s easy to feel lost in the shuffle of today’s healthcare system, when you see one doctor on one visit, and you might see another doctor on another visit. Our goal is to help you feel comfortable as part of the team.

    Your heart team ensures that you’ll always see providers you know and trust. Our nurse practitioners and physician assistants play a tremendous part in making that happen. The APCs are almost an extension of me in the exam room, and their knowledge is unbelievable.

    You’ll always see #heart providers you know and trust when you’re cared for by a #heartteam. via @MedStarWHC bit.ly/2rsSxxl

    Click to Tweet


    Having MedStar Heart & Vascular Institute within MedStar Washington Hospital Center and MedStar Union Memorial Hospital gives us the opportunity to concentrate on heart patients and all aspects of their care. With all of us working together as a team, we can manage and treat even the most challenging heart conditions and improve the quality of our patients’ lives.

    Call 202-877-3627 or click below to make an appointment with a member of our heart care team.

    Request an Appointment

  • May 04, 2018

    By MedStar Health Research Institute

    On January 19, 2017, the Department of Health and Human Services (HHS) and other federal agencies had announced a final rule that outlined revisions to the Common Rule, the regulations adopted by 17 federal department and agencies that govern IRB review requirements. These revisions were scheduled to become effective on January 19, 2018. In January 2018, the agencies published an interim final rule that delayed the effective and compliance date for these revisions until July 19, 2018.

    HHS issued Notice of Proposed Rule Making (NPRM) on April 20, 2018, which proposes an additional delay of six months to the compliance date for the revisions to the Common Rule. This NPRM is intended to provide those regulated by the Common Rule additional time to prepare to comply with the requirements of the new revisions.

    The NPRM is currently requesting comments on whether to permit institutions to implement three burden reducing provisions from the Common Rule revisions during this six month delay period. Those provisions are:

    • A revised definition of research, which deems certain categories of activities to not be research;
    • The allowance of no annual continuing review for certain categories of research, and
    • The elimination of the requirement that IRBs review grant applications or other funding proposals related to research.

    Under the NPRM, the compliance date of the Common Rule revisions would be changed from July 19, 2018, to January 21, 2019.

    The MedStar Research Compliance Program and Office of Research Integrity are working to prepare for implementation of the revisions to the Common Rule. As the compliance date approaches, additional information will be distributed and education sessions will be scheduled.

    For any questions, please contact the Research Compliance Program at researchcompliance@medstar.net or the Office of Research Integrity at MHRI-ORIHelpDesk@medstar.net.