The pathophysiology of typical gastro-oesophageal reflux disease (GORD) symptoms and reflux oesophagitis is associated with excess acid reflux, but both refractory GORD and laryngopharyngeal reflux (LPR) have strong links with functional gut disorders. Oesophageal pH impedance monitoring, our accepted gold standard for diagnosing GORD, has significant shortcomings when assessing proximal oesophageal and in particular pharyngeal reflux. In addition, identifying potential contamination of other parts of the respiratory tract such as lungs or sinuses is not possible. The association between irritable bowel syndrome (IBS) and both refractory GORD and LPR suggests a common pathogenesis.

The annual incidence of aneurysmal subarachnoid hemorrhage (SAH) in the United States is 6-16 cases per 100,000 population, with approximately 30,000 cases occurring each year.

Treatment of sickle cell disease (SCD) remains varied with only a minority of patients benefiting from stem cell transplant as a near cure. Others await the promise of more effective and less toxic treatments than hydroxyurea, especially children who are most susceptible to the morbidities and mortalities of SCD. The recent report of Hebert, Rakotoson et al. points to an evolution of in vitro diagnostics (IVD) testing of blood cells with the emerging need for cell-by-cell measurement of red blood cell (RBC) specific hemoglobin variant levels. The study further provides clinical validation as to the utility of measuring HbF content in RBCs of SCD patients, not just as a prognostic test, but likely serving as a companion diagnostic in phase 3 clinical trials of new SCD therapies. 

Calcitonin gene related peptide (CGRP) is a potent vasodilator and neurotransmitter that has been extensively studied in the context of migraine pathophysiology. Recently, studies have explored its role in the treatment of traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH). Although a multitude of therapies exist for migraine, there has been little study on the management of migraine following neurologic injury.

The Randomized intervention for Vesicoureteral Reflux (RiVUR) study was an effort by the National Institute of Health to identify the most significant question on the management of vesicoureteral reflux (VUR), i.e. Did antibiotic prophylaxis reduce the incidence of recurrent urinary tract infections (UTI) in children with VUR? During the initial phases of the RiVUR study, several similar studies were performed that seemed to indicate lack of benefit of antibiotic prophylaxis in VUR.