Mothers Who Refuse Vaccines For Their Children Dislike “One-Size-Fits-All” Approach

MedicalResearch.com Interview with:
Jennifer A. Reich PhD
University of Denver
Denver, CO 80208;

Medical Research: What are the main findings of the study?

Dr. Reich: Public health practitioners have been concerned about rising rates of vaccine refusal and hesitance. This study examines how mothers account for the decision to delay or opt out of vaccines. This study shows that contrary to popular representation, these mothers are not ignorant, but rather see themselves as experts on their own children and as best qualified to decide whether their children need vaccines. They also trust that their intensive mothering practices, including extended breastfeeding, consumption of organic foods, and social monitoring of their children will protect them against disease.
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MERS Transmission To Family Contacts Low

MedicalResearch.com Interview with:
Ziad A. Memish, M.D.
Alfaisal University
Riyadh Saudi Arabia

Medical Research: What are the main findings of the study?

Dr. Memish:  This is an important study as we looked at the secondary transmission of MERS-CoV among household/family contacts.  Of the total study population of 280 contacts from 26 clusters collected over 6 months period last year, only 12 family contacts were positive for MERS-CoV.

Knowing that 7 (2.5%) were positive by PCR, only additional 5 probable secondary transmission were identified by serology which is a very small fraction missed by PCR. Continue reading

Two Forms of Polycythemia Vera: One Indolent, One Aggressive

Jerry Spivak, M.D Professor of Medicine and Oncology Director, Center for the Chronic Myeloproliferative Disorders John Hopkins MedicineMedicalResearch.com Interview with:
Jerry Spivak, M.D
Professor of Medicine and Oncology
Director, Center for the Chronic Myeloproliferative Disorders
John Hopkins Medicine

Medical Research: What are the main findings of the study?

Dr. Spivak: The main findings of this study are that polycythemia vera occurs in two clinical forms: an indolent form in which only phlebotomy may be necessary and a more aggressive form requiring myelosuppressive therapy and that these two forms of the disease can be distinguished genetically.
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Sulfonylurea For Diabetes Linked To Increased Heart Disease Risk

Dr. Frank B. Hu Department of Nutrition Harvard School of Public Health Boston, MAMedicalResearch.com Interview with:
Dr. Frank B. Hu
Department of Nutrition
Harvard School of Public Health
Boston, MA

Medical Research: What are the main findings of the study?

Dr. Hu: in this study among approximately 5000 patients with type 2 diabetes followed for up to 10 years, longer duration of sulfonylurea therapy was associated with a higher risk of coronary heart disease. The continuous sulfonylurea therapy for 10 years was associated with almost two times greater risk of coronary heart disease compared with nonusers. However, given the observational nature of the study, we cannot make causal inference from these findings.

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Only 4% of US Stroke Patients Receive Approved Medication tPA

dr_opeolu_adeoyeMedicalResearch.com Interview with:
Opeolu Adeoye, MD MS FACEP FAHA
Associate Professor, Emergency Medicine and Neurosurgery
Division of Neurocritical Care
University of Cincinnati
Cincinnati, OH 45267

Medical Research: What are the main findings of the study?

Dr. Adeoye : Despite adequate access of the US population to hospitals that can deliver acute stroke care, only 4% of stroke patients in the US received tPA, the only approved medication for treating acute ischemic stroke.
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Children of Bipolar Parents Have Increased Novelty-Seeking and Impulsivity

MedicalResearch.com Interview with:
Manpreet K. Singh, MD MS
Assistant Professor of Psychiatry and Behavioral Sciences
Akiko Yamazaki and Jerry Yang Faculty Scholar in Pediatric Translational Medicine
Stanford University School of Medicine

Medical Research: What are the main findings of the study?

Dr. Singh: Our research team used a monetary incentive delay paradigm to measure fronto-limbic activity and connectivity associated with anticipation and receipt of reward and loss in healthy offspring of parents with bipolar I disorder. We found that compared to youth offspring without any family history of psychopathology, high-risk offspring had aberrant prefrontal and cingulate activations and connectivity during reward processing. Further, greater striatal, amygdalar, and insula activations while anticipating and receiving rewards and losses were associated with greater novelty-seeking and impulsivity traits in high-risk youth.
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Blood Pressure Control Improved By Patient Self-Management

Prof Richard McManus MA PhD FRCGP NIHR School for Primary Care Research, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire United KingdomMedicalResearch.com Interview with
Prof Richard McManus MA PhD FRCGP
NIHR School for Primary Care Research,
Nuffield Department of Primary Care Health
Sciences, University of Oxford,
Oxford, Oxfordshire United Kingdom

Medical Research: What are the main findings of the study?

Prof. McManus: The TASMIN-SR clinical trial followed 552 patients with an average age of 70 and high blood pressure with pre-existing cardiovascular disease, diabetes or chronic kidney disease.

After training in how to self-monitor blood pressuring using a readily available device, patients took readings twice each morning for the first week of each month, and following an individualised management plan were able to request additional medication from their general practitioner without the need for consultation.

At the end of the study, patients who self-managed had significantly lower blood pressure (by 9.2 / 3.4 mmHg) than those who were visiting their GP for blood pressure monitoring, which would be expected to lower stroke risk by around 30% if sustained.

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STDs Reduced in Young Girls Through Telephone Counseling

Dr. Ralph Joseph Diclemente PhD Behavoral Sciences & Health School Of Public Health Emory University Atlanta GeorgiaMedicalResearch.com Interview with:
Dr. Ralph Joseph Diclemente PhD
Behavoral Sciences & Health School Of Public Health
Emory University Atlanta Georgia

 

Medical Research: What are the main findings of the study? 

Dr. DiClemente: In our study of 701 African American girls we observed significant and durable reductions in laboratory-confirmed sexually transmitted infections (50% reduction in chlamydial infections and a 60% reduction in gonorrhea) among girls in our intervention group relative to the comparison condition over a 36-month follow-up period.  In addition, we observed significant increases in condom use during sex and reductions in sex while using drugs or alcohol.  The key finding is the durability of the results – 3 years in the life of an adolescent is a long period.

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Electronic Health Record Alerts Reduced Urinary Tract Infections

Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania, Philadelphia, PA 19104MedicalResearch.com Interview with:
Craig A Umscheid, MD, MSCE, FACP
Assistant Professor of Medicine and Epidemiology
Director, Center for Evidence-based Practice
Medical Director, Clinical Decision Support
Chair, Department of Medicine Quality Committee

Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center
University of Pennsylvania, Philadelphia, PA 19104

Medical Research: What are the main findings of the study?

Dr. Umscheid: We found that targeted automated alerts in electronic health records significantly reduce urinary tract infections in hospital patients with urinary catheters. In addition, when the design of the alert was simplified, the rate of improvement dramatically increased.

Approximately 75 percent of urinary tract infections acquired in the hospital are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine.  According to the Centers for Disease Control and Prevention, 15 to 25 percent of hospitalized patients receive urinary catheters during their hospital stay. As many as 70 percent of urinary tract infections in these patients may be preventable using infection control measures such as removing no longer needed catheters resulting in up to 380,000 fewer infections and 9,000 fewer deaths each year.

Our study has two crucial, applicable findings.  First, electronic alerts do result in fewer catheter-associated urinary tract infections. Second, the design of the alerts is very important. By making the alert quicker and easier to use, we saw a dramatic increase in the number of catheters removed in patients who no longer needed them. Fewer catheters means fewer infections, fewer days in the hospital, and even, fewer deaths. Not to mention the dollars saved by the health system in general.

In the first phase of the study, two percent of urinary catheters were removed after an initial “off-the-shelf” electronic alert was triggered (the stock alert was part of the standard software package for the electronic health record). Hoping to improve on this result in a second phase of the study, we developed and used a simplified alert based on national guidelines for removing urinary catheters that we previously published with the CDC. Following introduction of the simplified alert, the proportion of catheter removals increased more than seven-fold to 15 percent.

The study also found that catheter associated urinary tract infections decreased from an initial rate of .84 per 1,000 patient days to .70 per 1,000 patient-days following implementation of the first alert and .50 per 1,000 patient days following implementation of the simplified alert. Among other improvements, the simplified alert required two mouse clicks to submit a remove-urinary-catheter order compared to seven mouse clicks required by the original alert.

The study was conducted among 222,475 inpatient admissions in the three hospitals of the University of Pennsylvania Health System between March 2009 and May 2012. In patients’ electronic health records, physicians were prompted to specify the reason (among ten options) for inserting a urinary catheter. On the basis of the reason selected, they were subsequently alerted to reassess the need for the catheter if it had not been removed within the recommended time period based on the reason chosen.
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Rare APOB Gene Variant Linked to Exceptional Longevity

Dr. Manuel Serrano PhD Tumour Suppression Group CNIO, Melchor Fernandez Almagro 3, 28029 Madrid, Spain.MedicalResearch.com Interview with:
Dr. Manuel Serrano PhD
Tumour Suppression Group
CNIO, Melchor Fernandez Almagro 3, 28029 Madrid, Spain.


Medical Research: What are the main findings of the study?

Dr. Serrano: We investigated the contribution of rare genetic variation to human exceptional longevity (EL, individuals with ≥100 years of age) by exome-sequencing long-lived siblings in three different families where exceptional longevity clustered. We found only one gene that harbored rare variants that was likely to contribute to human longevity across all three families and this gene was the Apolipoprotein B gene (APOB). We further found that the frequency of these rare APOB variants associated with familial exceptional longevity was greater in a cohort of 206 nonfamilial cases of exceptional longevity compared to the control population, though this association did not reach statistical significance. In addition, we found rare variants in many genes within individual families that are likely to contribute to human longevity given previous studies in animals.
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