Category Archives: Author Interviews

Medical Research Author Interviews

Poor Work/Life Balance Cited As Main Reason For Few Female Surgeons

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MedicalResearch.com Interview with:
Miss Hui-Ling Kerr
SpR Trauma and Orthopaedics
Department of Trauma and Orthopaedic
Bristol Royal Infirmary, Bristol, UK

MedicalResearch.com: What is the background for this study?

Response: Gender inequality at consultant level in surgery has not improved despite greater opportunities for women and only a small proportion of women apply to become surgical trainees.

We wanted to find out if the lack of female surgical role models acted as a deterrent to first year female junior doctors and final year medical students towards a career in surgery.

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Intensive Diabetes Treatment Extends Life On Average 8 Years, Free of Serious Complications

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MedicalResearch.com Interview with:
Oluf Pedersen, MD
Specialist in Internal Medicine and Endocrinology,
The Novo Nordisk Foundation Center for Basic Metabolic Research,
Section of Metabolic Genetics, Faculty of Health and Medical Sciences,
University of Copenhagen,
Peter Gæde and
Jens Oellgaard
Department of Cardiology and Endocrinology
Slagelse Hospital Copenhagen

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Steno-2 study was the attempt to investigate the effect of an intensified, multifactorial intervention in type 2 diabetes simultaneously targeting risk factors such as hyperglycaemia, hypertension, dyslipidaemia, blood platelet aggregation, and elevated urinary albumin excretion rate as well as life style factors such as smoking, diet and a sedentary lifestyle. On top of that patients were by a dedicated team of care givers offered continued education and motivation.

A total of 160 Danish type 2 diabetes patients with microalbumuria (a biomarker of generalized vascular damage) were originally randomized either to intensified multifactorial treatment at Steno Diabetes Center, Copenhagen or to conventional multifactorial treatment at their general practitioners. The trial ended after 8 years, and patients in both of the original treatment arms were for the following 13 years given intensified multifactorial treatment as the one originally given to the intensified intervention group only.

Three previous milestone reports from the Steno-2 trial published in Lancet and New England Journal of Medicine have provided unprecedented evidence that this targeted and multifaceted approach reduces the risk of diabetic late complications such as kidney, eye or nerve disease as well as cardiovascular disease and total mortality with around fifty percent.

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Cancer Patients Have Increased Risk of Injuries Around Time of Diagnosis

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MedicalResearch.com Interview with:

Qing Shen, PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institutet

Qing Shen

Qing Shen,  PhD student
Department of Medical Epidemiology and Biostatistics
Karolinska Institutet

MedicalResearch.com: What is the background for this study?

Response: Injury, either iatrogenic (for example, complications from medical procedures and drug treatment) or non-iatrogenic (for instance, suicidal behavior and accidents), is one of the leading causes of non-cancer mortality for patients diagnosed with cancer. Iatrogenic injuries are common in those with cancer and have been shown to increase mortality in some cancer patients. Increased risks of suicide and accidental death after diagnosis have been reported, and the diagnostic process of cancer has been recognized highly stressful. It is, however, unknown whether the risk of injuries is also increased during the time period before receiving the diagnosis. Therefore, we analysed the risks of injuries during the weeks before and after diagnosis using a nationwide study sample in Sweden.

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Most Gastric Bypass Patients Keep Weight Off After Surgery

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MedicalResearch.com Interview with:

Matthew Leonard Maciejewski, PhD Professor in the Division of General Internal Medicine Department of Medicine Duke University School of Medicine Research Career Scientist and Director of the Health Economics and Policy Unit in the Center for Health Services Research in Primary Care Durham VA Medical Center

Dr. Matt Maciejewski

Matthew Leonard Maciejewski, PhD
Professor in the Division of General Internal Medicine
Department of Medicine
Duke University School of Medicine
Research Career Scientist and Director of the Health Economics and Policy Unit in the Center for Health Services Research in Primary Care
Durham VA Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: No study based on a US cohort undergoing current procedures has examined weight change comparing surgical patients and nonsurgical patients for as long as we have. This is the first study to report 10-year outcomes on gastric bypass patients and compare them to matched patients who did not get surgery. At 1 year, gastric bypass patients lost 31% of their baseline weight compared controls who only lost 1.1% of their baseline weight. At 10 years, gastric bypass had lost 28% of their baseline weight.

We also compared weight loss at 4 years for Veterans who received the 3 most common procedures (gastric bypass, sleeve gastrectomy, and adjustable gastric banding). At 4 years, patients undergoing gastric bypass lost more weight than patients undergoing sleeve gastrectomy or gastric banding. Given that few high quality studies have examined sleeve gastrectomy to 4 years, the 4-year sleeve outcomes contribute to filling this important evidence gap as the sleeve gastrectomy is now the most commonly performed bariatric procedure worldwide.

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Invasive Cardiac Therapies Linked To Better Survival Following Heart Attack

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MedicalResearch.com Interview with:

Dr Marlous Hall PhD Senior Epidemiologist Leeds Institute of Cardiovascular and Metabolic Medicine

Dr. Marlous Hall

Dr Marlous Hall PhD
Senior Epidemiologist
Leeds Institute of Cardiovascular and Metabolic Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is well known that death rates following heart attacks have fallen considerably over recent decades. Many studies have looked at the effect of medications and invasive strategies, and their association with better clinical outcomes is clear.

However, a big question remains: why have heart attack deaths fallen? Is it due to increased use of medications and treatment, is the risk of patients simply lower over time due to things like earlier diagnosis or are patients generally healthier with fewer comorbidities such as diabetes? Answering this is not straightforward – as “gold standard” studies like clinical trials on historic data cannot be done.

An alternative approach is to look for patterns in data observed from routine care to look at all these factors together. This study used a large and rich dataset covering heart attack care in the UK (Myocardial Ischaemia National Audit Project (MINAP)). This dataset was linked to outcome data from the Office for National Statistics to allow us to look at all the different factors that could influence the change in mortality over time.

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Repeat Urine Drug Testing Can Improve Compliance of Patients on Opioid Medications

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MedicalResearch.com Interview with:

N. Nick Knezevic, MD, PhD Vice Chair for Research and Education Associate Professor of Anesthesiology and Surgery at University of Illinois Advocate Illinois Masonic Medical Center Department of Anesthesiology Chicago, IL 60657

Dr. N. Nick Knezevic

N. Nick Knezevic, MD, PhD
Vice Chair for Research and Education
Associate Professor of Anesthesiology and Surgery at University of Illinois
Advocate Illinois Masonic Medical Center
Department of Anesthesiology
Chicago, IL 60657

MedicalResearch.com: What is the background for this study?

Response: Even though serious efforts have been undertaken by different medical societies to reduce opioid use for treating chronic non-cancer pain, still many Americans seek pain relief through opioid consumption. The purpose of this study was to accurately assess compliance of chronic opioid consuming patients in an outpatient setting and evaluate if utilizing repeated urine drug testing could improve compliance.

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Nurse-Initiated Protocols Can Improve Timeliness of Care in an Urban Emergency Department

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MedicalResearch.com Interview with
Mathew Douma, RN BSN ENC(C) CNCC(C)
Emergency Department, Royal Alexandra Hospital
Edmonton, Alberta, Canada; Masters of Nursing Student
University of Toronto, Toronto

MedicalResearch.com: What is the background for this study?

Response: Many emergency departments experience crowding, which is typically defined as a situation where demands for service exceed the ability of the emergency department to provide quality care in a timely fashion. Typically when patients are waiting in a waiting room they do not undergo diagnostics or treatments. In an effort to speed the process up and reduce the amount of time the patient spends in the emergency department, some facilities have created protocols for diagnostics or treatments typically outside the traditional scope of practice of nursing staff.

Our emergency department had protocols like this for almost 15 years, though we had never evaluated their effectiveness. So an interdisciplinary group in our emergency department updated them and then we set out to evaluate them.

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Comparable Diabetes and Heart Disease Care Provided By Physicians and Advanced Care Providers

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MedicalResearch.com Interview with:
Salim S. Virani, MD, PhD and
Julia Akeroyd MPH
Health Services Research and Development
Michael E. DeBakey Veterans Affairs Medical Center
Houston

MedicalResearch.com: What is the background for this study?

Response: Given the increase in the number of Americans seeking primary health care due to the Affordable Care Act, combined with current and anticipated physician shortages in the US, there is a growing need to identify other models of primary care delivery to address chronic diseases.

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IV Iron Postoperatively May Reduce Infections, Transfusions and Length of Hospital Stay

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MedicalResearch.com Interview with:
Alhossain A. Khalafallah, Clinical Professor
Menzies Institute for Medical Research,
University of Tasmania, Australia
Consultant Haematologist
Launceston General Hospital
Australia

MedicalResearch.com: What is the background for this study?

Response: There are limited data regarding the effect of postoperative anemia on patient’s outcomes. The issue of postoperative anemia was noticeably to affect a large cohort of patients world-wide.

This study was aiming at comparing the new approach with a single ferric carboxymaltose infusion versus standard or routine usual care for management of postoperative anemia.

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Low Uptake of Medicare Obesity Counseling Benefit

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MedicalResearch.com Interview with:

John A. Batsis, MD, FACP, AGSF Associate Professor of Medicine and The Dartmouth Institute Geisel School of Medicine at Dartmouth Section of General Internal Medicine - 3M Dartmouth-Hitchcock Medical Center Lebanon, NH

Dr. John Batsis

John A. Batsis, MD, FACP, AGSF
Associate Professor of Medicine and The Dartmouth Institute
Geisel School of Medicine at Dartmouth
Section of General Internal Medicine – 3M
Dartmouth-Hitchcock Medical Center
Lebanon, NH

MedicalResearch.com: What is the background for this study?

Response: In 2011, the Centers for Medicare and Medicaid implemented a regulatory coverage benefit to cover 22 brief, targeted 15-minute counseling visits by clinicians over the course of a 12-month period for Medicare beneficiaries with a body mass index exceeding 30kg/m2. This was an important policy determination in tackling the obesity epidemic in the United States. An emphasis on the importance of counseling, or intensive behavioral therapy, in a primary care setting set the foundation for this benefit.

Yet, it was unclear how and if this benefit (which would be free of charge without a copay or deductible for beneficiaries) was being implemented in clinical care. We therefore identified fee-for-service Medicare claims for the years 2012 and 2013 to determine whether the G0477 code (Medicare Obesity benefit code) was billed. We additionally explored the rate of uptake of the Medicare benefit in relation to the prevalence of obesity using the 2012 Behavior Risk Factor Surveillance System data.

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Inflammatory Biomarkers May Presage Development of Alzheimer’s

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MedicalResearch.com Interview with:

Inflammatory Biomarkers May Presage Development of Alzheimer's

Prof. Paul Morgan

Professor B. Paul Morgan
Director, Systems Immunity Research Institute
Institute of Infection and Immunity
School of Medicine
Cardiff University

MedicalResearch.com: What is the background for this study?

Response: Inflammation is a normal response of the body to infection or injury; however, it is well known that inflammation also has a dark side and when it escapes normal controls can cause disease. Some illnesses, like rheumatoid arthritis, have been known for many years to be caused by rogue inflammation and most of the drugs used to treat work by suppressing the inflammation (anti-inflammatories). More recently, it has become clear that inflammation is behind many other diseases that were previously thought of as diseases of ageing caused by wear and tear and lifestyle – these include heart disease and some brain diseases, notably Alzheimer’s disease the commonest cause of dementia. Evidence that inflammation is one of the drivers of disease has come from many sources, including some where it was noticed that people on long-term anti-inflammatory drugs for other reasons appeared to be protected from developing Alzheimer’s disease.

A problem is that Alzheimer’s disease, despite the name, is not a single disease but rather a group of conditions with similar symptoms, and inflammation is likely to be a cause in only some of the patients; further, most of the inflammation might be occurring very early in the disease, even before symptoms are obvious. So, there is an urgent need for a simple test or set of tests that can be used in individuals with the very earliest hints of Alzheimer’s disease – mild memory loss – that will pick out those who have brain inflammation and are most likely to develop Alzheimer’s disease. It might then be possible to treat this select group with anti-inflammatory drugs that will reduce brain inflammation and slow or stop progression of the disease.

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Experimental Antibody Reduced Amyloid Plaques in Alzheimer’s

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MedicalResearch.com Interview with:

Roger M. Nitsch, MD Professor and Director Institute for Regenerative Medicine · IREM University of Zurich Campus Schlieren Switzerland

Prof. Roger Nitsch

Roger M. Nitsch, MD
Professor and Director
Institute for Regenerative Medicine · IREM
University of Zurich Campus Schlieren
Switzerland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The main finding is that treatment with aducanumab resulted in an unprecedented reduction of brain amyloid plaques in patients with Alzheimer’s disease.  The removal of amyloid from patients brains were both dose- and time-dependent.  We also observed initial hints for stabilized brain functions in patients receiving aducanumab.  In contrast, patients in the placebo group continued to declined as usual in this stage of Alzheimer’s disease.

The main safety finding in 22% of all treated patients was ARIA – an Amyloid-Related Imaging Abnormality – suggestive of fluid shifts in the brains. In most cases, ARIA occurred in the absence of clinical signs and resolved spontaneously.  In one third of the ARIA cases, patients experienced transient headaches.  None of the patients had to hospitalized because of ARIA.

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