Addiction, Author Interviews, JAMA / 06.02.2017

MedicalResearch.com Interview with: Guillaume Sescousse, PhD Senior post-doc Donders Centre for Cognitive Neuroimaging The Netherlands with collaborators Maartje Luijten, PhD, and Arnt Schellekens, MD PhD MedicalResearch.com: What is the background for this study? What are the main findings? Response: People with an addiction process rewards in their brain differently from people who are not addicted. However, whether this is associated with “too much” or “too little” brain activity is an open question. Indeed, past research has produced conflicting findings. In order to get a reliable answer, we have combined 25 studies investigating brain reward sensitivity in more than 1200 individuals with and without addiction to various substances such as alcohol, nicotine or cocaine but also gambling. By analyzing the brain images from these studies, we have discovered an important difference in brain activity between expecting a reward and receiving a reward. Compared with non-addicted individuals, individuals with substance or gambling addiction showed a weaker brain response to anticipating monetary rewards. This weaker response was observed in the striatum, a core region of the brain reward circuit, possibly indicating that individuals with an addiction have relatively low expectations about rewards. In contrast, this same region showed a relatively stronger response to receiving a reward in individuals with substance addiction compared with non-addicted individuals. Many addiction rehab centres, such as Avante, offer targeted addiction relief strategies to help a specific person with their addiction. This stronger response possibly indicates a stronger surprise to getting the reward, and is consistent with low expectations. This same effect was not found among people addicted to gambling. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Education, Outcomes & Safety / 06.02.2017

MedicalResearch.com Interview with: Yusuke Tsugawa, MD, MPH, PhD Research Associate at Department of Health Policy and Management Harvard T.H. Chan School of Public Health   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior evidence has been mixed as to whether or not patient outcomes differ between U.S. and foreign medical graduates. However, previous studies used small sample sizes or data from a small number of states. Therefore, it was largely unknown how international medical graduates perform compared with US medical graduates. To answer this question, we analyzed a nationally representative sample of Medicare beneficiaries admitted to hospitals with a medical condition in 2011-2014. Our sample included approximately 1.2 million hospitalizations treated by 40,000 physicians. After adjusting for severity of illness of patients and hospitals (we compared physicians within the same hospital), we found that patient treated by international medical graduates had lower mortality than patients cared for by US medical graduates (adjusted 30-day mortality rate 11.2% vs 11.6%, p<0.001). We observed no difference in readmissions, whereas costs of care was slightly higher for international medical graduates. (more…)
Author Interviews, Melanoma / 03.02.2017

MedicalResearch.com Interview with: Dr. Diego Sampedro PhD Department of Chemistry, Centro de Investigación en Síntesis Química (CISQ) Universidad de La Rioja Logroño, Spain MedicalResearch.com: What is the background for this study? Response: Skin cancer is currently the most common type of cancer. While it implies a relatively low mortality rate, the reported cases of all types of skin cancer have been steadily increasing for the last decades. The ozone layer depletion and longer sunlight exposure times due to outdoors activities contribute to this increase. Solar light is well-known to lead to several skin cellular problems, including DNA damage, mutations, oxidative stress, sunburn and immune suppression. These deleterious effects of sunlight may be mitigated by the use of sunscreens. Sunscreens are inorganic or organic substances that are directly applied onto the skin, designed to minimize light transmission into the skin, mainly in the ultraviolet region of the solar spectrum. However, serious concerns exist about the safety of several commercial sunscreens components, as well as several drawbacks due to the lack of stability, biodegradability and effectiveness for skin protection. Thus, the development of new (and more efficient) types of sunscreens is of critical importance with a great potential impact in public health and industrial applications. (more…)
Author Interviews, Cancer Research, CT Scanning, JAMA, Lung Cancer / 02.02.2017

MedicalResearch.com Interview with: Ahmedin Jemal, DVM, PHD Vice President, Surveillance and Health Services Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? Response: In December 2013, the United States Preventive Services Task Force (USPSTF) recommended annual screening for lung cancer with low dose computed tomography (LDCT) for current or former heavy smokers who quit within the past 15 years. A previous study estimated that only 2-4% of heavy smokers received LDCT for lung cancer screening in 2010 in the United States. We sought to determine whether lung cancer screening among high risk smokers increased in 2015, following the USPSTF recommendation in 2013. (more…)
Author Interviews, Surgical Research / 02.02.2017

MedicalResearch.com Interview with: Karen Zaderej CEO, AxoGen Karen Zaderej joined AxoGen in May 2006. She has served as President, Chief Executive Officer and a member of the Board of Directors of AxoGen, Inc. since May 2010. Prior to her current role, she served as Chief Operating Officer from October 2007 to May 2010 and as Vice President of Marketing and Sales from May 2006 to October 2007. From October 2004 to May 2006, Karen worked for Zaderej Medical Consulting, a consulting firm she founded that helped medical device companies build and execute successful commercialization plans. From 1987 to 2004, Karen worked at Ethicon, Inc., a Johnson & Johnson company, where she held senior positions in marketing, business development, research & development, and manufacturing. Karen is a Director of SEBio, a non-profit supporting the life science industry in the southeastern United States. Karen earned an MBA from the Kellogg Graduate School of Business at Northwestern University and a Bachelor of Science degree in Chemical Engineering from Purdue University. MedicalResearch.com: Please tell us about yourself and how you became CEO at AxoGen. Response: I met Jamie Grooms, co-founder of AxoGen, in 2005 and we had one of those meetings that change your life. Jamie is a serial entrepreneur and loves to start businesses. He had tried to make nerves in the past but had been unsuccessful. When he saw new technology at the University of Florida that explained some of the issues in regenerating nerves, he decided to found a company focused on nerve repair. In parallel, I had been in business development and strategic marketing for Johnson & Johnson and we had looked at the nerve repair market. We determined there was a significant unmet need in nerve repair, but we could not find any technology at that time that solved the surgical need. Several years later, I left J&J and started a consulting business focused on market development and commercialization of early stage med tech companies. Jamie and I met, and I found the technology I had been looking for years earlier. We had an exciting conversation about the potential to improve the lives of patients with nerve injuries. I saw the possibility to create an entire new segment in med tech, one dedicated to nerve repair. With that great potential in front of me, I closed my consulting business, moved to Florida, and joined the AxoGen team. (more…)
Author Interviews, Frailty, JAMA, Outcomes & Safety, Surgical Research / 01.02.2017

MedicalResearch.com Interview with: Margaret L Schwarze, MD, MPP Associate Professor Division of Vascular Surgery University of Wisconsin MedicalResearch.com: What is the background for this study? Response: Surgery can have life-altering consequences for frail older adults, yet many undergo an operation during the last year of life. Surgeons commonly rely on informed consent to disclose risks of discrete complications; however, this information is challenging for patients to interpret with respect to their goals and values. Our research group developed a communication framework, called Best Case/Worst Case, to change how surgeons communicate with patients facing serious illness.  Surgeons use the framework to describe the best, worst, and most likely scenarios to present a choice between valid treatment alternatives and help patients imagine how they might experience a range of possible treatment outcomes. (more…)
ASCO, Author Interviews, Cancer Research, Colon Cancer, Genetic Research, Journal Clinical Oncology / 01.02.2017

MedicalResearch.com Interview with: Matthew B Yurgelun, M.D Instructor in Medicine, Harvard Medical School Dana-Farber Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has long been known that hereditary factors play a key role in colorectal cancer risk. It is currently well-established that approximately 3% of all colorectal cancers arise in the setting of Lynch syndrome, a relatively common inherited syndrome that markedly increases one’s lifetime risk of colorectal cancer, as well as cancers of the uterus, ovaries, stomach, small intestine, urinary tract, pancreas, and other malignancies. Current standard-of-care in the field is to test all colorectal cancer specimens for mismatch repair deficiency, which is a very reliable means of screening for Lynch syndrome. The prevalence of other hereditary syndromes among patients with colorectal cancer has not been known, though other such factors have been presumed to be quite rare. (more…)
Author Interviews, Blood Pressure - Hypertension, Genetic Research / 01.02.2017

MedicalResearch.com Interview with: Helen R Warren PhD Analysis, Statistics, Genetic Epidemiology Queen Mary, University of London MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study analysed data from UK Biobank, which is a large cohort including over 500,000 male and female participants from across the UK, aged 40-69 years. We performed a genetic association study for blood pressure, which analysed ~140,000 individuals of European ancestry (as currently interim genetic data is only available for ~150,000 participants). Our study identified 107 genetic regions associated with blood pressure, which had not been previously reported at the time of our analysis. All our new findings were robustly validated within independent replication data resources, comprising a large, total sample size of up to 420,000 individuals. (more…)
Author Interviews, Heart Disease, JAMA, Tobacco Research, UCLA / 01.02.2017

MedicalResearch.com Interview with: Holly R. Middlekauff, MD Professor UCLA Division of Cardiology David Geffen School of Medicine UCLA MedicalResearch.com: What is the background for this study? What are the main findings? Response: E-cigarettes are the fastest rising tobacco product in the US today, but almost nothing is known about their cardiovascular effects. Rather than wait decades for epidemiological data in e-cigarette users to become available, we reasoned that investigations into the known mechanisms by which tobacco cigarettes increase heart disease would provide insights into the health risks of e-cigarettes. We focused on 2 critical mechanisms: 1) cardiac adrenaline activity, and 2) oxidative stress, measured in chronic e-cigarrete users compared to matched, healthy controls. The major findings were that, compared to healthy controls, e-cig users had increased cardiac adrenaline activity (measured by a technique called "heart rate variability"). Furthermore, compared to healthy controls, the e-cig users had increased susceptibility to oxidative stress. (more…)
Author Interviews, Gastrointestinal Disease, Microbiome / 01.02.2017

MedicalResearch.com Interview with: Fernando Azpiroz, MD, PhD Chief of the Department of Digestive Diseases University Hospital Vall d’Hebron Autonomous University of Barcelona, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: This open-label, single-arm study, included 26 healthy volunteers who did not have gastrointestinal (GI) symptoms or a history of GI disorders, and were not required to change their diets during treatment. Twenty participants were included in the main evaluation and six were included as control subjects. Participants in the main study were given HOST-G904 (2.8 g/day) for three weeks, during which time they followed their usual diet. In the evaluation periods (three-day periods immediately before, at the beginning and at the end of the administration), the participants followed a standardized low-fiber diet with one portion of high-fiber foods, at which time the investigators measured the following: (1) number of daytime gas evacuations for two days; (2) volume of gas evacuated; and (3) microbiome composition (as measured by fecal Illumina MiSeq sequencing). (more…)
Author Interviews, Cancer Research, Technology / 01.02.2017

MedicalResearch.com Interview with: Vasileios Vavourakis Marie Skłodowska-Curie Fellow Centre for Medical Image Computing Department of Medical Physics & Biomedical Engineering Front Engineering Building, Malet Place University College London WC1E 6BT, London, UK  MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is already known that chemical factors play an important role in pathological angiogenesis, the process whereby cancer induces the formation of new blood vessels to provide it with nutrients. However, there is little knowledge about how mechanical forces induced by tumour growth affect the development and functionality of this pathological vasculature. By developing a mathematical & computational model – also referred in the research community as in-silico model – of the physical and chemical interactions occurring during angiogenic cancerous growth, we aimed to provide insights about how mechanical forces influence cancer-induced angiogenesis. The most important finding of our study is that mechanical forces play a key role in solid tumour-induced angiogenesis. (more…)
Author Interviews, Depression, OBGYNE / 01.02.2017

MedicalResearch.com Interview with: Kristina M. Deligiannidis, MD Associate Professor Center for Psychiatric Neuroscience The Feinstein Institute for Medical Research Director, Women’s Behavioral Health Zucker Hillside Hospital Northwell Health Associate Professor Psychiatry and Obstetrics & Gynecology Hofstra Northwell School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Because of effects on social behavior, including maternal behavior, oxytocin has often been seen as a potential mediator of postpartum depression and anxiety. The original objective of our study was to examine the relationship between the use of synthetic oxytocin during and after labor and the development of depressive and anxiety disorders within the first year postpartum. We hypothesized that women exposed to synthetic oxytocin before or during labor would have a reduced risk of postpartum depressive and anxiety disorders compared with those without any exposure. Our findings told the opposite story. We found that peripartum synthetic oxytocin exposure was associated with an increase in risk for the development of postpartum depression and anxiety. (more…)
Author Interviews, Health Care Systems, Johns Hopkins / 01.02.2017

MedicalResearch.com Interview with: Chester G. Chambers, Ph.D. Director, Enterprise Risk Management Program, Johns Hopkins Carey Business School Joint Appointment in Anesthesiology and Critical Care Medicine Maqbool Dada, Ph.D. Joint Appointment in Anesthesiology and Critical Care Medicine John Hopkins Medicine Kayode Ayodele Williams, M.B.A., M.B.B.S., M.D Medical Director : Blaustein Pain Treatment Center Associate Professor of Anesthesiology and Critical Care Medicine John Hopkins Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The result is based on a retrospective analysis of three specialty clinics in the Johns Hopkins System: a private practice low-volume clinic with one physician and no residents; a medium volume clinic that used one attending physician for each clinic session and included residents; and a high-volume clinic with multiple attending physicians and several residents. Our main finding is that physicians adjust face time based on congestion in the clinic, and seem to do this without always knowing they are doing it. Patients who arrive early and whose service begins before their appointment times, tend to get more face-time then other patients. This is similar to other service systems in which first-line providers speed-up when they see long queues at their stations.This is important because most of the prior research in this setting assumed that this never takes place. We verified that it does happen in multiple settings and the changes in processing rates are statistically significant. This means we need to rethink many earlier conclusions about how clinics run. (more…)
Author Interviews, Cancer Research, Gender Differences, Race/Ethnic Diversity / 01.02.2017

MedicalResearch.com Interview with: Sheila F. Dunn, MD, MSc Scientist, Women's College Research Institute Director, Family Practice Health Centre Staff Physician, Department of Family and Community Medicine Women's College Hospital Associate Professor, Department of Family and Community Medicine University of Toronto MedicalResearch.com: What is the background for this study? Response: Despite organized cervical and breast cancer screening programs, inequities in screening remain. In Ontario, women who are newcomers, especially those of South Asian and East Asian origin, have much lower screening rates than Canadian-born women. In order to address these inequities the CARES program used a multi-faceted community-based intervention to increase knowledge and promote cervical and breast cancer screening among newcomer and otherwise marginalized women in Toronto, Ontario, Canada. We reached out to women in the target groups through a network of community agencies. Women attended group educational sessions co-led by peers who spoke their language. Access to screening was facilitated through group screening visits, a visit health bus and on-site Pap smears. Administrative data were used to compare screening after the education date for CARES participants with a control group matched for age, screening status and area of residence. (more…)
Author Interviews, Pediatrics, Weight Research / 01.02.2017

MedicalResearch.com Interview with: Melissa N. Poulsen, PhD, MPH Postdoctoral Fellow Johns Hopkins Bloomberg School of Public Health Geisinger Center for Health Research MedicalResearch.com: What is the background for this study? Response: Several past studies report positive associations between early childhood antibiotic use (particularly in the first year of life) and body mass index (BMI) later in childhood. Studies have also observed positive associations with prenatal antibiotic use and BMI, but without information on childhood antibiotics, such studies cannot rule out an underlying causal relationship between prenatal antibiotic exposure and early childhood antibiotic use. No study to date has concurrently evaluated prenatal and early childhood antibiotic exposure. We used mother-child linked electronic health record data to determine whether prenatal and childhood antibiotic use are independently associated with BMI at age 3 years. (more…)
Accidents & Violence, Annals Internal Medicine, Author Interviews / 01.02.2017

MedicalResearch.com Interview with: Joan A. Reid, Ph.D., LMHC Assistant Professor Criminology Program DAV 266 University of South Florida St. Petersburg MedicalResearch.com: What is the background for this study? What are the main findings? Response: Firearm-associated homicide and suicide are leading causes of death among American youth (i.e., 10-24 years old), with disproportionately high rates observed among male youth of color. Notably, gun violence and psychological problems are often conflated in public discourse regarding gun violence and prevention. However, few studies have assessed the impact of exposure to violence, either as a witness or a victim, when exploring the association between gun-carrying behavior and psychological distress. (more…)
Author Interviews, Genetic Research, Nature, Neurological Disorders / 31.01.2017

MedicalResearch.com Interview with: Keerthi Krishnan PhD Cold Spring Harbor Laboratory Cold Spring Harbor, New York 11724 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Rett Syndrome is diagnosed as a neurodevelopmental disorder in girls, caused mainly by mutations in the gene MECP2. Many previous studies, including mine, have shown that mutations in MECP2 result in improper communication between nerve cells in the brain during sensitive periods of development. However, it was unclear if the same mechanisms were responsible for cognitive and behavioral problems found in adulthood. In this paper, we have utilized a natural, learned response called pup retrieval behavior to study adult neural plasticity in a female mouse model of Rett Syndrome. With some learning, adult female mice will gather scattered pups to the nest, in response to distress calls from the pups. We found that the Rett Syndrome model mice with reduced MECP2 protein do not gather pups efficiently. This is due to the abnormal formation of structures called perineuronal nets on a specific type of neurons (called parvalbumin+ GABAergic neurons) that block plasticity and prevent learning of the appropriate response. Furthermore, the same neural and molecular mechanisms found earlier in development were also found to mediate learning in adulthood. (more…)
Author Interviews, Coffee, Nutrition, Weight Research / 31.01.2017

MedicalResearch.com Interview with: Ruopeng An, PhD Assistant Professor Department of Kinesiology and Community Health College of Applied Health Sciences University of Illinois at Urbana-Champaign Champaign, IL 61820 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Coffee and tea are among the most widely consumed beverages in U.S. adults.1,2 Unlike other popular beverages including alcohol and sugar-sweetened beverages that are typically consumed in isolation, many people prefer drinking coffee and tea with add-ins like sugar or cream. These add-in items are often dense in energy and fat but low in nutritional value. Drinking coffee and tea with add-ins on a regular basis might impact an individual’s daily energy/nutrient intake and diet quality.3 The 2015-2020 Dietary Guidelines for Americans suggests that “coffee, tea, and flavored waters also can be selected, but calories from cream, added sugars, and other additions should be accounted for within the eating pattern.”4 To our knowledge, no study has been conducted to assess consumption of coffee and tea with add-ins in relation to daily energy and nutrient intake at the population level. Bouchard et al. examined the association between coffee and tea consumption with add-ins and body weight status rather than energy/nutrient intake, and consumption was measured by a few frequency-related questions instead of a 24-hour dietary recall.5 The purpose of this study was to examine consumption of coffee and tea with add-ins (e.g., sugar, cream) in relation to energy, sugar, and fat intake among U.S. adults 18 years of age and above. Data came from 2001-2012 National Health and Nutrition Examination Survey (NHANES), comprising a nationally-representative (biennially) repeated cross-sectional sample of 13,185 and 6,215 adults who reported coffee and tea consumption in in-person 24-hour dietary recalls, respectively. (more…)
Author Interviews, Pediatrics, Psychological Science / 31.01.2017

MedicalResearch.com Interview with: Matthew Cassels PhD candidate, Developmental Psychiatry University of Cambridge Cambridge UK MedicalResearch.com: What is the background for this study? Response: Around 70% of UK families with young children own a pet. However, the impact of pets on children’s lives is understudied and poorly understood. Researchers in the field of Human-Animal Interaction have been working towards addressing this gap in our understanding by focusing on the role of pets in our lives. Compared to the owners of other pets, dog owners have been found to be more likely to derive a sense of safety, companionship, and security from their pets, and to perceive them as more responsive and affectionate. Factors that contribute to differences in the quality of human-animal relationships are of great interest because the magnitude of the benefits derived from these relationships is related to their quality. Pets may be especially significant to young people, aiding them in their social and emotional development, and serving as important substitutes for human attachment figures. Children consider their relationships with their pets as among their most important, report strong emotional bonds with their pets, spontaneously list pets when asked to name close friends and providers of social support, report turning to their pets when feeling sad, identify pets more often than humans as providers of comfort, and rely on their pets as playmates and confidants. (more…)
Author Interviews, Endocrinology, JAMA, Kidney Disease / 31.01.2017

MedicalResearch.com Interview with: Geoffrey A. Block, MD Director of Research at Denver Nephrology Denver, Colorado MedicalResearch.com: What is the background for this study? Response: Secondary hyperparathyroidism is a chronic and progressive disorder characterized by elevations in parathyroid hormone (PTH). It is seen in most patients with advanced chronic kidney disease and has been associated with a number of important adverse health effects such as bone pain, fracture, premature cardiovascular disease, abnormal heart enlargement, pathologic calcium accumulation in blood vessels and tissues and premature death. Currently there are several classes of drugs used to treat high PTH but each are associated with challenging side effects which limit their effectiveness. Active vitamin D compounds are effective in lowering PTH but do so at the expense of causing elevations in other minerals such as calcium and phosphorus which are felt to be harmful. An oral drug known as cinacalcet (Sensipar®) is in the class of medicine known as ‘calcimimetics’ and reduces PTH and simultaneously reduces calcium and phosphorus however it must be taken daily due to its short half-life and is commonly associated with nausea when first initiated or the dose is increased. Clinical trials with cinacalcet are suggestive though not conclusive of a beneficial effect on improving cardiovascular events and prolonging life. (more…)
Author Interviews, Heart Disease, NEJM, NIH, Pediatrics / 30.01.2017

MedicalResearch.com Interview with: Victoria Pemberton, RNC, MS, CCRC Program Officer Division of Cardiovascular Sciences National Heart, Lung, and Blood Institute, NIH Bethesda, Maryland MedicalResearch.com: What is the background for this study? What are the main findings?
  • Previous studies have examined cardiac arrest when it occurs outside of the hospital in both children and adults, with current guidelines recommending hypothermia (body cooling) or normothermia (maintenance of normal body temperature) after such an arrest.   This trial addresses pediatric cardiac arrest in a hospital setting, for which no previous data existed. Because children who experience an in-hospital cardiac arrest differ significantly from children who arrest outside of the hospital, it is important to test these treatments in this population.
  • The trial found no significant differences in survival and neurobehavioral functioning a year after cardiac arrest between children assigned to the hypothermia arm and those assigned to normothermia.
(more…)
Annals Internal Medicine, Author Interviews, Education, Electronic Records / 30.01.2017

MedicalResearch.com Interview with: Dresse Nathalie Wenger Cheffe de clinique FMH médecine interne Département de Médecine Interne CHUV - Lausanne  MedicalResearch.com: What is the background for this study? Response: The structure of a residents’ working day dramatically changed during the last decades (limitation of working hours per week, wide implementation of electronic medical records (EMR), and growing volume of clinical data and administrative tasks), especially in internal medicine with increasing complexity of patients. Electronic Medical Records (EMR) have some positive effects but negative effects have been also described ie more time writing notes, more administrative works, and less time for communication between physicians and patients. Few time motion studies have been published about the resident's working day in Internal Medicine: the impact of the computer, and what really do the residents do during their work, especially the time spent with the patient versus the computer, as now the EMRs are widely implemented. Previous studies have been mostly performed in the US, so we decided to conduct one observational and objective study in Europe. (more…)
Author Interviews, Cancer Research, Fertility, OBGYNE, Pediatrics / 30.01.2017

MedicalResearch.com Interview with: Tamar Wainstock, PhD Department of Public Health; Faculty of Health Sciences Ben-Gurion University of the Negev ISRAEL MedicalResearch.com: What is the background for this study? Response: There is a controversy in the medical literature regarding the possible association between infertility or infertility treatments, and the long-term offspring neoplasm risk: while some studies have found such an association, others have not. Since the number of offspring conceived following treatments are growing, and as they age, it is critical to clarify this possible association. (more…)
Author Interviews, Cancer Research, CT Scanning, JAMA, Lung Cancer / 30.01.2017

MedicalResearch.com Interview with: Linda Kinsinger, MD, MPH National Center for Health Promotion and Disease Prevention U.S. Department of Veterans Affairs NW Washington DC 20420 MedicalResearch.com: What is the background for this study?  Response: The U.S. Preventive Services Task Force recommends annual lung cancer screening with low-dose computed tomography (LDCT) for current and former heavy smokers ages 55 to 80. However, clinicians have questioned the practical aspects of implementing lung cancer screening. VA provides care for 6.7 million Veterans each year, mostly older men – many of whom are current or former smokers – thus the implementation of a lung cancer screening program for VA patients would require substantial resources. In order to understand the feasibility and implications of this for patients and clinical staff, VA implemented a three-year Lung Cancer Screening Demonstration Project (LCSDP) in eight geographically-diverse VA hospitals. Investigators identified 93,033 primary care patients at eight sites who were assessed on screening criteria, of whom 2,106 patients were screened between July 2013 and June 2015. (more…)
Author Interviews, Diabetes, Endocrinology, Heart Disease, Lipids, Pharmacology, Weight Research / 30.01.2017

MedicalResearch.com Interview with: Gianluca Iacobellis MD PhD Professor of Clinical Medicine Division of Endocrinology, Diabetes and Metabolism Department of Medicine University of Miami, FL MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that epicardial fat, the visceral fat of the heart, is associated with coronary artery disease, diabetes and obesity. My studies have shown that epicardial fat can be easily measured with non invasive imaging procedures. Remarkably, epicardial fat has recently emerged as therapeutic target responding to medications targeting the fat. Liraglutide, a GLP-1 analog has shown to provide modest weight loss and beneficial cardiovascular effects beyond its glucose lowering action. So , we sought to evaluate the effects of liraglutide on epicardial fat. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA / 30.01.2017

MedicalResearch.com Interview with: Dr. Hayley B. Gershengorn, MD Associate Professor of Clinical Medicine, Department of Medicine (Critical Care) Assistant Professor, The Saul R. Korey Department of Neurology Montefiore Medical Center Bronx, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: The patient-to-intensivist ratio across intensive care units is not standardized and whether the patient-to-intensivist ratio impacts patient outcome is not well established. I n this study, we conducted a retrospective cohort analysis including 49,686 adults across 94 United Kingdom intensive care units. In this setting, a patient-to-intensivist ratio of 7.5 was associated with the lowest risk adjusted hospital mortality, with higher mortality at both higher and lower patient-to-intensivist ratios. (more…)
Author Interviews, Education, Neurological Disorders, Neurology, University of Pittsburgh / 30.01.2017

MedicalResearch.com Interview with: Neil A. Busis, M.D. University of Pittsburgh Physicians Department of Neurology Chief of Neurology, UPMC Shadyside Director of Community Neurology MedicalResearch.com: What is the background for this study? Response: Previous studies showed that neurologists have both one of the highest rates of burnout and the lowest rates of satisfaction with work-life balance, compared to other physicians. The mission of the American Academy of Neurology (AAN) is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction. This is why AAN President Dr. Terrence Cascino initiated this research, to better define the issue. Our findings can guide current and future programs to prevent and mitigate neurologist burnout, promote neurologist career satisfaction and well-being, and direct efforts to advocate on behalf of neurologists and their patients. (more…)
Accidents & Violence, Addiction, Author Interviews, NIH, Opiods, Race/Ethnic Diversity / 27.01.2017

MedicalResearch.com Interview with: Dr Meredith S Shiels Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda, MD MedicalResearch.com: What is the background for this study? Response: In most high-income countries, premature death rates have been declining, due to the overwhelming successes of public health efforts to prevent and treat chronic disease. The US is a major outlier, where death rates overall have plateaued, or even increased, as reported recently by our sister agency, the Centers for Disease Control and Prevention. Of particular concern are recent reports of increasing death rates among Americans during mid-life. To expand upon prior findings, we focused on premature death, which we defined as death occurring between the ages of 25 and 64. We examined finely detailed death certificate data for the entire U.S. population and described changes in death rates during 1999-2014 by cause of death, sex, race, ethnicity, and geography. To provide context to our findings, we compared trends in death rates in the U.S. to England and Wales and Canada. (more…)
Author Interviews, Endocrinology, Pediatrics / 27.01.2017

MedicalResearch.com Interview with: Adda Grimberg, MD Associate Professor of Pediatrics, Perelman School of Medicine, University of Pennsylvania Scientific Director, Diagnostic and Research Growth Center The Children's Hospital of Philadelphia Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study sought to update the last guidelines for the use of growth hormone (GH) by the Drug and Therapeutics Committee of the Pediatric Endocrine Society (PES), published in 2003, and was the first to be endorsed also by the Ethics Committee of the PES. To facilitate evidence-based decision making, it was the first such GH guidelines to follow the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) group. Because idiopathic short stature (ISS) remains a controversial indication, and diagnostic challenges often blur the distinction between ISS, growth hormone deficiency (GHD), and primary insulin-like growth factor-I deficiency (PIGFD), this guidelines statement focused on these three diagnoses and added recombinant IGF-I therapy to the GH guidelines for the first time. (more…)
Author Interviews, Metabolic Syndrome, Psychological Science, University of Pennsylvania, Weight Research / 27.01.2017

MedicalResearch.com Interview with: Rebecca L. Pearl PhD Department of Psychiatry, Center for Weight and Eating Disorders Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania MedicalResearch.com: What is the background for this study?  Response: Weight bias is a pervasive form of prejudice that leads to weight-based discrimination, bullying, and the overall stigmatization of obesity. Some individuals with obesity may internalize weight bias by applying negative weight stereotypes to themselves and “self-stigmatizing.” Exposure to weight bias and stigma increases risk for poor obesity-related health (in part by increasing physiological stress), but little is known about the relationship between weight bias internalization and risk for cardiovascular and metabolic diseases. (more…)