Author Interviews, Heart Disease, JAMA / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29970" align="alignleft" width="200"]Vinay Kini, MD, MS Division of Cardiovascular Medicine Hospital of the University of Pennsylvania The Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia Dr. Vinay Kini[/caption] Vinay Kini, MD, MS Division of Cardiovascular Medicine Hospital of the University of Pennsylvania The Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent studies have shown that use of cardiac stress tests has declined by about 25% among Medicare beneficiaries and by about 50% in Kaiser Permanente over the last several years. However, the reasons for these declines is not well understood. Decreases in the use of stress testing could be due to dissemination of appropriate use criteria and other clinical practice guidelines, advances in preventive care, reductions in reimbursement for testing, or other health system organizational characteristics. Therefore, our goal was to determine whether similar declines in testing are observed among a nationally representative cohort of commercially insured patients. We identified over 2 million stress tests performed among 33 million members of the commercial insurance company, and found that there was a 3% increase in the overall use of stress testing in this cohort between 2005 and 2012. Declines in the use of nuclear SPECT tests were offset by increases in the use of stress echocardiography, exercise electrocardiography, and newer stress test modalities such as coronary computed tomography angiography. The largest increase in use of testing was seen among younger individuals - there was a 60% increase in use of testing among patients aged 25-34, and a 30% increase among individuals aged 35-44.
Author Interviews, BMJ, Pediatrics, Social Issues / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29918" align="alignleft" width="200"]Charles Opondo, BPharm MSc PhD. Researcher in Statistics and Epidemiology National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford Dr. Charles Opondo[/caption] Charles Opondo, BPharm MSc PhD. Researcher in Statistics and Epidemiology National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study measured fathers’ involvement in their child’s upbringing in infancy by looking at their emotional response to their child (e.g. feeling confident with the child, making a strong bond with the child), how involved they were in childcare (e.g. changing nappies, playing, night feeding, and also general care tasks around the house such as meal preparation) and their feelings of being a secure in their role as a parent (e.g. feeling included by mother in childcare, not feeling inexperienced with children). We found that the children of fathers who scored highly in terms of their emotional response and feeling like a secure parent were less likely to have symptoms of behavioural problems when they were 9 or 11 years. However, fathers being more involved in direct childcare did not seem to affect the child’s risk of having later behavioural problems.
Author Interviews, Cancer Research, Dermatology, JAMA, UCLA / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29923" align="alignleft" width="200"]Albert Yoon-Kyu Han, PhD Class of 2017 Medical Scientist Training Program David Geffen School of Medicine at UCLA Dr. Albert Han[/caption] Albert Yoon-Kyu Han, PhD Class of 2017 Medical Scientist Training Program David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Squamous cell carcinoma (SCC) of the lip makes up a large portion of oral cancers (25%). Most of the demographic and prognostic indicators for lip SCC are only available through retrospective case series. Thus, we used the national cancer database (Surveillance, Epidemiology, and End Results, or SEER) to examine the incidence, treatment, and survival of patients with lip SCC. The main findings of this study were that lip Squamous cell carcinoma predominantly affects white men in their mid-60s. We also found that the determinants of survival for lip SCC include age at diagnosis, primary site, T stage, and N stage. More specifically, on the primary site, SCC of the upper and lower lip had similar survival, whereas SCC of the oral commissure was associated with decreased survival.
Author Interviews, NEJM, Outcomes & Safety, Surgical Research / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29912" align="alignleft" width="200"]Alan Karthikesalingam MD PhD, NIHR Academic Clinical Lecturer in Vascular Surgery St George's Vascular Institute London, UK Dr. Alan Karthikesalingam[/caption] Alan Karthikesalingam MD PhD, NIHR Academic Clinical Lecturer in Vascular Surgery St George's Vascular Institute London, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study was that the typical diameter at abdominal aortic aneurysm (AAA)  repair, and the population incidence of AAA repair, have been known to vary considerably between different countries. This study aimed to observe whether a discrepancy in the population incidence rate of AAA repair between England and the USA was seen alongside a discrepancy in population rates of AAA-related mortality or AAA rupture in those countries.
Author Interviews, Cancer Research, Education, Surgical Research / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29908" align="alignleft" width="200"]Dr. Dmitri Alden MD, FACS Surgical Oncologist, specializes in liver cancer, bile duct cancer, metastatic ovarian cancer and pancreatic cancer at Lenox Hill Hospital, NY Dr. Alden is an advocate of the role of empathy in medicine Dr. Dmitri Alden[/caption] Dr. Dmitri Alden MD, FACS Surgical Oncologist, specializes in liver cancer, bile duct cancer, metastatic ovarian cancer and pancreatic cancer at Lenox Hill Hospital, NY Dr. Alden is an advocate of the role of empathy in medicine and discusses his passion for compassionate care in this interview. Please see his bio and website at http://www.liversurgeryny.com. MedicalResearch.com: Why do you feel that empathy is a vital part of treating a patient? Response: Over the last decade many physicians, patients and other professionals began to recognize that medical care is much more than treatment with medications or an act of surgery. Healing involves pain and suffering and dealing with psychological issues connected to the stress of being taken out of one’s normal life routine. Pain is now considered a “vital sign” and only recently it became mandatory to address it properly and document it in a medical record. Empathy in my opinion is a “vital sign” of any relationship that forms between a patient and a medical professional. When expressed genuinely, it makes a tremendous impact on patient’s overall experience and recovery. MedicalResearch.com: How do you define empathy in regards to medical treatment? Response: Empathy is understanding and true genuine caring. Patients and doctors create a unique and very personal relationship built on trust and “chemistry”. The doctor’s ability to express empathy, step in the patient’s shoes, get to know their life, loves, personal problems and to structure care around this unique individual enhances the patient’s belief in the route of treatment chosen and the doctor’s ability to provide a cure. MedicalResearch.com: Do you feel that the medical system doesn't emphasize empathy enough? Response: Doctors are trained without an emphasis on empathy. They focus on acquiring immense amounts of information that need to be learned during medical school and residency. Emotions are currently left to the side in order to succeed. The end product is often a machine that knows what to do in any medical situation but has difficulty to connect on an emotional level. I feel that empathy is also a very important step towards achieving successful outcomes because a patient will feel more invested in following the doctor's advice if he feels there is compassion and understanding.
ADHD, Author Interviews, JAMA, Neurological Disorders, NIH / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29904" align="alignleft" width="200"]Gustavo Sudre, PhD Section on Neurobehavioral Clinical Research, Social and Behavioral Research Branch National Human Genome Research Institute Bethesda, Maryland Dr. Gustavo Sudre[/caption] Gustavo Sudre, PhD Section on Neurobehavioral Clinical Research, Social and Behavioral Research Branch National Human Genome Research Institute Bethesda, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: ADHD is the most common childhood neuropsychiatric disorder, affecting 7-9% of school age children. It is highly heritable (h2=0.7), but few risk genes have been identified. In this study, we aimed to provide quantitative brain-based phenotypes to accelerate gene discovery and understanding. ADHD is increasingly viewed as resulting from anomalies of the brain’s connectome. The connectome is comprised of the structural connectome (white matter tracts joining different brain regions) and the functional connectome (networks of synchronized functional activity supporting cognition). Here, we identified features of the connectome that are both heritable and associated with ADHD symptoms.
Author Interviews, Dermatology, Infections / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29900" align="alignleft" width="160"]Adam Friedman, MD, FAAD Associate Professor of Dermatology Residency Program Director Director of Translational Research Department of Dermatology George Washington School of Medicine and Health Sciences Dr. Adam Friedman[/caption] Adam Friedman, MD, FAAD Associate Professor of Dermatology Residency Program Director Director of Translational Research Department of Dermatology George Washington School of Medicine and Health Sciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was developed out of a session I and my colleague, Neal Bhatia, held at the 2016 Orlando Dermatology Aesthetic and Clinical Conference. As an interactive session which had the audience answer whether they clinically thought an image was representative of a fungal skin infection or not, we collected audience responses and were impressed by how even dermatologists struggle with making this diagnosis clinically. This is not so surprising given the protean nature and diverse presentations of these infections, not to mention the many mimics which are not due to infection. Only one of the thirteen images shown was appropriately diagnosed by 90% of the audience. This highlights that the importance of using bedside diagnostic techniques such as KOH preps and culture to identify underlying cause in order to appropriately use the right therapy for the right condition.
Author Interviews, Blood Pressure - Hypertension, Bone Density, JAMA, Kaiser Permanente, Osteoporosis, Pharmacology / 22.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29895" align="alignleft" width="200"]Joshua I. Barzilay, MD Kaiser Permanente of Georgia Duluth, GA 30096 Dr. Joshua I. Barzilay[/caption] Joshua I. Barzilay, MD Kaiser Permanente of Georgia Duluth, GA 30096 MedicalResearch.com: What is the background for this study? Response: Hypertension (HTN) and osteoporosis (OP) are age-related disorders. Both increase rapidly in prevalence after age 65 years. Prior retrospective, post hoc studies have suggested that thiazide diuretics may decrease the risk of osteoporosis. These studies, by their nature, are open to bias. Moreover, these studies have not examined the effects of other anti HTN medications on osteoporosis. Here we used a prospective blood pressure study of ~5 years duration to examine the effects of a thiazide diuretic, a calcium channel blocker and an ACE inhibitor on hip and pelvic fractures. We chose these fractures since they are almost always associated with hospitalization and thus their occurrence can be verified. After the conclusion of the study we added another several years of follow up by querying medicare data sets for hip and pelvic fractures in those participants with medicare coverage after the study conclusion.
Author Interviews, Immunotherapy, Multiple Sclerosis / 22.11.2016

MedicalResearch.com Interview with Ralph Kern, M.D. Senior vice president, Worldwide Medical Biogen MedicalResearch.com: What is the background for this study? Response: Previously reported clinical trials of daclizumab demonstrated significant efficacy across clinical and MRI measures, compared to placebo and interferon beta-1a 30 mcg intramuscular (IM) injection, and established the therapy’s safety profile for up to two to three years. These trials were the basis for approval by health authorities in the United States, European Union and Australia. Daclizumab is a once-monthly, self-administered, subcutaneous therapy for relapsing forms of MS (RMS). At ECTRIMS we presented the first interim results from EXTEND, a long-term extension study. EXTEND is an ongoing multicenter, open-label study to evaluate the safety and efficacy of daclizumab treatment in more than 1,500 patients with RMS. This interim ECTRIMS analysis includes up to five years of data from patients who were previously enrolled in DECIDE. DECIDE was a Phase 3 study evaluating the effects of daclizumab relative to interferon beta-1a IM. In the new analysis, patients who were treated with interferon beta-1a IM for two to three years in DECIDE switched to daclizumab when they enrolled in EXTEND, and were compared to daclizumab patients treated continuously in both DECIDE and EXTEND.
Author Interviews, Johns Hopkins, Kidney Disease, Nutrition, Race/Ethnic Diversity / 21.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29753" align="alignleft" width="80"]Deidra C. Crews, MD, ScM, FASN, FACP Associate Professor of Medicine, Division of Nephrology Associate Vice Chair for Diversity and Inclusion, Department of Medicine Director, Doctoral Diversity Program Johns Hopkins University School of Medicine Baltimore MD 21224 Dr. Deidra Crews[/caption] Deidra C. Crews, MD, ScM, FASN, FACP Associate Professor of Medicine, Division of Nephrology Associate Vice Chair for Diversity and Inclusion, Department of Medicine Director, Doctoral Diversity Program Johns Hopkins University School of Medicine Baltimore MD 21224 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies suggest that dietary patterns influence risk of kidney function decline. Barriers may hinder urban African Americans' following healthful diets that could mitigate their increased risk of kidney function decline. In this study, we characterized contextual barriers to healthful eating among urban African Africans with hypertension and examined the association of these barriers to kidney function decline over 1 year. We examined the presence of healthy foods in neighborhood stores of study participants. We also assessed them for food insecurity (the inability to afford nutritionally adequate and safe foods), directly observed and documented the presence of fruits and vegetables in their homes, and examined their fruit and vegetable intake via questionnaire.
Author Interviews, JAMA, Neurological Disorders, Parkinson's / 21.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29406" align="alignleft" width="120"]Adolfo Ramirez Zamora, MD Associate Professor of Neurology and Phyllis E. Dake Endowed Chair in Movement Disorders Department of Neurology Albany Medical College Dr. Adolfo Ramirez Zamora[/caption] Adolfo Ramirez Zamora, MD Associate Professor of Neurology and Phyllis E. Dake Endowed Chair in Movement Disorders Department of Neurology Albany Medical College MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with SPG 11 mutations can present with motor symptoms characterized by juvenile onset dystonia, Parkinsonism and lower extremity spasticity. Parkinsonism appears to be responsive to levodopa therapy early in the disease but treatment is complicated by the occurrence of motor fluctuations resembling parkinson disease. Patients have short duration of medication effects, unpredictable response to medications along with generalized, excessive involuntary movements known as dyskinesias. Deep Brain stimulation is a well-established treatment for movement disorders but it has never been used in this disease. We first report the clinical outcome obtained with globus pallidus internal deep brain stimulation in a patient with parkinsonism, dystonia, dyskinesias related to SPG 11. Additionally, we report for the first time the basal ganglia changes observed in the disease using intraoperative neuronal recordings. Patient had a sustained and remarkable response to stimulation over the next two years without side effects. Neurophysiologic changes revealed a unique pattern of neuronal firing despite of the resemblance to advance Parkinsons disease.
Author Interviews, Kidney Disease, UCSF / 21.11.2016

Tanushree Banerjee, PhD Research Specialist in the Department of Medicine Division of General Internal Medicine UCSFMedicalResearch.com Interview with: Tanushree Banerjee, PhD Research Specialist in the Department of Medicine Division of General Internal Medicine UCSF MedicalResearch.com: What is the background for this study? Response: Acidosis is usually noted in advanced chronic kidney disease (CKD) while it is relatively unexplored whether changes in the undetermined anions, as measured by anion gap occur earlier in the course of CKD. Consumption of animal-sourced protein is acid-inducing and therefore such diet presumably increases undetermined anions. Since higher dietary acid load is associated with progression of CKD, we wanted to explore whether the increase in undetermined anions in moderate CKD is associated with CKD progression.
Author Interviews, Critical Care - Intensive Care - ICUs, Emergency Care, Heart Disease, Kidney Disease / 21.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29537" align="alignleft" width="144"]Paul E Ronksley, PhD Assistant Professor Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary Canada Dr. Paul E Ronksley[/caption] Paul E Ronksley, PhD Assistant Professor Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary Canada MedicalResearch.com: What is the background for this study? Response: Prior studies have observed high resource use among patients with chronic kidney disease (CKD), which is related to the medical complexity of this patient population. However, there has been limited exploration of how patients with CKD use the emergency department (ED) and whether utilization is associated with disease severity. While the ED is essential for providing urgent or emergent care, identifying ways of improving ED efficiency and decreasing wait times has been recognized as a priority in multiple countries. Improving coordination and management of care for patients with multiple chronic conditions (the norm for CKD) in an outpatient setting may meet health care needs and ultimately improve patient experience and outcomes while reducing the burden currently placed on the ED. However, this requires an understanding of ED use among patients with CKD and the proportion of use that is amenable to outpatient care. Using a large population-based cohort we explored how rates of ED use vary by kidney disease severity and the proportion of these events that are potentially preventable by high quality ambulatory care. We identified all adults (≥18 years) with eGFR<60 mL/min/1.73m2 (including dialysis-dependent patients) in Alberta, Canada between April 1, 2010 and March 31, 2011. Patients with CKD were linked to administrative data to capture clinical characteristics and frequency of ED encounters, and followed until death or end of study (March 31, 2013). Within each CKD category we calculated adjusted rates of overall  emergency departmentt use, as well as rates of potentially preventable ED encounters (defined by 4 CKD-specific ambulatory care sensitive conditions (ACSCs); heart failure, hyperkalemia, volume overload, malignant hypertension).
Author Interviews, BMJ, Fertility, OBGYNE / 21.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29707" align="alignleft" width="144"]David McLernon PhD MPhil BSc Research Fellow in Medical Statistics Medical Statistics Team Institute of Applied Health Sciences University of Aberdeen Foresterhill Aberdeen Dr. David McLernon[/caption] David McLernon PhD MPhil BSc Research Fellow in Medical Statistics Medical Statistics Team Institute of Applied Health Sciences University of Aberdeen Foresterhill Aberdeen MedicalResearch.com: What is the background for this study? Response: Normally when a couple attend a fertility clinic to begin IVF treatment they are only informed about their chances of having a baby for the first attempt of IVF. In actual fact the first treatment is often unsuccessful and many couples will go on to have several complete cycles of the treatment– each involving the transfer of one or two fresh embryos potentially followed by one or more frozen embryo transfers. We felt that a prediction model that could calculate the chances of having a baby over the complete package of treatment would provide better information for couples.
Author Interviews, Cost of Health Care, Kidney Disease / 21.11.2016

[caption id="attachment_16840" align="alignleft" width="124"]Csaba P Kovesdy MD Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program Division of Nephrology, University of Tennessee Health Science Center Nephrology Section Chief, Memphis VA Medical Center Memphis TN, 38163 Dr. Csaba P. Kovesdy[/caption] MedicalResearch.com Interview with: Dr. Csaba P. Kovesdy Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program Division of Nephrology, University of Tennessee Health Science Center Nephrology Section Chief, Memphis VA Medical Center Memphis TN, 38163 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many ESRD patients initiate dialysis in an inpatient setting. This practice is expensive, and carries potential risks (e.g. hospital associated infections, medication errors, etc.). There is very little information about the characteristics of patients who transition to ESRD (i.e. start dialysis) in an inpatient setting, and about their outcomes. We examined a cohort of >50,000 US veterans who started dialysis during 2007-2011, and found that about half of them performed their first treatment in an inpatient setting. Compared to patients starting dialysis as outpatients, those who transitioned in an inpatient setting had a significantly higher prevalence of comorbid conditions, and were much less likely to have received pre-dialysis nephrology care, or to have a mature AV fistula or AV graft at the first hemodialysis treatment. Mortality was significantly higher in the inpatient start group, but the differences were attenuated by adjustment for comorbid conditions and vascular access.
Author Interviews, Gender Differences, Heart Disease, Surgical Research / 21.11.2016

MedicalResearch.com Interview with: Dr James Spratt Bsc, MD, FRCP, FESC, FACC Spire Edinburgh Hospitals and Spire Murrayfield Edinburgh Spire Shawfair Park Hospital MedicalResearch.com: What is the background for this study? Response: Gender differences exist between male and female patients following routine PCI but data regarding these differences in Chronic Total Occlusions (CTO) Percutaneous Coronary Intervention (PCI) is limited. We maintain a dedicated national (United Kingdom) prospective CTO database contributed to by dedicated CTO PCI operators (lifetime CTO PCI >300). We retrospectively analysed this database from 2011-2015 to compare outcomes and characteristics of male versus female patients undergoing CTO PCI. We attempted to limit the bias of this observational study by propensity matched analysis.
Author Interviews, Herpes Viruses, Vaccine Studies / 21.11.2016

MedicalResearch.com Interview with: Elisabeth J. Cohen, MD NYU Langone Medical Center MedicalResearch.com Editor’s note: Elisabeth J. Cohen, MD, of NYU Langone Medical Center, will head a five year study to evaluate new treatment protocols for herpes zoster ophthalmicus (HZO). Herpes zoster ophthalmicus is a form of shingles that can cause prolonged pain and permanently damage the eye. Dr Cohen and NYU have received a grant from the National Institutes of Health to investigate the longer-term use of suppressive antiviral medication to reduce complications of HZO, MedicalResearch.com: What is the background for this study? Can you tell us a little about herpes zoster/shingles? Response: The rationale for the study is two-fold: First: the accumulating evidence that zoster is followed by chronic active infection caused by the varicella zoster virus (VZV) that contributes to complications including vision threatening eye disease and life threatening stroke. Second: the proven efficacy of suppressive antiviral treatment in reducing recurrent herpes simplex virus eye disease, caused by a different herpes virus, but with similar disease manifestations. Zoster/shingles is caused by localized, unilateral reactivation of varicella zoster virus (VZV) in people who have had varicella/chicken pox resulting in a painful blistering rash that can be followed by chronic pain/postherpetic neuralgia. There are over one million new cases of zoster per year, and the incidence has increased over the past 6 decades for unknown reasons. Although the rate of zoster increases with age, the largest number of cases occur in people in their fifties.
Author Interviews, Gastrointestinal Disease, Microbiome, Nutrition / 21.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29871" align="alignleft" width="200"]Mahesh Desai, PhD Principal Investigator Allergology - Immunology - Inflammation Research Unit Department of Infection and Immunity Luxembourg Institute of Health Luxembourg Dr. Mahesh Desai[/caption] MedicalResearch.com: What is the background for this study? Response: Over the last few decades, our intake of dietary fiber has fallen drastically mainly due to the consumption of processed food, which has been connected to increased cases of intestinal diseases including colon cancer and inflammatory bowel disease. The gut microbiota is essential for us as it allows our body to digest dietary fiber contained in fruits and vegetables, that could otherwise not be processed. Changed physiologies and abundances of the gut microbiota following a fiber-deprived diet have been commonly linked to several intestinal diseases. However, the mechanisms behind these connections have remained poorly understood.
Author Interviews, Heart Disease, JAMA / 21.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29860" align="alignleft" width="200"]Dr. Doug Owens MD former USPSTF Task Force member Professor at Stanford University Henry J. Kaiser, Jr. Professor Director of the Center for Health Policy Freeman Spogli Institute for International Studies Center for Primary Care and Outcomes Research Department of Medicine and School of Medicine Stanford Dr. Doug Owens[/caption] Dr. Doug Owens MD former USPSTF Task Force member Professor at Stanford University Henry J. Kaiser, Jr. Professor Director of the Center for Health Policy Freeman Spogli Institute for International Studies Center for Primary Care and Outcomes Research Department of Medicine and School of Medicine Stanford MedicalResearch.com: What is the background for review and statement? Response: Cardiovascular disease is serious—it can lead to heart attacks and strokes, and is responsible for one in every three adult deaths in the U.S. People with no signs or symptoms and no past history of cardiovascular disease can still be at risk. Fortunately, some people can benefit from taking a medication called statins to reduce that risk.
Author Interviews, C. difficile / 21.11.2016

MedicalResearch.com Interview with: Yvette van Beurden PhD student Gastroenterology & Hepatology / Medical Microbiology & Infection Control VU University medical center Amsterdam, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of fecal microbiota transfer (FMT), which is defined as the transfer of intestinal microbiota from healthy donors to patients, has gained momentum across the globe, since it was established as a highly effective method for treatment of recurrent Clostridium difficile infection (CDI), with cure rates around 85%. However, worldwide implementation of FMT is currently limited by a lack of uniform guidelines, concerns about safety, and remaining uncertainty of long-term side effects. In our study, we reported the long-term follow up of patients treated with FMT for recurrent CDI. With a primary cure rate of 82%, our study supports the currently available evidence that fecal microbiota transfer is a very effective treatment for recurrent CDI. Importantly, a first post-FMT recurrence of CDI can be successfully treated with antibiotics.
Author Interviews, CDC, Pediatrics, Weight Research / 21.11.2016

MedicalResearch.com Interview with: Liping Pan, MD MPH Centers for Disease Control and Prevention Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: This CDC report is the first to use the WIC Participant Characteristic (WIC PC) data from the USDA to monitor trends in obesity among young children aged 2 to 4 years in the WIC program. The main findings of the study are: • 34 of 56 (61%) WIC state agencies reported modest decreases in obesity among young children from 2010 to 2014. • From 2000 to 2010, the prevalence of obesity among 2-4 year olds increased from 14.0% to 15.9%, then dropped to 14.5% from 2010 to 2014. • Obesity prevalence varied by state, ranging from 8.2 percent in Utah to 20.0 percent in Virginia. • From 2010 to 2014, obesity prevalence decreased among all major racial/ethnic groups, including non-Hispanic whites, non-Hispanic blacks, Hispanics, American Indians/Alaska Natives, and Asians/Pacific Islanders. • From 2000 to 2014, obesity prevalence decreased significantly among Asian/Pacific Islanders, from 13.9 percent to 11.1 percent.
Author Interviews, Technology / 21.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29851" align="alignleft" width="300"]YuHao Liu (Howard) Materials Research Laboratory University of Illinois, Urbana Champaign Tiny Skin Sensor Can Monitor Body Sounds[/caption] YuHao Liu (Howard) Materials Research Laboratory University of Illinois Urbana Champaign MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our research group has been working on developing the next-generation wearable technology - integrating electronic tattoos on human skin for healthcare monitoring. This novel platform allows us to explore new sensors and actuators that are better than the commercially available ones. We have developed sensors that can measure temperature, pressure, hydration, electrophysiology..etc. However, no one ever think about capturing sound from the body until our team developed this new technology. In fact, body sounds can be important indicator in healthcare monitoring or even disease diagnostic.
Author Interviews, Colon Cancer, Gout, NYU/NYMC, Rheumatology / 20.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29599" align="alignleft" width="150"]Michael Pillinger, MD Professor of Medicine and Biochemistry and Molecular Pharmacology NYU School of Medicine Dr. Michael Pillinger[/caption] Michael Pillinger, MD Professor of Medicine and Biochemistry and Molecular Pharmacology NYU School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: We are interested in the co-morbidities of gout and the fact that gout is accompanied by multiple cardiovascular, renal and other events. The implications of gout for cancer are less clear, but the basic biology suggests that either: 1) the acute and chronic inflammation of gout could contribute to a pro-cancer environment; 2) the anti-oxidant effects of urate could have anti-cancer properties; 3) the ability of uric acid to serve as a "danger signal" released from dying cells (potentially including cancer cells" could promote anti-cancer immunity. The clinical literature is murky at best.
Author Interviews, Autism, JAMA, Pediatrics / 20.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29602" align="alignleft" width="193"]Dr. Melanie Penner, MD FRCP (C) Clinician investigator and developmental pediatrician Holland Bloorview Kids Rehabilitation Hospital Dr. Melanie Penner[/caption] Dr. Melanie Penner, MD FRCP (C) Clinician investigator and developmental pediatrician Holland Bloorview Kids Rehabilitation Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have shown that accessing intensive behavioral intervention (IBI) services at younger ages is associated with improved outcomes for children with autism spectrum disorder (ASD). In Ontario, Canada, children wait years to access publicly-funded IBI. This analysis estimated costs and projected adult independence for three IBI wait time scenarios: the current wait time, a wait time reduced by half, and an eliminated wait time. The model inputs came from published literature. The main findings showed that eliminating the wait time generated the most independence and cost the least amount of money to both the government and society. With no wait time for intensive behavioral intervention, the government would save $53,000 (2015 Canadian dollars per person) with autism spectrum disorder over their lifetime, and society would save $267,000 (2015 Canadian dollars).
Author Interviews, Heart Disease, Menopause, Weight Research, Women's Heart Health / 20.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29651" align="alignleft" width="195"]Somwail Rasla, MD Internal Medicine Resident Memorial Hospital of Rhode Island Brown University Dr. Somwail Rasla[/caption] Somwail Rasla, MD Internal Medicine Resident Memorial Hospital of Rhode Island Brown University MedicalResearch.com: What is the background for this study? Response: Weight cycling has been studied as a possible risk factors for all-cause mortality and was found to be insignificant in some studies and significant in other studies when adjusted to age and timing of when the weight cycling occurred. It was proposed that weight cycling may increase risk of chronic inflammation by which weight cycling was considered to be a risk factor for increased morbidity and all cause mortalities. Other studies have reported that frequent weight cycling was associated with shorter telomere length, which is a risk factor for several comorbidities including CHD. Earlier studies showed that weight cycling has an association with increase in size of adipocytes as well as fluctuation of serum cholesterol, triglycerides, glucose, insulin, and glucagon which may contribute to the increased incidence of diabetes. Alternatively, in the nurses’ health study , weight cycling was not predictive of cardiovascular or total mortality.
Author Interviews, Brigham & Women's - Harvard, Kidney Disease, Nutrition / 20.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29645" align="alignleft" width="197"]Dr. Teodor G. Paunescu PhD Assistant Professor of Medicine Harvard Medical School Boston Dr. Teodor G. Paunescu[/caption] Dr. Teodor G. Paunescu PhD Assistant Professor of Medicine Harvard Medical School Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with kidney disease frequently report food aversion and poor dietary intake leading to malnutrition, a complication associated with high morbidity and mortality. However, there are no effective treatments currently available to address this complication, and the mechanisms underlying anorexia and food aversion in these patients remain unclear. Because of the critical role of olfaction in flavor appreciation and dietary intake, we decided to quantify olfactory (smelling) deficits in advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. We found that patients with kidney disease have significant olfactory deficits that need objective assessments for accurate characterization. Our results also indicate that olfactory deficits likely attribute to nutritional impairment in patients with kidney disease.
Author Interviews, Brigham & Women's - Harvard, Kidney Disease, Stem Cells / 20.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29634" align="alignleft" width="200"]Ryuji Morizane M.D. Ph.D. Associate Biologist, Renal Division, Brigham and Women’s Hospital Affiliated Faculty, Harvard Stem Cell Institute Instructor, Harvard Medical School Dr. Ryuji Morizane[/caption] Dr. Ryuji Morizane MD, PhD Associate Biologist, Renal Division Brigham and Women’s Hospital Affiliated Faculty, Harvard Stem Cell Institute Instructor, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Polycystic kidney disease (PKD) accounts for 10% of end-stage kidney disease (ESKD), and there is currently no curable treatment available for patients with PKD. The adult onset form of PKD, the most common type of PKD, takes 30 years to form cysts in humans; therefore, it is difficult to study mechanisms of PKD to find novel therapeutics for patients.
Author Interviews, Pediatrics, Toxin Research / 20.11.2016

MedicalResearch.com Interview with: Toby Litovitz, MD Executive & Medical Director, National Capital Poison Center Professor of Emergency Medicine, Georgetown University Clinical Professor of Emergency Medicine The George Washington University Washington DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the past decade, a dramatic and persistent rise in the severity of swallowed batteries has been attributed to increased use of 20 mm diameter lithium coin cell batteries. With its larger diameter compared to traditional button cells, these cells get stuck in the esophagus of small children. There the greater voltage (3 V for lithium coin cells rather than 1.5 V for traditional button batteries), causes these cells to rapidly generate an external current that hydrolyzes tissue fluids, generating hydroxide and causing severe burns, injury and even death. Severe or fatal complications include perforations of the esophagus, tracheoesophageal fistulas, recurrent laryngeal nerve damage leading to vocal cord paralysis, spondylodiscitis, strictures and aortoesophageal fistulas – the latter nearly always fatal.
Author Interviews, Endocrinology, Hormone Therapy, JCEM, Menopause, Osteoporosis / 20.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29927" align="alignleft" width="131"]Dr Georgios Papadakis FMH, Médecin InternenMédecin assistant Service d'endocrinologie, diabétologie et métabolisme Lausanne Dr Georgios Papadakis[/caption] Dr Georgios Papadakis FMH, Médecin InternenMédecin assistant Service d'endocrinologie, diabétologie et métabolisme Lausanne MedicalResearch.com: What is the background for this study? Response: This study was mainly motivated by the absence of available data on the effect of menopausal hormone therapy (MHT) on bone microarchitecture, as well as contradictory results of previous trials regarding the persistence of a residual effect after MHT withdrawal. We performed a cross-sectional analysis of 1279 postmenopausal women aged 50-80 years participating in OsteoLaus cohort of Lausanne University Hospital. Participants had bone mineral density (BMD) measurement by dual X-ray absorptiometry (DXA) at lumbar spine, femoral neck and total hip, as well as assessment of trabecular bone score (TBS), a textural index that evaluates pixel grey-level variations in the lumbar spine DXA image, providing an indirect index of trabecular microarchitecture.
AHRQ, Author Interviews, Cost of Health Care, OBGYNE, Surgical Research / 20.11.2016

MedicalResearch.com Interview with: Kamila Mistry, PhD MPH AHRQ MedicalResearch.com: What is the background for this study? Response: Although the overall cesarean section (C-section) rate in the United States has declined slightly in recent years, nearly a third of all births continue to be delivered by C-section—higher than in many other industrialized countries. A number of medical as well as nonmedical factors may contribute to high C-section rates. C-section is the most common surgical procedure performed in the United States. This operation carries additional risks compared with vaginal delivery, such as infection and postoperative pain. A C-section also may make it more difficult for the mother to establish breastfeeding and may complicate subsequent pregnancies. Consensus guidelines from the American Congress of Obstetricians and Gynecologists and other national efforts to improve perinatal care have shown promise in reducing nonmedically indicated C-sections. However, recent research has found wide variation in hospital C-section rates even for low-risk deliveries.