Author Interviews, Genetic Research, Heart Disease, JACC / 20.09.2016

MedicalResearch.com Interview with: Prof. dr. P. van der Harst Interventional Cardiologist Scientific Director Cardiac Catheterization Laboratory University Medical Center Groningen Groningen The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The electrocardiogram harbors important clues for the development and progression of heart diseases. We studied the voltages of the QRS-complex, a measure of cardiac hypertrophy which is associated with heart failure and various cardiomyopathies. We carried out a genome-wide association study (GWAS) and identified 52 regions in the genome that were associated with one or more QRS characteristics. 32 of these were novel. In these 52 regions we found 67 candidate genes that are might play a role in the adequate function of the human heart and the development of heart disease. (more…)
Author Interviews, NYU, Transplantation / 20.09.2016

MedicalResearch.com Interview with: Ariane K. Lewis, MD Division of Neurocritical Care Departments of Neurology and Neurosurgery NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Death by neurologic criteria (DNC, also known as brain death) is widely accepted by physicians, lawyers, and ethicists as being equivalent to cardiopulmonary death. Declaration of DNC is based on strict criteria written by the American Academy of Neurology in 1995 that require: • Identification of a definitive etiology for catastrophic brain injury; • Confirmation that prerequisite conditions are met (normal blood pressure and temperature, exclusion of complicating factors such as medications or laboratory abnormalities that could impact the exam); and • Demonstration that a patient is comatose, lacks brainstem reflexes, and is incapable of breathing spontaneously. If a portion of the examination cannot be performed, an ancillary test such as an electroencephalogram or angiogram is used to confirm lack of brain activity or blood flow to the brain. If a patient is pronounced dead by neurologic criteria, organ support is discontinued unless organ donation is planned. An independent representative from an organ donation team approaches families to discuss donation, and if families agree to donation, organs are given to patients on the 120,000 person waitlist in the United States based upon need. (more…)
Author Interviews, Blood Pressure - Hypertension, CDC, Compliance, Race/Ethnic Diversity / 19.09.2016

MedicalResearch.com Interview with: Matthew Ritchey, DPT, PT, OCS, MPH Epidemiologist Division for Heart Disease and Stroke Prevention National Center for Chronic Disease Prevention and Health Promotion MedicalResearch.com: What is the background for this study? Response: High blood pressure is a leading cause of heart disease, stroke, kidney disease and death. Unfortunately, almost one in three U.S. adults (around 75 million) has high blood pressure, and nearly half of that group (about 34 million) doesn’t have it under control. As part of CDC’s ongoing efforts to monitor trends and risk factors contributing to cardiovascular disease, we collaborated with colleagues at the Centers for Medicare and Medicaid Services to look at blood pressure medicine nonadherence among Medicare Part D enrollees ages 65 and over. Being nonadherent means that patients skip doses of their medicine or stop taking it altogether. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JACC, Kidney Disease / 19.09.2016

MedicalResearch.com Interview with: Elvira Gosmanova MD Department of Nephrology University of Tennessee Health Science Center Memphis TN, 38163 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been long known that elevated blood pressure is a risk factor for numerous adverse health-related outcomes. However, the majority of individuals do not have blood pressure in a constant range. In contrary, blood pressure measured in the same individual tends to fluctuate over time. Moreover, some individuals have more blood pressure fluctuation, as compared with others. The impact of fluctuation in blood pressure is still poorly understood. Smaller studies suggested that increased fluctuation in blood pressure may be associated with hazardous health outcomes. However, large scale studies were still lacking. Therefore, we conducted a study involving close to 3 million US veterans to investigate the association of increased visit-to-visit variability of systolic blood pressure (which was our measure of fluctuation of blood pressure over time) and all-cause mortality, and incident coronary heart disease, stroke, and end-stage renal disease. We found that there was strong and graded increase in the risk of all the above outcomes with increasing visit-to-visit variability of systolic blood pressure. (more…)
Author Interviews, BMJ, Genetic Research, Weight Research / 19.09.2016

MedicalResearch.com Interview with: Prof. John C. Mathers Director, Human Nutrition Research Centre Institute of Cellular Medicine and Newcastle University Institute for Ageing Newcastle University Biomedical Research Building Campus for Ageing and Vitality Newcastle on Tyne MedicalResearch.com: What is the background for this study? Response: More than 90 different genetics variants are associated with body fatness and, of these, the FTO gene has the biggest effect. People who are homozygous for the unusual variant of FTO i.e. carry two copies of the risk allele, are on average 3kg heavier than those not carrying the risk allele. In addition, they have 70% greater risk of being obese. Since the FTO gene is associated with being heavier, we wondered whether it made it more difficult for people to lose weight. (more…)
Accidents & Violence, Author Interviews, NIH, OBGYNE / 19.09.2016

MedicalResearch.com Interview with: Pauline Mendola, PhD Investigator, Epidemiology Branch Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH Bethesda, MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Efforts to monitor and reduce maternal mortality during and around the time of pregnancy largely focus on causes physiologically related to the pregnancy, despite the fact that increasing evidence suggests violent death – including homicide and suicide – are leading causes. In this study, we analyzed US death certificates from 2005-2010 from states that include pregnancy information on the death record in order to estimate rates of pregnancy-associated homicide and suicide, and to determine if risk of violent death was increased for women during pregnancy and postpartum. Given the large proportion of death records with unknown pregnancy status, we adjusted for a range of possible misclassification and found that pregnancy-associated homicide risk ranged from 2.2-6.2 per 100,000 live births, while pregnancy-associated suicide risk ranged from 1.6-4.5 per 100,000 live births. Overall, homicide risk was 1.8 times higher among pregnant/postpartum women compared to non-pregnant women in the population. The risk of suicide was 38% lower among pregnant/postpartum women than the general population. (more…)
Author Interviews, Brain Cancer - Brain Tumors, Case Western, MRI, Radiology, Technology / 19.09.2016

MedicalResearch.com Interview with: Dr. Pallavi Tiwari PhD Assistant Professor biomedical engineering Case Western Reserve University MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the biggest challenges in neuro-oncology currently is distinguishing radionecrosis, a side-effect of aggressive radiation, from tumor recurrence on imaging. Surgical intervention is the only means of definitive diagnosis, but suffers from considerable morbidity and mortality. The treatments for radionecrosis and cancer recurrence are very different. Early identification of the two conditions can help speed prognosis, therapy, and improve patient outcomes. The purpose of this feasibility study was to evaluate the role of machine learning algorithms along with computer extracted texture features, also known as radiomic features, in distinguishing radionecrosis and tumor recurrence on routine MRI scans (T1w, T2w, FLAIR). The radiomic algorithms were trained on 43 studies from our local collaborating institution - University Hospitals Case Medical Center, and tested on 15 studies at a collaborating institution, University of Texas Southwest Medical Center. We further compared the performance of the radiomic techniques with two expert readers. Our results demonstrated that radiomic features can identify subtle differences in quantitative measurements of tumor heterogeneity on routine MRIs, that are not visually appreciable to human readers. Of the 15 test studies, the radiomics algorithm could identify 12 of 15 correctly, while expert 1 could identify 7 of 15, and expert 2, 8 of 15. (more…)
Author Interviews, Frailty, Geriatrics, Lancet, Technology / 19.09.2016

MedicalResearch.com Interview with: Anat Mirelman, PhD Director- Laboratory of Early Markers of Neurodegeneration (LEMON) Center for the study of Movement , Cognition and Mobility (CMCM) Department of Neurology Tel Aviv Sourasky Medical Center Sackler School of Medicine, Tel Aviv University Tel Aviv 64239, Israel MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main aim of this research was to evaluate the efficacy of using a motor cognitive training using virtual reality in reducing fall frequency and fall risk in older adults. Falls are a leading cause of morbidity and mortality in older adults. The prevalence of falls is huge, with one out of every 3 adults aged 65 years or older will fall at least once per year, with approximately half of these fallers suffering multiple falls in this period . These statistics are even higher in neurodegenerative conditions such as in Parkinson’s disease and in people with cognitive impairments. For example, studies have shown that as much as 80% of people with Parkinson’s disease fall each year. So many older adults are falling. The consequences of falls are huge. The most dramatic result is hip fracture. But this is relatively rare. However, even in the absence of a fracture or other injury, falls often lead to fear of falling, social isolation, and depression, which in turn often leads to inactivity, muscle weakness, impaired balance and gait, more falls, more social isolation. In other words, falls often start a vicious cycle, which has many important negative health consequences. Falls are associated with morbidity and mortality and they also have a huge economic impact. In many western countries, 1-2% of healthcare dollars are spent on falls. For many years, age-associated changes in muscle strength, balance and gait were viewed as the key factors that contribute to the risk of falls. However, more recently, we and others showed that certain aspects of cognition are also critical to safe ambulation. For example people with AD often fall, almost to the same amount as people with PD, highlighting the cognitive component of falls. This makes sense intuitively if we Imagine the cognitive skills we need just to cross a busy intersection. These tasks require executive function, specially, planning, the ability to avoid obstacles, and the ability to perform two or more tasks at the same time. (more…)
Author Interviews, CDC, Infections, Outcomes & Safety / 19.09.2016

MedicalResearch.com Interview with: James Baggs, PhD Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? What are the main findings? Response: We used medical claims data to estimate the amount of antibiotics used in US hospitals from 2006 - 2012. Data came from the Truven Health MarketScan Hospital Drug Database, which included about 300 hospitals and more than 34 million discharges. Antibiotic use in hospitals was very common with more than half of patients receiving at least one antibiotic during their hospital stay. Overall rates of antibiotic use in U.S. hospitals did not change over time; however, there were significant changes in the types of antibiotics prescribed. Importantly, the types of antibiotics with the largest increases in use were the types of antibiotics often considered to be the most powerful. Of particular concern, there was a 37% rise in the use of carbapenems, commonly referred to as “last resort” antibiotics. (more…)
Author Interviews, Memory, Scripps / 19.09.2016

MedicalResearch.com Interview with: Ron L. Davis, PhD Professor and Chair Department of Neuroscience Florida campus of The Scripps Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: While calcium’s importance for our bones and teeth is well known, its role in neurons—in particular, its effects on processes such as learning and memory—has been less well defined. Our new study, published in the journal Cell Reports, offers new insights how calcium in mitochondria—the powerhouse of all cells—can impact the development of the brain and adult cognition. Specifically, we show in fruit flies, a widely used model system, that blocking a channel that brings calcium to the mitochondria called “mitochondrial calcium uniporter” causes memory impairment but does not alter learning capacity. That surprised us – we thought they wouldn’t be able to learn at all. This is important because defects in the same calcium channel function have been shown to be associated with intellectual disability in humans. (more…)
Author Interviews, Endocrinology, Prostate, Prostate Cancer, Testosterone, Urology / 19.09.2016

MedicalResearch.com Interview with: Dr. Jesse Ory Department of Urology, Faculty of Medicine Dalhousie University, Halifax Nova Scotia, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of Testosterone Therapy (TT) in men diagnosed with and treated for prostate cancer (CaP) has been highly controversial for several decades. Unfortunately, this controversy is largely founded on the results of a single patient in a study by Huggins and Hodges in the 1940s [1]. This wasn't challenged until recently, when Morgentaler reviewed the literature on the topic and found no scientific basis for the assumption that TT will act like fuel on the fire of prostate cancer [2]. He also proposed a mechanism, the "saturation hypothesis" that helps account for why TT may in fact be safe for men with prostate cancer. [3]. Over the past decade, retrospective evidence has been accumulating that supports the safety of Testosterone Therapy in hypogonadal men with CaP on Active Surveillance, or in those who have been definitively treated for prostate cancer.. (more…)
Author Interviews, Nutrition, Ovarian Cancer, Race/Ethnic Diversity, Vitamin D / 19.09.2016

MedicalResearch.com Interview with: Bo (Bonnie) Qin, Ph.D. Post-Doctoral Associate Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903 MedicalResearch.com: What is the background for this study? Response: Ovarian cancer is the leading cause of death from gynecologic cancer in the US. African-American patients diagnosed with ovarian cancer tend to have a worse 5-year survival rate compared to their European-American patients. Therefore, identifying preventive factors in African-Americans women is particularly important. African Americans tend to consume less calcium and vitamin D from dietary sources, due to a higher prevalence of lactose intolerance, and supplemental intake. Meanwhile, darker color of the skin reduces the synthesis of vitamin D upon sun exposure. They together place African-American women at risk for calcium and vitamin D deficiency. It remains unknown whether calcium, vitamin D, lactose and dairy products are associated with ovarian cancer risk in African-American women and our study aimed to answer this question. (more…)
Author Interviews, Diabetes, Endocrinology, Hormone Therapy / 19.09.2016

MedicalResearch.com Interview with: Jon Rasmussen, MD, PhD fellow Department of Internal Medicine Herlev Hospital, Denmark MedicalResearch.com: What is the background for this study? Response: Abuse of anabolic androgenic steroids has become highly prevalent among young men involved in recreational strength training. A recent meta-analysis estimated that approximately 18% of young men involved recreational strength training abuse anabolic steroids. Well-known adverse effects following abuse of anabolic steroids include hypogonadism (For those who have interest, we have recently published a paper concerning this issue, it can be read and downloaded at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161208). Yet, we have a poor understanding on the adverse effects these compounds might have on the metabolism and insulin sensitivity. (more…)
Author Interviews, Diabetes, OBGYNE / 19.09.2016

MedicalResearch.com Interview with: Anastasia Katsarou PhD LUND University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study is using data from the Mamma study which screened pregnant women during 2003-2005. During this period, we gathered results from the oral glucose tolerance tests that the women underwent at the 28th week of pregnancy. We used data on the 2hour blood glucose levels from these tests and the frequency of women who were diagnosed with gestational diabetes and grouped them into months and seasons. We gathered also data on the mean monthly temperatures from the Swedish Meteorological and Hydrological Institute. We observed that the 2hour glucose levels and the frequency of women diagnosed with gestational diabetes were statistically significantly higher during the summer months. (more…)
Author Interviews, Biomarkers, Diabetes, Pancreatic / 19.09.2016

MedicalResearch.com Interview with: Dr. Pavel Škrha Charles University, Prague Czech Republic MedicalResearch.com: What is the background for this study? What are the main findings? Response: Incidence of pancreatic cancer (PAC) is still increasing. The main problem is in the late diagnosis of the cancer. It was found, that diabetes mellitus was much more frequent in the pancreatic cancer patients than in the general population. DM can be already the first symptom of the disease (secondry T3cDM). In our study nearly 80 % of all the pancreatic cancer patients had DM/prediabetes and it was of new-onset (less than 2 years before the cancer diagnosis) in 73 % out of them. We have measured the current marker of PAC (CA 19-9) together with serum microRNA-196 and -200 (that we have chosen in the previous pilot study). All the markers were significantly elevated in the pancreatic cancer patients, without any difference between the subgroups according to DM presence/absence. While the sensitivity of CA 19-9 alone (to detect the cancer) was 85 % (specificity 73 %), combining all the three markers improved it to 95 % (specificity 77 %). In the pancreatic cancer group, there were only six patients with T1 or T2 stage (others had an advanced stage of the disease - T3, T4). While CA 19-9 alone identified only 2 patients of them, the combined test identified all the six patients (data not shown in the poster). (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 19.09.2016

MedicalResearch.com Interview with: Nish Patel, MD and Nileshkumar J. Patel, MD University of Miami Miller School of Medicine MedicalResearch.com: What is the background for this study? Response: Out of hospital cardiac arrest (OHCA) is estimated to affect approximately 300,000 people in the United States annually. Pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) contributes 23-54% of OHCA patients, with the median values at the lower end of this range. Coronary artery disease is thought to be responsible for up to 70% of these OHCA cases. It has been suggested that urgent coronary intervention in unconscious patients after cardiac arrest may improve survival. In the 2015 American Heart Association (AHA) guidelines, coronary angiography is recommended in patients with OHCA patients with a suspected cardiac etiology and ST elevations (STE) on ECG (Class of recommendation I, Level of evidence B), and it should be considered in patients after cardiac arrest presenting without STE but with suspected cardiac etiology of cardiac arrest (Class of recommendation II a, Level of evidence B). However, there is paucity of information about the use of coronary angiography and percutaneous coronary intervention (PCI) and its potential benefit for the VT/VF OHCA patient population. Therefore, we reviewed the Nationwide Inpatient Sample (NIS), to examine temporal trends of coronary angiography and PCI in VT/VF OHCA in the United States, for patients with and without STE. We also studied the temporal trends of survival to discharge in these patient populations. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 19.09.2016

MedicalResearch.com Interview with: Islam Elgendy, MD Cardiology Fellow University of Florida MedicalResearch.com: What is the background for this study? What are the main findings? Response: The optimal systolic blood pressure target in adults with coronary artery disease is not well known. The Eighth Joint National Committee Panel recommended a target therapeutic goal <150 mm Hg for adults aged ≥60 years and <140 mm Hg in those aged <60 years. These recommendations are inconsistent with the different society guidelines (such as American Heart Association/American College of Cardiology, European Society of Cardiology, and American Society of Hypertension) which recommended a therapeutic target < 140 mm Hg. Given that the dyad of hypertension and coronary artery disease is the most prevalent chronic disease dyad among adults, we aimed to assess the long term risk of all-cause mortality with the different systolic blood pressure targets. Using the extended follow-up data from the US cohort of the INVEST trial, we demonstrated that achieving a systolic blood pressure of 130 to <140 mm Hg in the initial 2-3 years of treatment is associated with reduced all-cause mortality after ≈11.6 years of follow-up in hypertensive patients with coronary artery disease. (more…)
Author Interviews, Mayo Clinic, Nutrition, Pediatrics, Weight Research / 17.09.2016

MedicalResearch.com Interview with: David R. Jacobs, Jr., PhD Mayo Professor of Public Health Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN 55454-1075 MedicalResearch.com: What is the background for this study? Response: Project EAT (Eating and Activity in Teens and Young Adults) is on ongoing longitudinal study which began by screening middle and secondary school students in the Minneapolis and St Paul Metropolitan are. Students were the 11-18 years old (average age 15), then followed up at average ages 20 and 25. We had devised an eating pattern in about 2006, which a) predicts a lot of things in several different studies (including total mortality in the Iowa Women's Health Study) and b) looks a great deal like the recently released 2015 Dietary Guidelines for Americans (DGA). We call our diet pattern A Priori Diet Quality Score (APDQS) and think of it as close to or in the style of a Mediterranean/prudent/healthy diet. We hypothesized that this pattern would be associated with lower weight (in general with better long term health, but the focus in Project EAT was weight and BMI), probably least so at age 15. The minimal hypothesized effect in adolescence relates to the very large energy expenditure in adolescent growth years; we thought that diet composition would be less important for body weight at that time than energy intake (and APDQS is about diet composition). (more…)
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Endocrinology, Heart Disease, Thyroid Disease / 17.09.2016

MedicalResearch.com Interview with: Layal Chaker, MD, MSc PhD candidate Department of Endocrinology and Epidemiology Erasmus Medical Center Rotterdam, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of thyroid function with coronary heart disease is well–established but not much was known about the association of thyroid function with sudden cardiac death. We conducted the study with the hypothesis that thyroid hormone levels affect cardiovascular risk factors and therefore could also affect the risk of sudden cardiac death (SCD). We were surprised to see that when we control our analyses for these cardiovascular risk factors, the association of high and high-normal thyroid function with SCD remained similar, suggesting that other pathways could play a role. Thyroid hormone has different effects on the cardiovascular systems and future studies should identify which pathway could be responsible for the increased risk of sudden cardiac death with higher thyroid hormone levels. This could lead to better assessment of individual risk and identify possible prevention targets. (more…)
Author Interviews, Brigham & Women's - Harvard, Infections, JAMA, Ophthalmology / 17.09.2016

MedicalResearch.com Interview with: Dr. Daria Van Tyne, PhD The Gilmore Lab Department of Ophthalmology Harvard Medical School Massachusetts Eye and Ear Infirmary Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: A specific clone of E. coli, type ST131, which produces an extended-spectrum beta-lactamase (ESBL – an enzyme that inactivates many penicillin-type antibiotics), has rapidly spread around the globe to become the leading cause of multidrug-resistant, non-intestinal E. coli infection. Despite this, E. coli is a rare cause of infection of the cornea. A patient was recently seen at the Massachusetts Eye and Ear Infirmary with a severe E. coli infection of the cornea, and the large number of antibiotic resistances of this strain tipped us off to the possibility that it might be the highly virulent ST131 ESBL type. By sequencing the DNA of its genome, we found that it was indeed ST131 ESBL E. coli. Moreover, we discovered a new mutation in this strain that allows it to produce a slimy outer coating on its surface. This slime layer, or capsule, makes the bacteria more resistant to removal by phagocytic cells of the immune system. The slime layer also makes these particular colonies appear different on a special type of agar that contains the dye Congo Red. (more…)
Accidents & Violence, Author Interviews, Cannabis, Columbia, Opiods / 17.09.2016

MedicalResearch.com Interview with: June H. Kim Doctoral candidate,Department of Epidemiology Mailman School Public Health Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: A previous study indicated that states with medical marijuana laws had a reduced rate of opioid overdoses. If this is true, we'd expect to see similar reductions in opioid use associated with these laws. For this study, we used data from the FARS, a national surveillance system that records any crash events on US public roads that result in a fatality. Some states provide uniform testing of the majority of their deceased drivers, year to year. Among these states, we found that there was a lower prevalence of positive opioid toxicology tests among drivers crashing in states with an operational medical marijuana versus drivers crashing in states before a future medical marijuana law is implemented, particularly among drivers aged 21-40. (more…)
Author Interviews, Pediatrics, Social Issues, Toxin Research / 17.09.2016

MedicalResearch.com Interview with: Dr. Katherine Ahrens PhD Office of Population Affairs Rockville, MD 20852 MedicalResearch.com: What is the background for this study? Response: Lead exposure among children is linked to many adverse effects on health and cognitive development, which can be irreversible. The National Center for Health Statistics (NCHS) has linked 1999 to 2012 National Health and Nutrition Examination Survey (NHANES) data to administrative data for the Department of Housing and Urban Development’s (HUD) largest rental assistance programs (1999 through 2014), and these linked data allow calculation of the first-ever national blood lead level estimates among children living in HUD-assisted housing. Here we compare blood lead levels among children 1 to 5 years of age in 2005 to 2012 who received housing assistance during 1999 to 2014 with levels among children who did not receive housing assistance during that period. (more…)
Author Interviews, Cost of Health Care, OBGYNE, Outcomes & Safety, University Texas / 17.09.2016

MedicalResearch.com Interview with: Fangjian Guo, MD, PhD Assistant Professor BIRCWH Scholar Department of Obstetrics & Gynecology Center for Interdisciplinary Research in Women’s Health The University of Texas Medical Branch MedicalResearch.com: What is the background for this study? What are the main findings? Response: National guidelines consistently recommend against cervical cancer screening among women with a history of a total hysterectomy for a benign condition. These women are unlikely to develop high-grade cervical lesions. The goal of our study was to assess whether these guidelines are being followed. We examined the use of Pap testing among US adult women with a history of total hysterectomy for a benign condition and the roles of health care providers and patients in the initiation of Pap test use. We found that in 2013, 32% of women who have had a hysterectomy received an unnecessary recommendation for cervical cancer screening from a health care provider in the past year; 22.1% of women with hysterectomy received unnecessary Pap testing. Although the majority of Pap tests were performed at a clinician’s recommendation, approximately one fourth were initiated by patients without clinician recommendations. According to standard 2010 US Census population figures, about 4.9 million unnecessary Pap tests are performed annually among women who have had a total hysterectomy for a benign condition. At approximately $30 per test, $150 million in direct medical costs could be saved annually if screening guidelines were followed for these women. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 17.09.2016

MedicalResearch.com Interview with: Holly Mattix-Kramer, MD, MPH Public Health Sciences Medicine, Nephrology Associate Professor Loyola Medicine, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that the Systolic Blood Pressure Lowering Intervention Trial (SPRINT) showed that intensive systolic blood pressure lowering reduces all-cause mortality by 27% compared to standard blood pressure lowering among adults age 50 years and older without diabetes or stroke but with high cardiovascular disease risk. We applied these findings to the U.S. population and asked "What if intensive systolic blood pressure lowering were applied to the U.S. population who meet SPRINT eligibility criteria? We found that approximately 18.1 million U.S. adults meet SPRINT criteria and that their annual mortality rate is 2.2%. If intensive systolic blood pressure lowering reduces all-cause mortality by 27%, then the annual mortality rate would be reduced to 1.6% and approximately 107,500 deaths would be prevented each year. (more…)
Addiction, Alcohol, Author Interviews, Psychological Science / 16.09.2016

MedicalResearch.com Interview with: Kristina J. Berglund Department of Psychology University of Gothenburg MedicalResearch.com: What is the background for this study? What are the main findings? Response: In Sweden, care providers do offer different treatment strategies for individuals who have alcohol problems, where some offer a treatment where the goal is abstinence and other offer a treatment where the goal is low-risk consumption. We wanted to investigate how important it was for having a successful treatment when there was congruence between the patient’s goals and the advocated goal of the treatment, and when there was not. The main findings was that that if the patient had a goal of abstinence than it was much more likely to reach that goal if the patient went to a treatment that advocated abstinence. It was less likely to reach the goal if a patient had a goal of low-risk consumption and went to a treatment that advocated low-risk consumption. The treatment that advocated abstinence was also more effective when the patient were ambivalent of his/her own goal. (more…)
Author Interviews, Diabetes, Social Issues, Weight Research / 16.09.2016

MedicalResearch.com Interview with: Professor Timothy Frayling PhD Professor of Human Genetics University of Exeter Medical School Exeter, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that genes and environmental factors influence our Body mass index. We know less about if and how they interact. We wanted to answer the question of whether or not aspects of the environment and our lifestyles accentuate any genetic predisposition to obesity. The question is important as it may highlight aspects of the environment that cause some people to be particularly susceptible to gaining weight. Previous, separate, studies have suggested that specific aspects of the environment are to blame. These included sugary drinks, fried food and TV watching. (more…)
Author Interviews, Diabetes, Vitamin D / 16.09.2016

MedicalResearch.com Interview with: Dr. Elisa Benetti PhD Department of Drug Science and Technology University of Turin Turin, Italy MedicalResearch.com: What is the background for this study? Response: The idea for this study comes from the debate on the role of vitamin D supplementation in the prevention or progression of type 2 diabetes (T2DM). Epidemiological data point at a strong association between vitamin D deficiency and T2DM prevalence, however a causal relationship is still lacking. Here we wanted to explore the effect of vitamin D administration on insulin-sensitivity, particularly focusing on skeletal muscle, which is a crucial tissue in the maintenance of glucose homeostasis and which was suggested to be a tissue target of vitamin D. Using a murine model of insulin-resistance induced by a High Fat-High Sugar Diet (HFHS), we demonstrated that a vitamin D supplementation (7 μg•kg-1, i.p. three times/week) was able to revert the deleterious effects evoked by the diet, including the increase in body weight and in the HOMA-IR (a parameter of insulin resistance) and the glucose tolerance impairment. Consistently, at the muscle level, vitamin D increased the insulin sensitivity by reducing tissue inflammation and fat accumulation (myosteatosis). These effects are due, at least in part, to the inhibition exerted by vitamin D on carboxymethyl-lysine (CML) production, one of the main Advanced Glucose End-products (AGEs), and on its receptor RAGE. Collectively, our data indicate the ability of vitamin D to reduce the development of muscle insulin resistance, the primary defect in T2DM patients. (more…)
Author Interviews, Depression, Diabetes / 16.09.2016

MedicalResearch.com Interview with: Dr Cathy E. Lloyd Professor of Health Studies School of Health, Wellbeing and Social Care Faculty of Wellbeing, Education and Language Studies The Open University Milton Keynes UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know from earlier epidemiological research that people with diabetes have an increased risk of developing depression and other mental health problems compared to those without diabetes. However the impact of this and what treatment and care should be provided is still unclear, in particular in countries other than the US or the UK. Our study aims to redress that imbalance, collecting data on diabetes and depression in 16 countries across the globe. Ours is the first study to measure depressive symptoms but also use a standardised clinical interview to diagnose depression according to ICD criteria. Overall 10.6% received a diagnosis of Major Depressive Disorder (MDD), however prevalence rates differed widely between countries with 1% diagnosed with MDD in Uganda and nearly 30% in Bangladesh. Twenty-five percent reported subthreshold levels (PHQ-9 score 5 -9) of depression. Those with MDD were significantly more likely to be female and living in an urban rather than rural location (p<0.001). Age and duration of diabetes did not significantly differ between those with and without MDD. Multi-variable analyses demonstrated that while controlling for country, a diagnosis of MDD was significantly associated with female sex, lower education, taking insulin, less exercise, higher levels of diabetes-related distress and a previous diagnosis of MDD. A negligible proportion of those with either MDD or subthreshold levels of depression had a diagnosis or any treatment for their depression recorded in their medical records. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, Stanford / 16.09.2016

MedicalResearch.com Interview with: Ilana B. Richman, MD Palo Alto VA Health Care System, Palo Alto, California Center for Primary Care and Outcomes Research/Center for Health Policy Department of Medicine Stanford University School of Medicine Stanford, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: In November of 2015, researchers published results from the Systolic Blood Pressure Intervention Trial (SPRINT). This large, NIH-funded study compared a systolic blood pressure target of 120 mm Hg vs 140 mm Hg among hypertensive, nondiabetic patients at elevated risk for cardiovascular disease. SPRINT reported a 25% reduction in the rate of cardiovascular disease and death among those treated to a lower target. Those treated to a lower target blood pressure, though, experienced certain adverse events more frequently. Our cost effectiveness analysis asked two questions: given the potential risks and benefits described in SPRINT, does achieving a lower systolic blood pressure result in net benefit over the course of a lifetime? And if it does, how much would it cost, compared to standard treatment? We found that achieving a lower blood pressure target does result in a net benefit, with a gain of about 0.9 years of life (quality adjusted) among those treated to a lower target compared to those treated to a standard target. This gain, though, required some investment. We found that treating to a lower blood pressure target cost $23,777 per quality-adjusted life year gained. Compared to other commonly used interventions here in the US, this would be considered an excellent value. (more…)
Author Interviews, OBGYNE, Pediatrics, PLoS / 16.09.2016

MedicalResearch.com Interview with: Joseph Leigh Simpson, MD FACOG, FACMG President at International Federation of Fertility Societies March of Dimes Foundation White Plains, NY MedicalResearch.com: What is the background for this study? Response: Preterm birth (PTB) is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. A total of 1.1 million infants die each year. Preterm births and their complications are the leading cause of deaths in children under age 5. The biological basis of preterm birth remains poorly understood, and for that reason, preventive interventions are often empiric and have only limited benefit. Large differences exist in preterm birth rates across high income countries: 5.5 percent in Sweden and at present 9.6 percent in the U.S. The International Federation of Gynecologists and Obstetricians (FIGO)/March of Dimes Working Group on Preterm Birth Prevention hypothesized that identifying the risk factors underlying these wide variations could lead to interventions that reduce preterm birth in countries having high rates. (more…)