Author: Marie Benz MD FAAD
02 Sep Low Uptake of Medicare Obesity Counseling Benefit
MedicalResearch.com Interview with: [caption id="attachment_27587" align="alignleft" width="125"]
Dr. John Batsis[/caption]
John A. Batsis, MD, FACP, AGSF
Associate Professor of Medicine and The Dartmouth Institute
Geisel School of Medicine at Dartmouth
Section of General Internal Medicine - 3M
Dartmouth-Hitchcock Medical Center
Lebanon, NH
MedicalResearch.com: What is the background for this study?
Response: In 2011, the Centers for Medicare and Medicaid implemented a regulatory coverage benefit to cover 22 brief, targeted 15-minute counseling visits by clinicians over the course of a 12-month period for Medicare beneficiaries with a body mass index exceeding 30kg/m2. This was an important policy determination in tackling the obesity epidemic in the United States. An emphasis on the importance of counseling, or intensive behavioral therapy, in a primary care setting set the foundation for this benefit.
Yet, it was unclear how and if this benefit (which would be free of charge without a copay or deductible for beneficiaries) was being implemented in clinical care. We therefore identified fee-for-service Medicare claims for the years 2012 and 2013 to determine whether the G0477 code (Medicare Obesity benefit code) was billed. We additionally explored the rate of uptake of the Medicare benefit in relation to the prevalence of obesity using the 2012 Behavior Risk Factor Surveillance System data.
01 Sep Inflammatory Biomarkers May Presage Development of Alzheimer’s
MedicalResearch.com Interview with: [caption id="attachment_27583" align="alignleft" width="125"]
Prof. Paul Morgan[/caption]
Professor B. Paul Morgan
Director, Systems Immunity Research Institute
Institute of Infection and Immunity
School of Medicine
Cardiff University
MedicalResearch.com: What is the background for this study?
Response: Inflammation is a normal response of the body to infection or injury; however, it is well known that inflammation also has a dark side and when it escapes normal controls can cause disease. Some illnesses, like rheumatoid arthritis, have been known for many years to be caused by rogue inflammation and most of the drugs used to treat work by suppressing the inflammation (anti-inflammatories). More recently, it has become clear that inflammation is behind many other diseases that were previously thought of as diseases of ageing caused by wear and tear and lifestyle - these include heart disease and some brain diseases, notably Alzheimer's disease the commonest cause of dementia. Evidence that inflammation is one of the drivers of disease has come from many sources, including some where it was noticed that people on long-term anti-inflammatory drugs for other reasons appeared to be protected from developing Alzheimer's disease.
A problem is that Alzheimer's disease, despite the name, is not a single disease but rather a group of conditions with similar symptoms, and inflammation is likely to be a cause in only some of the patients; further, most of the inflammation might be occurring very early in the disease, even before symptoms are obvious. So, there is an urgent need for a simple test or set of tests that can be used in individuals with the very earliest hints of Alzheimer's disease - mild memory loss - that will pick out those who have brain inflammation and are most likely to develop Alzheimer's disease. It might then be possible to treat this select group with anti-inflammatory drugs that will reduce brain inflammation and slow or stop progression of the disease.
01 Sep Experimental Antibody Reduced Amyloid Plaques in Alzheimer’s
MedicalResearch.com Interview with: [caption id="attachment_27578" align="alignleft" width="100"]
Prof. Roger Nitsch[/caption]
Roger M. Nitsch, MD
Professor and Director
Institute for Regenerative Medicine · IREM
University of Zurich Campus Schlieren
Switzerland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The main finding is that treatment with aducanumab resulted in an unprecedented reduction of brain amyloid plaques in patients with Alzheimer's disease. The removal of amyloid from patients brains were both dose- and time-dependent. We also observed initial hints for stabilized brain functions in patients receiving aducanumab. In contrast, patients in the placebo group continued to declined as usual in this stage of Alzheimer's disease.
The main safety finding in 22% of all treated patients was ARIA - an Amyloid-Related Imaging Abnormality - suggestive of fluid shifts in the brains. In most cases, ARIA occurred in the absence of clinical signs and resolved spontaneously. In one third of the ARIA cases, patients experienced transient headaches. None of the patients had to hospitalized because of ARIA.
01 Sep Cancer Drug May Mitigate Compulsive Cocaine Memories
MedicalResearch.com Interview with: Dr Stefania Fasano Cardiff University MedicalResearch.com: What is the background for this study? Response: Exposure to drugs of abuse such as cocaine produces intense and long-lasting memories that are critical in the transition from recreational drug-taking to uncontrolled drug use. In the brain, addictive drugs usurp cellular circuits and signalling molecules involved in normal memory processes; hence, these drug-related memories resist extinction and contribute to high rates of relapse. Despite almost five decades of experimental research, there are currently no approved medications for cocaine dependence.01 Sep Breaking a Feedback Loop May Trigger Cell Death in Triple Negative Breast Cancer
MedicalResearch.com Interview with: [caption id="attachment_27570" align="alignleft" width="147"]
Dr. Jim Lambert[/caption]
James R. Lambert, PhD.
Department of Pathology
University of Colorado Anschutz Medical Campus
Aurora, CO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our laboratory has been investigating a novel small molecule drug, AMPI-109, as a targeted therapeutic agent for triple-negative breast cancer (TNBC). We demonstrated that AMPI-109 is a potent inducer of apoptosis in TNBC cells and that its cell killing activities are largely specific for the TNBC subtype of breast cancer. Through our efforts to identify the molecular mechanism of AMPI-109 action in TNBC cells we identified the oncogenic phosphatase, PRL-3 as a mediator of AMPI-109 action and as a potential direct target of the drug in TNBC cells.
Our studies have defined PRL-3 as an oncogenic driver of triple-negative breast cancer as exemplified by knocking down PRL-3 using shRNAs, or treating TNBC cells with AMPI-109, ultimately results in TNBC cell apoptosis. We thus became interested in elucidating the mechanisms whereby loss of PRL-3 expression, or function, results in cell death. During the course of these investigations we noted that at early times following PRL-3 knock down TNBC cells undergo a period of cell senescence followed by induction of apoptosis. This dynamic reprogramming of triple-negative breast cancer cell fate was determined to be mediated through signaling events mediated by an autocrine tumor necrosis factor receptor 1 (TNF-R1) feedback loop. TNF-R1, which binds the pro-inflammatory cytokine TNFα, is a widely studied mediator of both cell survival and cell death yet the precise molecular mechanism controlling this toggling effect of TNF-R1 on TNBC cells remained largely unknown.
In this report, we demonstrate that PRL-3 is transcriptionally regulated by the pro-inflammatory NF-ĸB pathway in triple-negative breast cancer cells, and that PRL-3 knock down elicits an autocrine TNF-R1 feedback loop that results in cell cycle arrest and senescence as a pre-determinant to engaging apoptosis of TNBC cells. These studies reveal a previously undescribed mechanism for how PRL-3 influences TNBC cell growth and further increase our understanding of the role of TNFα signaling in the disease.
01 Sep Digital Rectal Exam and PSA May Detect Distinct Subtypes of Prostate Cancer
MedicalResearch.com Interview with: [caption id="attachment_27566" align="alignleft" width="160"]
Dr. Jim Hu[/caption]
Jim C. Hu, MD
Ronald Lynch Professor of Urologic Oncology
Weill Cornell Medicine
New York, NY 10065
MedicalResearch.com: What is the background for this study?
Response: Initial results from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), a large-scale randomized controlled trial of prostate cancer screening in the United States, radically changed the landscape of prostate cancer screening insofar as it led the United States Preventative Services Task Force (USPSTF) to recommend against routine screening with prostate-specific antigen (PSA). Though many subsequent studies have continued to investigate the role of PSA in screening, there is a paucity of data examining the use of digital rectal examination (DRE) for screening in the PSA era. Indeed, the USPSTF recommendation did not explicitly address DRE, calling for further research to evaluate the role of periodic DRE in prostate cancer screening. Likewise, while recent guidelines from the National Comprehensive Cancer Network (NCCN) recommend use of PSA in all men who elect screening, the role of digital rectal examination is equivocal.
We sought to evaluate the value of digital rectal examination and PSA for detection of clinically significant prostate cancer and prostate cancer-specific (PCSM) and overall mortality in a secondary analysis of the PLCO.
01 Sep Most Childhood Asthma Responds To Evidenced Based Therapy
MedicalResearch.com Interview with: [caption id="attachment_27559" align="alignleft" width="125"]
Prof. Francine Ducharme[/caption]
Francine M. Ducharme, MD, FRCPC
Professor, Departments of Paediatrics and Social and Preventive Medicine
University of Montreal
Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The management of asthma attacks in preschoolers has been the subject of much recent debate. The results of a study published in 2009 had shaken the pediatric world. The study reported that preschool children with viral-triggered flare-ups did not respond to standard treatment and, suggesting that this was due to their young age. Such finding was particularly worrisome as the majority of asthma-related emergency room visits and hospitalizations involve preschool children.
We conducted this large cohort study in which children aged 1 to 17 years with a moderate or severe asthma attack were treated using the established evidence-based therapy adjusted to the severity of exacerbation assessed by the Pediatric Respiratory Assessment Measure (PRAM), administered rapidly. We explored the determinants of the failure of emergency therapy. Age was not a factor. Instead, in addition to attack severity and symptoms between attacks, it was rather the presence of respiratory viral infection or fever triggering the attack that was more often associated with treatment failure, i.e., higher hospitalization rates, more returns to the emergency room, and reduced speed of recovery over the 10 days after discharge. Viral detection occurred more frequently in preschoolers (67%) than in older children (46%) with asthma.
Nevertheless, the results confirm the overall effectiveness of standard treatment, adjusted to the severity of the attack and administered early, in the vast majority of children, regardless of age and viral detection. Indeed, although a failure rate of nearly 40% was expected in this group of children with moderate to severe attack, only 17% of the participants did not respond to standard treatment. This rate was significantly higher (19%) in children with viral infection compared to uninfected children (13%).
01 Sep Persistent Postpartum Pain Linked To Higher Risk of Depression
MedicalResearch.com Interview with: MS WEI DU, First author Third Year Medical Student DUKE-NUS Medical School and DR BAN LEONG SNG, Senior Author Senior Consultant Department of Women’s Anesthesia KK Women’s and Children’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? MS WEI DU: We performed a cohort study involving 200 healthy women...
01 Sep Long-Acting Beta-Agonists-Steroid Combination in Pediatric Asthma
MedicalResearch.com Interview with: David A Stempel, MD Medical Affairs Lead US Medical Affairs GlaxoSmithKline MedicalResearch.com: What is the background for this study? What are the main findings? Response: Long-acting beta-agonists (LABAs) have been shown to increase the risk of asthma-related death among adults and the risk of asthma-related hospitalization among children. It is unknown whether the concomitant use of inhaled glucocorticoids with LABAs mitigates those risks. This trial prospectively evaluated the safety of the LABA salmeterol, added to fluticasone propionate, in a fixed-dose combination in children.31 Aug Maternal High Dose Monthly Vitamin D May Be Useful During Breastfeeding
MedicalResearch.com Interview with: [caption id="attachment_27553" align="alignleft" width="125"]
Dr. Ben Wheeler[/caption]
Dr. Ben Wheeler MB ChB(Otago) DCH CCE FRACP
Senior Lecturer / Paediatrician / Paediatric Endocrinologist
Department of Women’s & Children’s Health : Te Tari Hauora Wāhine me te Tamariki
Dunedin School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Vitamin D is essential for calcium and bone metabolism. It is unique among vitamins in that it is mainly derived from synthesis in the
skin after exposure to UV-B radiation. In the absence of fortification, few foods are rich in vitamin D, including human milk, which contains very low amounts. Breastfeeding infants in higher latitude countries such as New Zealand, much of North America and
Central/Northern Europe are at risk of vitamin D deficiency.
The most profound manifestation of vitamin D deficiency in growing children is rickets, characterized by bone deformities, impaired growth, biochemical abnormalities, and depending on the severity of deficiency, seizures. Studies also identified a number of common factors that potentially affect the risk of rickets, including darker pigmented skin, maternal vitamin D deficiency during pregnancy, season of birth, and age.
A potential alternative strategy to improve the vitamin D status of breastfed infants is high-dose vitamin D supplementation to pregnant and lactating women. This would be attractive from a compliance perspective, promote exclusive breastfeeding, and treat both the mother and her infant.
Thus, the primary aim of this randomized, placebo-controlled study was to determine the effect of two different monthly doses of maternal vitamin D supplementation on the vitamin D status of non–vitamin D–supplemented breastfed infants and their mothers.
31 Aug How Can Radiologists Detect Cancer In a Fraction of a Second?
MedicalResearch.com Interview with: [caption id="attachment_27548" align="alignleft" width="125"]
Dr. Karla Evans[/caption]
Karla K. Evans, Ph.D.
Lecturer, Department of Psychology
The University of York
Heslington, York UK
MedicalResearch.com: What is the background for this study?
Response: This research started after initially talking to radiologists and pathologists about how they search a radiograph or micrograph for abnormalities. They talked about being able to tell at the first glance if the image had something bad about it. Jokingly, they talked about “having the force” to see the bad. We wanted to know whether this hunch after the brief initial viewing was real and to systematically test it. We collected radiographic and micrographic images, half of them that had signs of cancer in them and half of them that didn't, and we briefly presented them (250 millisecond to 2000 milliseconds) to radiologists or pathologistsrespectively. They simply had to report whether they would recall the patient or not and try localize on the outline the location of the abnormality. We first reported these finding in the following paper.
Evans et al. (2013) The Gist of the Abnormal: Above chance medical decision making in the blink of an eye. Psychonomic Bulletin & Review (DOI) 10.3758/s13423-013-0459-3
In addition to finding that radiologists and pathologists can indeed detect subtle cancers in a quarter of a second we also found that they did not know where it was in the image leading us to conclude that the signal that they were picking up must be a global signal (i.e. the global image statistic or the texture of the breast as a whole) rather than the result of a local saliency. This led me to start further exploring this signal in order to characterize it when I moved to University or York, UK to establish my own lab.
31 Aug Missing Hand Persists in Brain Decades After Amputation
MedicalResearch.com Interview with: Sanne Kikkert, DPhil student FMRIB Centre, University of Oxford Oxford, United Kingdom MedicalResearch.com: What is the background for this study? Response: One of the most mysterious questions about the brain’s ability to adaptively change to new circumstances is: what happens to the brain once a key input is lost (e.g. through amputation)? It has been thought that the hand representation in the brain, located in the primary somatosensory cortex, is maintained by regular sensory input from the hand. Indeed, textbooks teach that any sensory representation in the brain will be ‘overwritten’ if its primary input stops. Following this explanation, people who have undergone hand amputation would show extremely low or no activity related to its original focus in the brain area of the missing hand. However, we know that amputees often experience phantom sensations from their missing hand, such that when asked to move a phantom finger they can ‘feel’ that movement. We previously showed that we can trace some activity in the missing hand brain area when amputees move their phantom hand. In this study, we were interested in finding how the representation of a missing hand is stored in the brain.31 Aug Urinary Biomarkers Predict Progression of Acute Kidney Injury In Heart Failure
MedicalResearch.com Interview with: Xiaobing Yang, MD Division of Nephrology, Nanfang Hospital Southern Medical University MedicalResearch.com: What is the background for this study? Response: AKI is a common complication in patients with acute decompensated heart failure (ADHF) and associated with increased death and worse clinical outcomes. Early detecting which patients are going to suffer progressive AKI or proceed to death could help physicians to plan and initiate timely managements. We analyzed data and samples of 732 ADHF patients from a prospective, multicenter study in China. We demonstrated that kidney injury biomarkers, measured at the first time of AKI clinical diagnosis, could predict which patients were going to have AKI progression or worsening of AKI with death. Notably, three urinary biomarkers, including urinary angiotensinogen (uAGT), urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary IL-18 (uIL-18), were all able to forecast which patients with the earliest stages of AKI were most likely to suffer progressive AKI.31 Aug Advantaged Patients Receive More Low-Value Medical Services
MedicalResearch.com Interview with: Dr. Rachel O. Reid MD MS Associate Physician Policy Researcher RAND Corporation MedicalResearch.com: What is the background for this study? What are the main findings? Response: Waste in the US health care system is both common and expensive, estimated to be in the range of $750 billion annually. Contributing to this waste is over-treatment and use of low value services that offer little or no clinical benefit to patients. We studied 1.46 million adults from across the US with commercial insurance and found that spending on 28 low value services totaled $32.8 million in 2013, accounting for 0.5% of their medical spending or $22 per person annually. The most commonly received low-value services included hormone tests for thyroid problems, imaging for low-back pain and imaging for uncomplicated headache. The greatest proportion of spending was for spinal injection for lower-back pain at $12.1 million, imaging for uncomplicated headache at $3.6 million and imaging for nonspecific low-back pain at $3.1 million. Low-value spending was lower among patients who were older, male, black or Asian, lower-income or enrolled on consumer-directed health plans, which have high member cost-sharing.31 Aug Fewer Overall New Cardiovascular Drugs, But More Biologics Researched
Posted at 18:14h
in Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Pharmacology
MedicalResearch.com Interview with:
[caption id="attachment_27299" align="alignleft" width="125"]
Dr. Aaron Kesselheim[/caption]
Aaron S. Kesselheim, M.D., J.D., M.P.H.
Associate Professor of Medicine at Harvard Medical School
Director, Program On Regulation, Therapeutics, And Law (PORTAL)
Division of Pharmacoepidemiology and Pharmacoeconomics
Brigham and Women's Hospital
Boston MA 02120
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It has been previously reported that the number of new cardiovascular drugs approved by the U.S. Food and Drug Administration (FDA) has declined in recent years. So we sought to empirically assess trends in the development of new cardiovascular therapeutics.
31 Aug Modified Microscopy for Lyme Disease Found Unreliable
MedicalResearch.com Interview with: [caption id="attachment_27677" align="alignleft" width="149"]
Dr. Audun Aase[/caption]
Audun Aase, PhD
Department Director, Infectious Disease Immunology
Norwegian Institute of Public Health
Oslo, Norway
MedicalResearch.com: What is the background for this study?
Response: Controversies related to Lyme disease and tick transmitted diseases have gained much attention in the public media in Norway, both regarding treatment regimens and diagnostics. People with long-lasting disease may relate their symptoms to previous tick bite and/or suboptimal-treated Lyme disease and have adopted the diagnosis chronic Lyme disease. As many of these patients lack objective proof of Lyme disease, they look for alternative test to signify their suspicion.
A modified microscopy method for detection of the Borrelia burgdorferi s.l. (the causative agent of Lyme disease) in human blood was published in 2013. The authors behind the method examined blood from suspected chronic Lyme disease patients, and the results showed presence of Borrelia spirochetes in most of the specimens. Using the same method, they also claimed to detect the Babesia parasites in many of the samples. The method gained much publicity and the patients advocated strongly for this method as most other laboratory tests had failed to prove their diagnosis.
31 Aug Early Invasive Cardiac Treatment Provided Longterm Benefit For Patients With Non-STEMI Acute Coronary Syndrome
MedicalResearch.com Interview with: [caption id="attachment_27529" align="alignleft" width="125"]
Prof. Lars Wallentin[/caption]
Prof Lars Wallentin, MD PHD
Senior Professor Cardiology
Uppsala Clinical Research Center,
Uppsala University
MedicalResearch.com: What is the background for this study?
Response: The FRISC2 study was performed 1996 – 1998 and reported 1999 for the first time a significant reduction in death and myocardial infarction by early invasive compared to non-invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). The results at 6 months, 1, 2 and 5 years were published in The Lancet and pivotal in changing the treatment guidelines and thereby improving outcomes in patients with NSTE-ACS. These findings were within the next few years verified in the TACTICS-TIMI18 and RITA3 trials. However the later performed ICTUS trial, starting after these results were published and accordingly with a substantial early crossover to the invasive arm, showed neutral results. Recently the reduction in event rates by an early invasive strategy was again validated in patients above 80 years of age, which were less well represented in the initial trials. These benefits of an early invasive strategy have previously been shown sustained for at least five years based on results from the FRISC2, RITA3, and ICTUS trials. The FRISC2 and TACTICS-TIMI18 trials also showed that the benefits with an early invasive strategy seemed confined to patients with signs of myocardial necrosis as indicated by elevated troponin level at entry. In addition the FRISC2 trial found that the benefits were larger in patients with signs of inflammatory activity as indicated by a high level of growth differentiation factor 15 (GDF-15) at entry. These pivotal results have been the basis for the current international treatment guidelines recommending an early invasive treatment strategy in patients with NSTE-ACS and elevated troponin and/or other indicators of a raised risk.
31 Aug Parents Likely To Use Food To Soothe Fussy Infants
MedicalResearch.com Interview with: [caption id="attachment_27521" align="alignleft" width="133"]
Dr. Kai Ling Kong[/caption]
Kai Ling Kong, PhD, MS
Assistant Professor
Division of Behavioral Medicine
Department of Pediatrics
School of Medicine and Biomedical Sciences
State University of New York at Buffalo
MedicalResearch.com: What is the background for this study?
Response: Infant temperament, or individual behavior styles, can be reliably measured and is related to weight status. However, we know very little about the association of infants’ temperament and their motivation to eat versus engage in other activities (relative food reinforcement). Examining such associations is an important step given the need to use behavioral strategies in obesity prevention in early life. The purpose of our study was to determine if infant temperament, specifically the factors that have been linked with obesity risk, are associated with infant relative food reinforcement.
31 Aug Genotyping and 3D Imaging Help Identify Genes That Influence Facial Appearance
MedicalResearch.com Interview with: [caption id="attachment_27260" align="alignleft" width="200"]
Dr. Seth Weinberg[/caption]
Seth M. Weinberg, PhD
Assistant Professor, Department of Oral Biology
Assistant Professor, Department of Anthropology
Director, CCDG Imaging and Morphometrics Lab
MedicalResearch.com: What is the background for this study?
Response: Scientists have long recognized that aspects of facial appearance have a genetic basis. This is most obvious when we look at the faces of people in the same family. It is also well known that mutations in certain genes can result in syndromes where the face is affected. However, very little is known about how specific genes influence the size and shape of normal human facial features. To date, only a handful of studies have looked at this question, and while these studies have reported several interesting results, only a small number of genes have so far been linked to normal variation in facial features. The primary goal of our study was to test for evidence of association between detailed facial measures derived from 3D images and common genetic variants spread across the entire genome. We also attempted to independently replicate some of the findings from previous studies.
31 Aug Drug-Eluting Stents Reduce Need for Revascularization after PCI
MedicalResearch.com Interview with: Dr. Kaare Harald Bønaa Principal investigator University of Tromsø, Norway MedicalResearch.com: What is the background for this study? Response: The NORSTENT study was designed shortly after the “Barcelona fire storm” in 2006 that raised severe safety concerns against drug-eluting stents (DES). At that time there was evidence for increased risk of stent thrombosis with DES. How this could influence long term results compared to PCI with bare metal stents (MMS) was not known. Accordingly, we designed the NORSTENT study with the primary composite endpoint of all-cause mortality and non-fatal spontaneous myocardial infarction at a medial of 5 years of follow-up.31 Aug Opportunities for Improvement in Pediatric Resuscitation Across US EDs
MedicalResearch.com Interview with: Marc Auerbach, MD, FAAP, MSc Associate Professor of Pediatrics (Emergency Medicine) and of Emergency Medicine Co-chair INSPIRE (International Network for Simulation Based Pediatric Innovation Research and Education) Director, Pediatric Simulation Yale Center for Medical Simulation; MedicalResearch.com: What is the background for this study? What are the main findings? Response: Severely ill infants and children present to any of over 5000 United States Emergency Departments every day. A direct comparison of the quality of resuscitative care across EDs is challenging due to the low frequency of these high stakes events in individual EDs. This study utilized in-situ simulation-based measurement to compare the quality of resuscitative care delivered to two infants and one child by 58 distinct interprofessional teams across 30 EDs. Composite quality scores correlated with annual pediatric patient volume, with higher volume departments demonstrating higher scores. The pediatric readiness score measures compliance with guidelines created by the American Academy of Pediatrics, the American College of Emergency Physicians and the Emergency Nurses Association. The pediatric readiness score correlated with composite quality scores measured by simulation.31 Aug Genetic Counselling Did Not Increase Anxiety in Breast and Ovarian Cancer Patients
Posted at 12:29h
in Author Interviews, Breast Cancer, Genetic Research, Mental Health Research, Ovarian Cancer, Psychological Science
MedicalResearch.com Interview with:
Mag. Dr. Anne Oberguggenberger PhD
Medizinische Universität Innsbruck
Department für Psychiatrie, Psychotherapie und Psychosomatik
Innsbruck Austria
MedicalResearch.com: What is the background for this study?
Response: Genetic counseling and testing is increasingly integrated in routine clinical care for breast- and ovarian cancer (BOC). Knowledge on follow-up psychosocial outcomes in all different groups of counselees is essential in order to improve follow-up care and counselees’ quality of life.
31 Aug Clinical Interventions Reduced Hospital Readmissions After PCI Stent Surgery
Posted at 02:45h
in AHA Journals, Author Interviews, Heart Disease, Hospital Readmissions, Surgical Research
MedicalResearch.com Interview with:
[caption id="attachment_27509" align="alignleft" width="200"]
Dr. Jason Wasfy[/caption]
Jason H. Wasfy, MD, MPhil
Assistant Medical Director, Massachusetts General Physicians Organization
Director of Quality and Analytics
Massachusetts General Hospital Heart Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Reducing preventable readmissions after PCI is a way to both improve the quality of care for our patients and improve value for patients with coronary artery disease. Through a variety of tactics, we were able to reduce the 30 day readmission rate for patients after PCI by nearly half. Keep in mind that this is only the readmission rate to our hospital, so we will need to confirm these results with data including patients who may have been readmitted to other hospitals after a PCI at Mass General.
30 Aug Most Physicians Overestimate Efficacy of Common Treatments
MedicalResearch.com Interview with: [caption id="attachment_27370" align="alignleft" width="159"]
Dr. Daniel Morgan[/caption]
Daniel J. Morgan M.D., M.S
Associate Professor
Epidemiology & Public Health
University of Maryland School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Physicians are generally taught if a treatment is indicated, not how well the treatment works. Although this has been part of evidence based medical training, doctors still perform poorly with ability to understand risk and how treatment limits risk (Bayesian reasoning). Many publications focus on relative risk reduction which inflates the perception of an effect over the more accurate absolute risk reduction.
30 Aug Surge in Fentanyl Deaths in Florida and Ohio Linked to Illicitly Manufactured Opioids
MedicalResearch.com Interview with: [caption id="attachment_27499" align="alignleft" width="125"]
Alexis B. Peterson, PhD[/caption]
Alexis B. Peterson, PhD
(Epidemic Intelligence Service Officer)
[caption id="attachment_27435" align="alignleft" width="125"]
Dr. R. Mathew Gladden[/caption]
R. Matthew Gladden, PhD (Behavioral Scientist)
MedicalResearch.com What is the background for this study?
Response: In March and October 2015, the Drug Enforcement Administration and the Centers for Disease Control and Prevention (CDC) issued nationwide alerts identifying fentanyl, particularly illicitly manufactured fentanyl, as a threat to public health and safety. During 2013-2014, Ohio and Florida reported significant increases in fentanyl-involved overdose deaths (fentanyl deaths) and fentanyl submissions (drug products obtained by law enforcement that tested positive for fentanyl).
Fentanyl is a synthetic opioid 50-100 times more potent than morphine. The University of Florida and the Ohio Department of Public Health with CDC assistance compared trends in fentanyl deaths, fentanyl submissions, and fentanyl prescribing during January 2013–June 2015.
In-depth review of medical examiner and coroner reports of fentanyl deaths occurring in Ohio’s 14 high-burden counties were performed to identify circumstances surrounding fentanyl overdose death.
30 Aug Study Supportive of Modest Effect of Cognitive Activity on Prevention of Dementia
Posted at 18:40h
in Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Education
MedicalResearch.com Interview with:
[caption id="attachment_27491" align="alignleft" width="180"]
Dr. Deborah Blacker[/caption]
Deborah Blacker MD, ScD
Director of the Gerontology Research Unit
Department of Psychiatry
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study? What are the main findings
Response: Many observational studies have found that those who are cognitively active have a lower risk of developing Alzheimer's disease or any type of
dementia.
However, we and others have been concerned that these findings
might be spurious due to two potential biases:
- 1) confounding, meaning that those who are cognitively active have lower rates of Alzheimers disease for another reason, in particular the effect of greater education, which is associated with both lower risk of Alzheimers and higher levels of cognitive activity; and
- 2) reverse causation, meaning that theassociation could be due to a reduction in cognitive activity among those already in the long preclinical phase of cognitive decline before Alzheimers dementia (rather than the lack of cognitive activity causing the Alzheimers). Our study performed a systematic review of the literature on the association, and then a set of bias analyses to assess whether confounding or reverse causation could account for the observed associations.
30 Aug Study Finds CPAP Improved Quality of Life But Did Not Reduce Cardiovascular Risk
Posted at 18:23h
in Author Interviews, Heart Disease, NEJM, Obstructive Sleep Apnea, Sleep Disorders
MedicalResearch.com Interview with:
Prof. Craig Anderson, PhD
Professor of Stroke Medicine and Clinical Neuroscience
Medicine, The George Institute for Global Health
University of Sydney
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We wished to prove whether treatment of obstructive sleep apnea with continuous positive airway pressure (CPAP ) can modify the risk of cardiovascular disease. The is a lot of association data from epidemiological and clinical studies but no large scale international clinical trials assessing the effects of CPAP on the prevention of serious cardiovascular events like heart attack and stroke.
Our study in nearly 3000 adults with prior heart attack or stroke and moderate to severe obstructive sleep apnea showed that CPAP treatment did not prevent recurrent cardiovascular events or major cardiovascular risk factors. However CPAP did improve wearers' sense of wellbeing, mood and work productivity.
30 Aug Injuries From Falls Cost Medicare Almost As Much As Cancer Treatment
Posted at 17:58h
in Accidents & Violence, Author Interviews, CDC, Cost of Health Care, Frailty, Geriatrics
MedicalResearch.com Interview with:
[caption id="attachment_27484" align="alignleft" width="150"]
Elizabeth Burns MPH[/caption]
Elizabeth Burns, MPH
Health Scientist, Division of Unintentional Injury Prevention
National Center for Injury Prevention and Control
CDC
MedicalResearch.com: What is the background for this study?
Response: Falls are the leading cause of both fatal and non-fatal injuries among Americans aged 65 and older. In 2000, the direct cost of falls were estimated to be $179 million for fatal falls and $19 billion for non-fatal falls. Fall injuries and deaths are expected to rise as more than 10,000 Americans turn 65 each day. Within the next 15 years, the U. S. population of older Americans is anticipated to increase more than 50%, with the total number of older adults rising to 74 million by 2030.
30 Aug Cardioprotective Effect of Metformin in Diabetes Determined
MedicalResearch.com Interview with: [caption id="attachment_27474" align="alignleft" width="164"]
Dr. Jolanta Weaver[/caption]
Jolanta U Weaver, FRCP MRCS PhD CTLHE
Senior Lecturer in Diabetes Medicine
Honorary Consultant Diabetologist
Newcastle
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Vascular stem cells, which are associated with an improvement of heart disease, are improved in type 1 diabetes by repurposing metformin, known to reduce heart disease in type 2 diabetes.
We treated patients with type 1 diabetes with metformin for 8 weeks. The metformin dose varied between 500 mg a day to 2000 mg a day, depending on what patients were happy to take. Subjects were requested to keep diabetic control unchanged to study the direct effect of metformin on heart disease. Circulating endothelial progenitor cells (vascular stem cells) count, Hill’s colonies and pro angiogenic cells function (in test tube) improved in comparison to patients, who did not take metformin but remained on standard therapy.
Endothelial cells associated with vascular damage, on the other hand, were reduced following metformin therapy confirming improved vascular health. The glycaemic control remained unchanged (as planned at the onset of the study) to allow us to examine the effect of metformin ALONE on vascular health. Patients did not suffer any serious side effects.