Author Interviews, Breast Cancer, Mammograms / 06.05.2016

MedicalResearch.com Interview with: Ragnhild Falk PhD Oslo Centre for Biostatistics and Epidemiology Research Support Services Oslo University Hospital and Solveig Hofvind PhD Department of Screening Cancer Registry of Norway and Oslo and Akershus University College of Applied Sciences Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: The issue of overdiagnosis has been heavily debated, and a variety of results have been presented. However, the exact proportion of overdiagnosis is unknown as one do not know what would have happen in the absent of screening. We have split the proportion of overdiagnosis into two parts based on the time at which the death occur; scenario 1 as the proportion of women diagnosed with a screen-detected breast cancer and who died within the lead-time period, and scenario 2 as women detected with slow growing tumors that never would have caused any harm during the women’s life if she had not attended screening. In principle, all screening programs will detect breast cancer among women who die of other causes in the near future since there exist competing risk of death among women targeted by screening. Although the all-cause mortality rates are low, it is inevitable. We wanted to focus on the first scenario and estimated the number of women diagnosed with screen detected breast cancer who died within the estimated lead-time period caused by screening. We estimated his proportion to be less than 4 percent of all screen-detected cases in the given England & Wales and the Norwegian setting. (more…)
Author Interviews, Columbia, Pediatrics, Vaccine Studies / 06.05.2016

MedicalResearch.com Interview with: Melissa Stockwell, MD, MPH, FAAP Florence Irving Associate Professor of Pediatrics and Population and Family Health Columbia University - College of Physicians & Surgeons and Mailman School of Public Health Medical Director, New York-Presbyterian Hospital Immunization Registry (EzVac) Co-Director, Primary Care Clinician Research Fellowship in Community Health New York, NY 10032  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Stockwell: Fragmentation of immunization records place children at risk for underimmunization and overimmunization. Nearly all 50 states, 5 cities, and the District of Columbia operate an immunization information system, which is a system that collects and centralizes immunization data for children and adolescents from immunization providers at a regional or state level. More than 75% of US office-based physicians have adopted an electronic health record (EHR), but until recently, clinicians wanting to access patient immunization information in an IIS generally had to manually look up the patient data on a state or local IIS website, that data was not available to them within their own EHR. In this study, we demonstrated that exchange of immunization information between an immunization information system (IIS) and an EHR at point of care had a significant impact on up-to-date rates, overimmunization, and immunization record completeness for low-income, urban children and adolescents. (more…)
Author Interviews, BMJ, Weight Research / 06.05.2016

MedicalResearch.com Interview with: Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus Norfolk Place, Paddington, London MedicalResearch.com: What is the background for this study? Response: The prevalence of overweight and obesity has increased rapidly over the past decades in all areas of the world. This has raised serious public health concerns because of the relationship between excess weight and increased risk of many chronic diseases including cardiovascular disease, several types of cancer, type 2 diabetes, gallstones, gout, osteoarthritis, and several other conditions as well as all-cause mortality. Body mass index (BMI) is an established way of measuring adiposity and is calculated by dividing the weight in kilograms with the height in metres squared. Although overweight (BMI 25-29.9) and obesity (BMI ≥30) has been associated with increased risk of mortality in several previous studies, the largest previous study showed that when compared to normal weight, overweight was associated with reduced mortality, and only grade 2 obesity (BMI ≥35) was associated with increased risk of mortality. However, there were several limitations in that study, for example, smoking and prevalent or prediagnostic illness were not taken into account, both of which can cause lower body weight and increased mortality and may therefore bias the optimal BMI range upwards. In addition, many large studies which did not use the standard WHO categories of normal weight, overweight and obesity, but had used smaller increments to categorize BMI to provide more detailed assessment of the dose-response relationship between BMI and mortality, had been excluded.  (more…)
Author Interviews, Outcomes & Safety, Pharmacology / 06.05.2016

MedicalResearch.com Interview with: Serene I. Chen MD Dr. Chen is an emergency medicine resident at Highland Hospital, in Oakland, California. She was a student at the Yale School of Medicine when this research was conducted. MedicalResearch.com: What is the background for this study? Dr. Chen: To address the rise in U.S. drug shortages, the Food and Drug Administration Safety and Innovation Act (FDASIA) was passed in 2012—and early evidence does suggest that the overall number of new shortages have decreased. However, we found that drugs that are frequently used emergency departments and other acute settings are still affected by more frequent and increasingly prolonged shortages. (more…)
Author Interviews, Compliance, Heart Disease, JACC / 05.05.2016

MedicalResearch.com Interview with: Dr. Kevin Curl, MD Sidney Kimmel Medical College Jefferson University  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Curl: If left untreated, half of coronary bypass vein grafts will become occluded within 10 years of surgery.  We reviewed the health records of over 350 patients who had a previous coronary artery bypass graft (CABG) a minimum of three years prior.  Our goal was to identify the long-term trends with medication adherence in this high risk population, namely aspirin and statin medications.  The American College of Cardiology and the American Heart Association recommend both statins and aspirin medications unless they are unsafe for the individual patient. The mean age of the study population was 69 years, most patients had previously undergone "triple bypass" with 3 grafts, and the mean time from surgery was 11 years.  We found that only 52 percent of patients were taking both aspirin and a statin medication. In addition, patients not taking a statin had higher (22 percent) low-density lipid or “bad” cholesterol. (more…)
Author Interviews, Bipolar Disorder, Infections, Johns Hopkins, Mental Health Research, Microbiome, Schizophrenia / 05.05.2016

MedicalResearch.com Interview with: Emily G. Severance, Ph.D Stanley Division of Developmental Neurovirology Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Severance: This research stems in part from anecdotal dialogues that we had with people with psychiatric disorders and their families, and repeatedly the issue of yeast infections came up. We found that Candida overgrowth was more prevalent in people with mental illness compared to those without psychiatric disorders and the patterns that we observed occurred in a surprisingly sex-specific manner.  The levels of IgG antibodies directed against the Candida albicans were elevated in males with schizophrenia and bipolar disorder compared to controls. In females, there were no differences in antibody levels between these groups, but in women with mental illness who had high amounts of these antibodies, we found significant memory deficits compared to those without evidence of past infection. (more…)
Author Interviews, Radiology, Weight Research / 05.05.2016

MedicalResearch.com Interview with: Albert Roh MD Radiology Resident Maricopa Integrated Health System MedicalResearch.com: What is the background for this study? Dr. Roh: Obesity is well documented to be associated with many medical conditions.  Currently, obesity is defined as body mass index (BMI) over 30 kg/m^2.  Although simple to calculate and relatively accurate, BMI has its limitations.  BMI does not factor in the subject’s body type or fat distribution pattern.  For example, a muscular subject and a fatty subject may both have BMI of 30 and be considered obese, although the muscular subject would not be predisposed to the comorbidities associated with obesity.  Similarly, two subjects may have the same BMI but have different fat distribution patterns: “apple” with fat distributed primarily on the chest/abdomen and “pear” with fat distributed on the hips.  The “apple” fat distribution correlates better with the comorbidities associated with obesity. (more…)
Author Interviews, Genetic Research, MD Anderson, Pain Research / 05.05.2016

MedicalResearch.com Interview with: Hui-Lin Pan, MD, PhD Helen T. Hawkins Distinguished Professor and Deputy Division Head for Research Division of Anesthesiology and Critical Care, Unit 110 The University of Texas MD Anderson Cancer Center Houston, TX MedicalResearch.com: What is the background for this study? Dr. Hui-Lin Pan: Chronic nerve pain caused by damage to the peripheral nerve is a debilitating health problem and remains very difficult to treat. Sensory neurons in the spinal cord are normally inhibited by inhibitory neurotransmitters (GABA and glycine) to regulate transmission of painful information. A major feature of nerve injury-induced chronic pain is reduced spinal cord inhibition, resulting from diminished activity of a chloride transporter called KCC2. In this study, we investigated whether increasing KCC2 expression at the spinal level using a lentiviral vector can restore KCC2 activity, thereby reducing chronic nerve pain. (more…)
Author Interviews, Colon Cancer, Menopause, Surgical Research / 05.05.2016

MedicalResearch.com Interview with: Josefin Segelman MD, PhD Senior consultant colorectal surgeon Department of Molecular Medicine and Surgery Karolinska Institutet Ersta Hospital Stockholm Sweden MedicalResearch.com: What is the background for this study? Dr. Segelman: Hormonal factors influence the development of colorectal cancer. Observational studies and clinical trials have reported a protective effect of hormone replacement therapy and oral contraceptives. Oophorectomy alters endogenous levels of sex hormones, but the effect on colorectal cancer risk is unclear. Removal of the ovaries alters levels of sex hormones in both pre- and postmenopausal women. In premenopausal women, bilateral oophorectomy is followed by surgical menopause as the endogenous estrogen levels drop. Both before and after natural menopause, bilateral oophorectomy promptly decreases endogenous androgen levels by half as the ovaries and adrenals are equally important for androgen production. MedicalResearch.com:  What are the main findings? Dr. Segelman: The present nationwide cohort study explored the association between removal of the ovaries for benign indications and subsequent risk of colorectal cancer. Among 195 973 women who underwent the procedure from 1965 – 2011, there was a 30% increased risk of colorectal cancer compared with the general population. After adjustment for various factors, women who underwent bilateral oophorectomy had a higher risk of rectal cancer than those who had unilateral oophorectomy (HR 2.28, 95% CI 1.33-3.91). (more…)
Author Interviews, BMJ, Johns Hopkins, Outcomes & Safety / 05.05.2016

MedicalResearch.com Interview with: Michael Daniel The Johns Hopkins University School of Medicine M.D. Candidate 2016 Michael G. Daniel is a graduating medical student at the Johns Hopkins School of Medicine. He will be attending the Osler Internal Medicine Residency Training Program next year at the Johns Hopkins Hospital. His research focus is on Patient Safety, Quality, and Outcomes improvement. Summary: Medical error ranks as the third leading cause of death in the United States, but is not recognized in national vital statistics because of a flawed reporting process. Using recent studies on preventable medical error and extrapolating the results to the 2013 U.S. hospital admissions we calculated a mortality rate or 251,454 deaths per year. MedicalResearch.com: What made you want to research this topic? Response: I decided to study medicine because I wanted to improve patient health. However, I realized that improving patient health is not only about curing a disease but is sometimes about fixing the way we deliver healthcare. MedicalResearch.com: Is this news surprising to you? Response: Yes, because all previous estimates of medical error were much lower and when I started the research I couldn’t use the CDC statistics to get current data. (more…)
Author Interviews, Microbiome, Nutrition, Pediatrics, Weight Research / 05.05.2016

MedicalResearch.com Interview with: Jacob (Jed) E. Friedman, Professor, Ph.D. Department of Pediatrics, Biochemistry & Molecular Genetics Director, NIH Center for Human Nutrition Research Metabolism Core Laboratory University of Colorado Anschutz MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scientists have long established that children who are breastfed are less likely to be obese as adults, though they have yet to identify precisely how breastfeeding protects children against obesity. One likely reason is that children who are breastfed have different bacteria in their intestines than those who are formula fed. The study, published Monday in the American Journal of Clinical Nutrition examines the role of human milk hormones in the development of infants’ microbiome, a bacterial ecosystem in the digestive system that contributes to multiple facets of health. “This is the first study of its kind to suggest that hormones in human milk may play an important role in shaping a healthy infant microbiome,” said Bridget Young, co-first author and assistant professor of pediatric nutrition at CU Anschutz. “We’ve known for a long time that breast milk contributes to infant intestinal maturation and healthy growth. This study suggests that hormones in milk may be partly responsible for this positive impact through interactions with the infant’s developing microbiome.” Researchers found that levels of insulin and leptin in the breastmilk were positively associated with greater microbial diversity and families of bacteria in the infants’ stool. Insulin and leptin were associated with bacterial functions that help the intestine develop as a barrier against harmful toxins, which help prevent intestinal inflammation. By promoting a stronger intestinal barrier early in life, these hormones also may protect children from chronic low-grade inflammation, which can lead to a host of additional digestive problems and diseases. In addition, researchers found significant differences in the intestinal microbiome of breastfed infants who are born to mothers with obesity compared to those born to mothers of normal weight. Infants born to mothers with obesity showed a significant reduction in gammaproteobacteria, a pioneer species that aids in normal intestinal development and microbiome maturation. Gammaproteobacteria have been shown in mice and newborn infants to cause a healthy amount inflammation in their intestines, protecting them from inflammatory and autoimmune disorders later in life. The 2-week-old infants born to obese mothers in this study had a reduced number of gammaproteobacteria in the infant gut microbiome. (more…)
Author Interviews, Emergency Care, Heart Disease, Opiods / 05.05.2016

MedicalResearch.com Interview with: William Eggleston, PharmD Fellow in Clinical Toxicology/Emergency Medicine Upstate Medical University Upstate New York Poison Center MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Eggleston: The case series describes two deaths associated with loperamide abuse with supportive post-mortem findings. It adds to the growing body of literature reporting cardiac toxicity after loperamide abuse and demonstrates the deadly consequences. It also highlights the growing trend of loperamide abuse amongst opioid addicted patients looking to get high or stave off withdrawal symptoms. MedicalResearch.com: What should readers take away from your report? Dr. Eggleston: Readers should recognize that loperamide is an OTC opioid medication that acts similarly to morphine or heroin in the body after high doses. The drug is easily abused due to its low cost, ease of accessibility, legal status, and lack of social stigma associated with its possession. Most importantly, loperamide is a cardiac toxin that causes conduction disturbances in high doses and can produce deadly dysrhythmias. (more…)
Author Interviews, Dermatology, JAMA, Technology, Telemedicine / 05.05.2016

MedicalResearch.com Interview with: Lori Uscher-Pines, PhD RAND Corporation Arlington, Virginia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although many communities in the U.S. are underserved by dermatologists, access is particularly limited among Medicaid patients. Teledermatology may be one solution to improve access. Our goal with this study was to assess the effect of a novel teledermatology initiative on access to dermatologists among enrollees in a Medicaid Managed Care Plan in California’s Central Valley. Among all patients who visited a dermatologist after the introduction of teledermatology from 2012-2014 (n=8614), 49% received care via teledermatology. Among patients newly enrolled in Medicaid following Medicaid expansion in 2014, 76% of those who visited a dermatologist received care via teledermatology. Patients of primary care practices that engaged in teledermatology had a 64% increase in the fraction of patients visiting a dermatologist (vs. 21% in other practices) (p<.01). Compared with in-person dermatology, teledermatology served more patients under age 17, male patients, nonwhite patients, and patients without comorbid conditions. Conditions managed across settings varied; teledermatology physicians were more likely to care for viral skin lesions and acne whereas in-person dermatologists were more likely to care for psoriasis and skin neoplasms. (more…)
Author Interviews, Breast Cancer, Chemotherapy, Heart Disease, Kaiser Permanente / 04.05.2016

MedicalResearch.com Interview with: Reina Haque, PhD MPH Research scientist Kaiser Permanente Southern California Department of Research & Evaluation MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Haque: The study fills an important knowledge gap about the long-term association of aromatase inhibitors on cardiovascular disease risk in breast cancer survivors. This was a retrospective cohort study that included a cohort of 13,273 postmenopausal breast cancer survivors who were diagnosed with breast cancer, either estrogen or progesterone receptor positive, from 1991 to 2010. The patients were followed through 2011, or a maximum of 21 years. The study participants were divided into four groups based on the drugs they received: 31.7 percent were treated only with tamoxifen; 28.6 percent only with aromatase inhibitors; 20.2 percent used both; and 19.4 percent did not use any of these drugs. These oral drugs are used to combat breast cancer recurrence, but may have long-term side effects on other organs. The study determined that the risk of cardiac ischemia (which can lead to a heart attack) and stroke were not elevated in patients who only took aromatase inhibitors compared to those who only took tamoxifen. These results provide reassurance that aromatase inhibitors may not increase risk of the potentially fatal cardiovascular outcomes compared to tamoxifen. (more…)
Author Interviews, Depression, JAMA / 04.05.2016

MedicalResearch.com Interview with: Dipl.-Psych. R. Redlich Neuroimaging Group Klinik und Poliklinik für Psychiatrie und Psychotherapie Westfaelische Wilhelms-Universitaet Muenster MedicalResearch.com: What is the background for this study? Response: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. The ability to advise psychiatrists and patients accurately regarding the chances of successful ECT is of considerable value, particularly since ECT is a demanding procedure and, despite having relatively few side effects, has a profound impact on patients. Therefore, the present study sought to predict ECT response in a psychiatric sample by using a combination of structural Magnetic Resonance Imaging data and machine-learning techniques. (more…)
Author Interviews, Heart Disease, JAMA, Stroke / 04.05.2016

MedicalResearch.com Interview with: Dr. Ben Freedman OAM  Deputy Director Research Strategy, Heart Research Institute/Charles Perkins Centre Professor of Cardiology, Sydney Medical School Head Vascular Biology Anzac Research Institute Honorary VMO, Concord Repatriation General Hospital University of Sydney MedicalResearch.com: What is the background for this study? Dr. Freedman: Guidelines recommend that patients with atrial fibrillation (AF) at high enough risk for stroke should be treated with anticoagulant. Anticoagulant drugs are remarkably effective in reducing stroke risk by about two thirds, and death by between a quarter and a third. Unfortunately, strokes can still occur when patients are prescribed anticoagulant for Atrial Fibrillation, and it is often presumed this residual risk of stroke represents treatment failure, though there are few data about this important issue. MedicalResearch.com: What are the main findings? Dr. Freedman: We were able to compare the risk of stroke in a cohort of patients with AF commenced on anticoagulant, with a very large closely-matched cohort seen in general practice at the same time but without AF. This is a unique comparison. We found that the residual risk of stroke in such anticoagulant-treated patients was virtually identical to that in the matched control cohort. The implication is that the residual risk of stroke may not be treatment failure, but the risk of non-cardioembolic stroke in people of a similar age and stroke risk profile but without Atrial Fibrillation. The residual risk of death in those on anticoagulant was higher than the matched controls, and intermediate between the control rate and the mortality rate for untreated AF. (more…)
Author Interviews, Education, Gender Differences, Surgical Research / 04.05.2016

MedicalResearch.com Interview with: Alison M. Fecher, MD Assistant Professor of Surgery Indiana University Health MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Fecher: It has long been known that female faculty are underrepresented in departments of surgery at U.S. medical schools. Our study wanted to identify obstacles women face in entering certain surgical subspecialties and in career advancement. We found that women are poorly represented in some of the most competitive subspecialties, including cardiothoracic and transplant surgery. We also found that women tend to advance more slowly up the career ladder, with many of them spending more years at the assistant professor level than their male counterparts. One reason for this may be that they tend to publish less peer-reviewed articles than male faculty; however, our results show that the publications of female faculty often has a greater impact on the field, as measured by citations and recentness of articles. (more…)
Author Interviews, CDC, Infections, JAMA / 04.05.2016

MedicalResearch.com Interview with: MedicalResearch.com: What is the background for this study? Dr. Fleming-Dutra: One of the most urgent public health threats of our time is the emergence of antibiotic-resistant bacteria. The use of antibiotics is the single most important factor leading to antibiotic resistance around the world.  Simply using antibiotics creates resistance.  To combat antibiotic resistance we have to use antibiotics appropriately — only when needed and, if needed, use them correctly.  In 2015, the White House released the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), which set a goal for reducing inappropriate outpatient antibiotic use by 50% by 2020.  However, the amount of antibiotic use in the outpatient setting that is inappropriate was unknown. MedicalResearch.com: What are the main findings? Dr. Fleming-Dutra: In this study, we estimate that at least 30% of antibiotics prescribed in doctors’ offices, emergency departments and hospital-based clinics are unnecessary—meaning that no antibiotic was needed at all, which equates to 47 million unnecessary antibiotic prescriptions written annually in these outpatient settings.  Most of those unnecessary antibiotic prescriptions were written for acute respiratory conditions, a key driver of antibiotic overuse. Thus, in order to reach the White House goal of reducing inappropriate outpatient antibiotic use by 50%, a 15% reduction in overall antibiotic use in outpatient settings is needed by 2020. (more…)
Author Interviews, Genetic Research, Science / 04.05.2016

MedicalResearch.com Interview with: Lluís Ribas de Pouplana, Ph.D IRB Barcelona Barcelona 08028 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ever since the discovery of the genetic code it became obvious that the system had not grown to its full theoretical potential of making proteins with 63 different amino acids. Francis Crick called the code 'a frozen accident', but it was unclear what had actually froze it. In this article we offer an explanation to that, and we validate it experimentally. What we find is that the central pieces of the genetic code, the transfer RNAs, are unable to incorporate enough specific elements for the system to be able to use 63 of them without confusion. Since you need a new tRNA for each new amino acid, once the tRNA identification limit is reached you also reach the maximum number of usable amino acids. This limit happened to be reached at 20, and that's where it has stayed for 3 billion years. (more…)
Author Interviews, Dermatology, Heart Disease, Rheumatology / 04.05.2016

MedicalResearch.com Interview with: Lihi Eder, MD, PhD Assistant Professor of Medicine University of Toronto Scientist, Women’s College Research Institute,Room  6326 Women’s College Hospital Toronto, ON, Canada  MedicalResearch.com: What is the background for this study? Dr. Eder: Psoriasis is a chronic immune-mediated skin disease affecting 2-3% of the general population. Psoriatic arthritis (PsA) affects 15-30% of patients with psoriasis. Until recently, only few studies assessed the risk of developing cardiovascular events in patients with PsA and while most studies found a higher cardiovascular risk in these patients, others reported cardiovascular rates that were similar to the general population. (more…)
Author Interviews, Urology / 03.05.2016

MedicalResearch.com Interview with: Errol Singh, M.D. Urologist and CEO of PercuVision MedicalResearch.com: What is the background for this study? Dr. Singh: We set out to better understand the American public’s fears around Foley catheters and hopefully bring attention to the fact that hospitalizations due to infections from urinary catheters are on the rise. Interestingly enough, 20 percent of hospital patients undergo a urinary catheterization, which is the second most common procedure following intravenous therapy. The procedure, however, often leads to complications including infections mostly caused by trauma. MedicalResearch.com: What are the main findings? Dr. Singh: The main findings of the 2016 Urinary Catheter Fear Survey revealed that three out of five men (58 percent) are fearful of urinary catheterizations, while one out of every four men is very fearful of the procedure. Younger men also seem to be more fearful than their older counterparts. More than two-thirds (68 percent) of men ages 18-34 surveyed are fearful of urinary catheterizations, compared to 43 percent of males 65 and over. Clearly, females are less fearful, with 46 percent of women saying they are not fearful of urinary catheterizations, compared to 37 percent of men. It’s also important to note that half of all women surveyed say they fear the procedure, and 25 percent reporting they are very fearful. You can find more of the 2016 Urinary Catheter Fear Survey results on our website atwww.percuvision.com. (more…)
AHA Journals, Author Interviews, Duke, Geriatrics, Heart Disease, Surgical Research / 03.05.2016

MedicalResearch.com Interview with: Jessica J. Jalbert PhD From the Division of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston, MA LASER Analytica New York, NY MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Jalbert: Landmark clinical trials have demonstrated that carotid artery stenting (CAS) is a safe and efficacious alternative to carotid endarterectomy (CEA) for the treatment of carotid artery stenosis. Clinical trials, however, tend to enroll patients that are younger and healthier than the average Medicare patient. We therefore sought to compare outcomes following CAS and CEA among Medicare patients. MedicalResearch.com: What are the main findings? Dr. Jalbert: We found that outcomes among real-world Medicare patients undergoing CAS and CEA were similar. While our results were inconclusive due to small sample size, we also found some evidence suggesting that patients over the age of 80 and those with symptomatic carotid stenosis may have better outcomes following carotid endarterectomy than CAS. (more…)
Author Interviews, Cancer Research, Dermatology / 03.05.2016

MedicalResearch.com Interview with: Orit Markowitz, MD, FAAD Director of Pigmented Lesions and Skin Cancer Assistant Professor of Dermatology Mount Sinai Medical Center, NY, NY Director of Pigmented lesions clinic Brooklyn VA, Brooklyn, NY Adjunct Professor, Dermatology SUNY Downstate Medical Center, Brooklyn, NY Chief of Dermatology Queens General Hospital, Jamaica, NY MedicalResearch.com: How common is skin cancer? Is the incidence rising in US adults?  Who is most at risk? Dr. Markowitz: The annual incidence of skin cancer is more than breast, colon, lung, and prostate cancer combined. Of the 7 most common skin cancers in the US melanoma is the only one whose incidence is increasing. The highest risk group for skin cancer are fair skin, adults with a history of sun exposure. (more…)
Author Interviews, Cancer Research, Surgical Research / 03.05.2016

MedicalResearch.com Interview with: Desiree Ratner, MD Director, Comprehensive Skin Cancer Program, Mount Sinai Beth Israel and Professor of Dermatology Icahn School of Medicine at Mount Sinai MedicalResearch.com: How big is the problem of skin cancer in the US?  Dr. Ratner: Skin cancer is an enormous problem in the United States and the numbers are increasing every year.  There are over 2 million cases of basal cell carcinoma per year, over 700,000 cases of squamous cell carcinoma per year, and over 140,000 cases of melanoma per year in the U.S. alone. MedicalResearch.com: What type of patients do you evaluate and treat? Dr. Ratner: My practice is limited to skin cancer, so most of my patients are referred to me by general dermatologists for surgery.  I see patients who require Mohs surgery for non-melanoma skin cancers, excisions for non-melanoma skin cancers, and other surgical procedures for a variety of other benign and malignant lesions. (more…)
Author Interviews, Immunotherapy, JAMA, Multiple Sclerosis, UCSF / 02.05.2016

MedicalResearch.com Interview with: Jennifer Graves, MD, PhD, MAS Adult and Pediatric Multiple Sclerosis Centers UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Graves: Cessation of medications with effects on immune trafficking may be more likely to cause rebound inflammatory activity in autoimmune diseases such as multiple sclerosis.  We observed 5 strikingly severe relapses consistent with rebound events following cessation of fingolimod treatment and identified several similar cases in the literature.  At our center the rebound events occurred with an approximate 10% frequency. MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Graves: Fingolimod cessation may be complicated by rebound phenomena in some patients, similar to what has been observed with natalizumab. Both of these medications have effects on immune cell trafficking, likely explaining the association with rebound events.  Careful consideration must be taken in stopping these medications. (more…)
Alzheimer's - Dementia, Author Interviews, Depression, Lancet / 02.05.2016

MedicalResearch.com Interview with: Saira Saeed Mirza, MD, PhD Department of Epidemiology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Mirza: Depressive symptoms appearing in late-life have been extensively studied for their relationship with dementia. They not only very frequently occur in demented patients, but also predict dementia. In this context, depressive symptoms have largely been assessed at a single time point only. However, depression is a disorder which remits and relapses, and symptoms do not remain same over the years. Given this pattern of disease progression, it is more important to study the course of depression over time in relation to long-term health outcomes such as dementia, rather than assessing it at a single time-point, which will neglect the course of depression. This is important as people follow different courses of depression, and different courses of depression might carry different risks of dementia. When we studied the course of depressive symptoms over 11 years in community dwelling older adults in Rotterdam, and the subsequent risks of dementia, we observed that only those who had increasing or worsening depressive symptoms were at a higher risk of dementia. In this group of people, about one in five persons developed dementia. Interestingly, people suffering from high depressive symptoms at a single time point were not at a higher dementia risk than those without depressive symptoms. (more…)
Author Interviews, Pediatrics, Vitamin D / 02.05.2016

MedicalResearch.com Interview with: Hope Weiler, RD (CDO), PhD Associate Professor Canada Research Chair tier I, Nutrition and Health Across the Lifespan, Director, Mary Emily Clinical Nutrition Research Unit School of Dietetics and Human Nutrition McGill University Macdonald Campus Ste Anne de Bellevue, QC  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Weiler: Vitamin D is a fat soluble with important functions in growth during infancy and childhood, especially for the skeleton. It is for this reason that many policy recommendations for infants stipulate that newborn infants receive a supplemental form of vitamin D. In Canada, it is recommended by Health Canada (www.hc-sc.gc.ca) that newborn infants receive 400 international units of vitamin D from birth to a year of age or until that amount can be obtained from diet. In Canada, older children and adults can make vitamin D when their skin is exposed to direct sunlight between April and October; however, parents are advised to avoid placing their infants in direct sunlight. Thus supplemental vitamin D is particularly important in infancy. Often newborn infants begin life with low body stores of vitamin D (Weiler and colleagues, CMAJ 2005). This prompted Dr. Weiler’s research group at McGill University to test how much vitamin D is needed by newborn infants in Canada. They learned that 400 to 1200 international units of vitamin D given daily to healthy term born infants is enough to support healthy bone growth and mineral deposition (Gallo and colleagues, JAMA 2013). In conducting tests of bone health, they also learned that the amount of muscle was enhanced and fat reduced when infants had very good vitamin D stores. Vitamin D stores are reflected in the blood. Blood concentrations of a vitamin D form called 25-hydroxyvitamin D are used to establish if stores are in a healthy range. In the recent study published in Pediatric Obesity by Hazell et al, values above 75 nanomoles per litre of blood plasma were linked to lower amounts of body fat (~450 g) at 3 years of age. The 450 g difference is almost a pound of fat. This is a meaningful amount to young children where typical amounts of body fat are 10-times that equating to 4.5 kg (almost 10 pounds). Thus the lower fat is still in a healthy range. (more…)
Author Interviews, Brain Injury, JAMA, Pediatrics / 02.05.2016

MedicalResearch.com Interview with: Zachary Y. Kerr, PhD, MPH Sports Injury Epidemiologist Director, NCAA Injury Surveillance Program Datalys Center for Sports Injury Research and Prevention Indianapolis, IN 46202 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kerr: A 2013 Institutes of Medicine report called for more research on concussion in athletes aged 5-21 years.  Although there is much research on the incidence of concussion across this age span, there is less related to outcomes such as symptoms and return to play time, let along comparisons by age. In examining sport-related concussions that occurred in youth, high school, and college football, we found differences in the symptomatology and return to play time of concussed players.  For example, the odds of return to play time being under 24 hours was higher in youth than in college.  Also, over 40% of all concussions were returned to play in 2 weeks or more. (more…)