Author Interviews, Cost of Health Care / 14.03.2016

MedicalResearch.com Interview with: Steffie Woolhandler MD, MPH, FACP and David U. Himmelstein MD, FACP CUNY School of Public Health at Hunter College MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Cadillac Tax aims to eventually eliminate tax subsides to employer-sponsored coverage.  When an employer provides health benefits to an employee, the employee pays no income or FICA tax on the value of those benefits, although the benefits are obviously part of the employee's compensation.  In other words, the taxpayers are currently picking up part of the employee's health insurance costs. Economists and politicians have been justifying the ACA's Cadillac Tax by portraying it as a "Robin Hood" tax that would take from the rich and give to the poor. That view of the Cadillac Tax is untrue.   We found that the main beneficiaries of the current tax subsidies to employer sponsored coverage are middle class families (defined by a family income between $39,000 and $100,000 in 2009 dollars) for whom the subsidies boost their effective income by about 5%.   These middle class people are the ones who would be most harmed when the Cadillac Tax kicks-in and curtails the current tax subsidies. (more…)
Abuse and Neglect, Autism, Depression / 14.03.2016

MedicalResearch.com Interview with: Dr. Rebecca A. Charlton PhD Senior Lecturer in Psychology; Undergraduate Admissions Tutor Department of Psychology Goldsmiths, University of London New Cross London, UK MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Charlton: Although Autism Spectrum Disorders are classified as developmental disorders, they last throughout life. Autism Spectrum Disorders were first identified in the 1940s, but it was only from the 1960s onwards that awareness of the condition began to increase. Initial research into Autism focused on the area of greatest need, i.e. childhood and education. Only now that those individuals first diagnosed with Autism are reaching old age are studies able to examine what happens in late-life. Although there are an increasing number of older adults with a diagnosis of Autism Spectrum Disorders, it is often difficult to identify individuals willing to participate in research. One alternative is to explore Autism traits in the general population, this is known as the Broad Autism Phenotype (BAP). These BAP traits occur in relatives of those with Autism and in the general population. By examining the BAP in community-dwelling older adults, we can begin to understand whether these traits confer additional risk to in ageing. MedicalResearch.com: What did you do in the study? What are the main findings? Dr. Charlton: Adults aged over 60 years old were recruited to take part in the study. They completed questionnaires reporting on presences of  Broad Autism Phenotype traits, executive functions (the ability to plan and organise behaviour), mood (depression and anxiety), and social support. Of the 66 individuals who participated, 20 individuals reported significant BAP traits – classified as the  Broad Autism Phenotype group. Individuals in the BAP group reported more problems with executive functions, higher rates of depression and anxiety, and less social support than those in the non-BAP group. Further analyses demonstrated that having  Broad Autism Phenotype traits was the factor that most explained presence of depression and anxiety symptoms among these older adults. (more…)
Author Interviews, BMJ, Pediatrics / 14.03.2016

MedicalResearch.com Interview with: Ashley Bryce, NIHR PhD student Centre for Academic Primary Care, University of Bristol (first author) Dr Céire Costelloe NIHR Health Protection Research Unit in Healthcare associated infections and AMR, Imperial College London (senior author)  MedicalResearch.com: What is the background for this study? Response: Antimicrobial resistance is an internationally recognised threat to health. Previous antibiotic use has been shown to be a risk factor for antimicrobial resistance in adults. The contribution of primary healthcare is particularly important as this is where almost 80% of all antibiotics used within the health service are prescribed. Children receive a lot of primary healthcare services and, as such, receive a disproportionately high number of antibiotics compared with middle aged populations. Despite this, little research has been published describing the prevalence of bacterial resistance in children or the risk factors of importance in this group. MedicalResearch.com: What are the main findings? Response: Prevalence of resistance to commonly prescribed antibiotics in primary care in children with urinary tract infections caused by E coli is high, particularly in countries outside the OECD, where one possible explanation is the availability of antibiotics over the counter. This could render some antibiotics ineffective as first line treatments for urinary tract infection. Routine use of antibiotics in primary care contributes to antimicrobial resistance in children, which can persist for up to six months after treatment. (more…)
AHA Journals, Author Interviews, Heart Disease, McGill / 14.03.2016

MedicalResearch.com Interview with: Dr George Thanassoulis MD MSc FRCPC McGill University Health Center and Research Institute Montreal, Quebec, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Thanassoulis: Currently statins are recommended in most countries worldwide based on 10-yr risk of heart disease but because age is the best predictor of future heart disease this leads to many more older patients being eligible for statins at the expense of younger people.  This means that even young patients with higher levels of low-density cholesterol, a known cause of heart disease, are not eligible for statins until they are much older.  However, waiting for these individuals to become "old enough for treatment" permits their higher LDL  to continue to damage their arteries leading, in some cases, to advanced coronary disease at the time when statins are finally stated.  So we are missing an opportunity to effectively prevent heart disease. What our analysis shows is that we need to consider not just someone's risk of having a heart attack but also whether they would be expected to benefit from statins.  By integrating information from randomized trials we were able to show that there were over 9.5 million Americans who were at low risk (and not eligible for statin therapy) that would have the same absolute benefit as higher risk people who we currently treat.  These patients, as expected, were younger but had higher levels of LDL cholesterol.  We also showed that statin therapy in these individuals would avoid more than 250,000 cardiac events over 10 years.  (more…)
Author Interviews, Heart Disease / 14.03.2016

MedicalResearch.com Interview with: Prof. Dr. Thomas Pilgrim Inselspital Berne Switzerland  Medical Research: What is the background for this study? Dr. Pilgrim: Long-term prognostic implications of different clinical manifestations of coronary artery disease are insufficiently understood at this time. A time variable pattern of recurrent events following PCI for STEMI, Non-STE-ACS or stable ischemic heart disease may have important implications for medical management and secondary prevention. Medical Research:? What are the main findings? Dr. Pilgrim: In our analysis, we found a differential in timing of ischemic events after PCI according to presentation with STEMI, NSTE-ACS, or stable ischemic heart disease, respectively. While patients with NSTE-ACS were at increased risk of death at any time after PCI as compared to patients with stable ischemic heart disease, patients with STEMI had an increased risk during the first 30 days after PCI but not thereafter compared to patients with stable ischemic heart disease. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA, OBGYNE / 14.03.2016

MedicalResearch.com Interview with: Ida Behrens, MD and Heather Boyd PhD Department of Epidemiology Research Statens Serum Institut Copenhagen, Denmark MedicalResearch.com: What is the background for this study? Response: Over the past decade, we have begun to realize that a woman’s pregnancy experiences can be a predictor of her future health. Miscarriages, stillbirths and preterm deliveries have all been linked with an increased risk of later cardiovascular disease, as have hypertensive disorders of pregnancy (preeclampsia and gestational hypertension). Women with preeclampsia also have an increased risk of peripartum cardiomyopathy, a rare but serious condition that severely compromises heart function at the end of pregnancy or shortly after delivery. We were interested to find out whether women with preeclampsia or gestational hypertension during one or more pregnancies also had an increased risk of cardiomyopathy later in life. MedicalResearch.com: What are the main findings? Response: Using Danish national registers, we followed more than 1 million women with pregnancies between 1978 and 2011 – with an average follow-up of almost 18 years per woman – to see whether women with hypertensive disorders of pregnancy had increased rates of cardiomyopathy later in life, compared with women who only had normotensive pregnancies. We found that the women with hypertensive disorders of pregnancy had a two-fold increased risk of cardiomyopathy later in life. Interestingly, only half of this increase in risk could be linked to chronic hypertension, which is common among women who have previously had a hypertensive disorder of pregnancy. The remaining 50% was not associated with hypertension and could potentially be directly attributable to the woman’s pregnancy experience (or to an underlying cause common to both hypertensive disorders of pregnancy and cardiomyopathy).  (more…)
Author Interviews, Breast Cancer / 14.03.2016

MedicalResearch.com Interview with: Professor Nigel Bundred MD, FRCS Professor of Surgical Oncology Institute of Cancer Sciences University Hospital of South Manchester MedicalResearch.com: What is the background for this study? Dr. Bundred: HER-2 is a cancer-causing gene which is expressed in some cells by having more copies of the gene and predicts for early relapse and metastasis from the tumour. Despite this, even in the absence of anything other than local treatment, some 50% of patients still survive for five years without relapse. Herceptin was discovered and licensed for use in 2006 because it improved survival when given with chemotherapy after surgery, from 66% at five years to 90% at five years. The use of Herceptin and chemotherapy before surgery to shrink the tumour indicates that around 30% of patients have a complete pathological response with this treatment. Combination of dual anti-HER-2 therapies and  Neoadjuvant chemotherapy given for six months before surgery has been shown to increase pCR rate to 50% and a single study utilising the combination of pertuzumab and trastuzumab (two anti-HER-2 monoclonal antibodies) given for four months revealed a 16.8% pCR rate. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Heart Disease / 14.03.2016

MedicalResearch.com Interview with: Pei-JieChen, Ph.D. Professor of Exercise Science, President of Shanghai University of Sport MedicalResearch: What is the background for this study? Dr. Pei-JieChen: Traditional Chinese exercises (such as Tai Chi, Qigong, Baduanjin) have been used for 2000 years with great contributions to human health, which are increasingly popular around the world. And traditional Chinese exercise is a low-risk, promising intervention that could be helpful for improving quality of life and depression in patients with cardiovascular diseases (CVDs).However, there appears to be no consensus agreement that traditional Chinese exercises (TCEs) could be effective for CVDs. Therefore, we performed a systematic review and meta-analysis to estimate the effectiveness of Traditional Chinese exercise for patients with CVDs. MedicalResearch: What are the main findings? Dr. Pei-JieChen: The pooling revealed that TCEs could decrease systolic blood pressure by 9.12 mmHg and diastolic blood pressure by 5.12 mmHg. Patients performing traditional Chinese exercises were also found superior compared with those in the control group in terms of triglyceride, six-minute walk test, Minnesota Living with Heart Failure Questionnaire results, SF-36 physical function, and Profile of Mood States depression. (more…)
Author Interviews, JAMA, Ophthalmology / 14.03.2016

MedicalResearch.com Interview with: Fanny Raguideau Evaluateur en pharmaco-épidémiologie Direction Scientifique et de la Stratégie Européenne Pôle Epidémiologie des produits de santé  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Retinal detachment (RD), including both exudative types often associated with systemic diseases that might be receiving antibiotics for related conditions as well as rhegmatogenous which require prompt surgical intervention to reduce the chance of irreversible severe vision loss, has an annual incidence rate of 1 per 10,000 in the general population. Rhegmatogenous is the most common type. Fluoroquinolones are one of the most commonly prescribed classes of antibiotics. Thanks to their broad-spectrum antibacterial coverage, they are effective in the treatment of a wide variety of community-acquired infections. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have suggested that oral fluoroquinolone use increased the risk of Retinal detachment, however this association remains controversial. We conducted a nationwide self-matched design study to overcome limitations of previous studies. Our finding of a significant increased risk of  Retinal detachment, including both rhegmatogenous and exudative types, following use of oral fluoroquinolone strongly supports the existence of this association. (more…)
Author Interviews, Cancer, Cancer Research, Cost of Health Care / 14.03.2016

MedicalResearch.com Interview with: Hrishikesh Kale School of Pharmacy Virginia Commonwealth University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The cost of cancer care in the United States is extremely high and escalating every year. Because of increased cost sharing, patients are paying higher out-of-pocket costs for their treatments. Along with high medical expenses, cancer survivors face problems such as loss of employment and reduced productivity. It has been well-established in the literature that because of high out-of-pocket costs, many cancer survivors forgo or delay medical care and mental health-related services and avoid filling prescriptions. This puts their physical and mental health at risk. A related issue is the growing number of cancer survivors in the U.S. As of January 2014, there were approximately 14.5 million cancer survivors in the U.S. By 2024, this number is expected to reach 19 million as a result of improved survival among patients with cancer along with an aging population. Therefore, we decided to investigate the prevalence and sources of financial problems reported by a nationally representative sample of cancer survivors from the 2011 Medical Expenditure Panel Survey. We also studied the impact of cancer-related financial burden on survivors’ health-related quality of life and psychological health. (more…)
Alzheimer's - Dementia, Author Interviews, Exercise - Fitness, Lifestyle & Health / 14.03.2016

MedicalResearch.com Interview with: Cyrus A. Raji, MD, PhD Resident in Diagnostic Radiology UCLA Health System  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Raji: The purpose of this study was to investigate the relationship between caloric expenditure from leisure physical activities (15 different ones were assessed from walking to gardening to dancing to swimming etc.). Increased caloric expenditure from these physical activities were related to larger gray matter volumes in key brain areas for memory and learning (hippocampus, precuneus) that are also affected by Alzheimer's. These findings were demonstrated in 876 persons who had MRI scans and caloric expenditure assessed. Five years after the scan a subset of 326 persons from the larger group of 876 were followed cognitively and it was found that those with larger gray matter volumes associated with physical activity in the orbital frontal cortex and precuneus had a 2 fold reduction in the risk for cognitive decline to mild cognitive impairment and Alzheimer's dementia.  (more…)
Author Interviews, Infections, OBGYNE, Pediatrics / 14.03.2016

MedicalResearch.com Interview with: Elaine Tuomanen, MD Chair and Full Member Dept of Infectious Diseases St Jude Children’s Research Hospital 262 Danny Thomas Place Memphis, TN 38105 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Tuomanen: While investigating mechanisms of brain repair during infection in a mouse model system, we found that components from the surfaces of bacteria could traffic from the mother to the fetus. The bacterial components moved across the placenta and into the fetal brain. To our surprise, the fetal brain did not respond with neuronal death like we see in children with meningitis. Rather, fetal neurons proliferated. This response involved the innate immune system (TLR2) inducing the neuronal transcription factor, FoxG1, which is known to drive proliferation. The newly born neurons migrated appropriately to the cortical plate, the area on the surface of the fetal brain that forms the cortex, a major part of the adult brain. Although the neurons moved to the right place in the brain, there were too many and they crowded together in the cortex, changing the architecture of the brain. At birth, affected mice seemed to have no abnormalities. However, when we tested if this change in architecture would affect brain function after birth, mice were shown to progressively develop defects in learning, memory and other cognitive functions. This indicates there is a window during pregnancy where components of bacteria from the mother can change fetal brain architecture and subsequent postnatal behavior (more…)
Allergies, Author Interviews, Immunotherapy / 14.03.2016

MedicalResearch.com Interview with: Stacy L. Rosenberg, MD UPMC Montefiore Allergy and Immunology Fellow MedicalResearch.com: What is the background for this study? Dr. Rosenberg: Allergy shots or allergen immunotherapy (AIT) is an effective therapy for allergic rhinoconjunctivitis (hay fever).  Low adherence has been a significant barrier, whereas rush immunotherapy to environmental allergens provides rapid build-up and offers quicker efficacy, which may improve adherence.  However, there have been concerns for increased risk of systemic reactions with rush protocols.  We describe a new protocol for modified rush AIT that offers quicker build-up towards a maintenance dose with improved safety and lower risk of systemic reactions.  We also hypothesize that there are specific characteristics that distinguish patients who develop systemic reactions in the setting of modified environmental rush immunotherapy (MERIT). MedicalResearch.com: What are the main findings? Dr. Rosenberg: Overall, MERIT has a good safety profile.  A subset of patients did develop systemic reactions, which were mild.  Lower BMI was associated with systemic reactions and there was a trend between history of urticaria (hives) and younger age with development of systemic reactions.  Significantly more patients with systemic reactions had allergen extracts containing cat, dust mite, and weed pollen.  Neither gender, asthma, nor anaphylaxis history were associated with an increased risk of systemic reactions. (more…)
Author Interviews, Nutrition / 12.03.2016

MedicalResearch.com Interview with: Noelle R Noyes PhD Department of Clinical Sciences Colorado State University, Fort Collins MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is the increasing concern about antibiotic resistant infections, and what we can do as a society to help minimize the development and spread of antibiotic resistance. Antibiotic resistance is a natural and ancient phenomenon in bacteria, but we can do things to bacterial populations to increase the amount of resistant bacteria and to promote the spread of resistant bacteria. It behooves us to try to identify specific practices that might be contributing to increases in antibiotic resistance, and to understand how we can change them to minimize risk. Towards this end, our study utilized new methods for investigating the ecology of antibiotic resistance throughout the process of beef production, from the time cattle enter feedlots through slaughter to the beef products that we eventually buy in the grocery store. Livestock production is thought to play a role in antibiotic resistance, although we have very little understanding of how important this role may be compared to other sectors like human hospitals, municipal wastewater treatment, daycare facilities, etc… We wanted to use new DNA sequence-based methods to try to get a high-level picture of what was happening with antibiotic resistance genes in feedlots and slaughterhouses. This high-level picture could then help us to understand how important cattle production may be in the overall ecology of antibiotic resistance, including the food chain and wider environment. (more…)
Addiction, Author Interviews, Pediatrics / 11.03.2016

MedicalResearch.com Interview with: Yanning Wang, MS Statistical Research Coordinator Department of Pathology, Immunology and Laboratory Medicine Department of Health Outcomes and Policy University of Florida College of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of new stimulant medications have been approved for attention deficit/hyperactivity disorder (ADHD) treatment in the past decade. The expansion of this market, along with the increase in ADHD diagnosis, provides greater availability of these drugs. This has raised public health concerns about potential non-medical use of prescription stimulants. Our study analyzed data from the National Monitoring of Adolescent Prescription Stimulants Study, which recruited and surveyed youth aged 10 to 18 years from entertainment venues in 10 US cities. We found that 6.8% of youth (750 out of 11,048) used prescription stimulants in the past 30 days. Among those 750 youth, more than half reported some type of non-medical use, and using someone else’s medication was the most common form (88.4 %). We investigated the difference between two subgroups of non-medical users: youth who only used stimulants non-medically, and those who had a prescription and reported non-medical use in the past 30 days. We found youth who only used stimulants non-medically at higher rate of using other substances and more likely to have close friends who have tried other drugs. (more…)
Author Interviews, Prostate Cancer, Surgical Research / 11.03.2016

MedicalResearch.com Interview with: Naveen Pokala, MD Division of Urology University of Missouri Columbia, MO 65212 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Pokala: The main purpose of the study was to determine survival outcome following salvage prostatectomy in men that fail radiation therapy. Radiation and surgery are the main modalities utilized to treat localized prostate cancer. When patients fail radiation treatment, traditionally, only hormonal treatment was offered. With refinements in surgical techniques, a select few of these patients that have recurrence after radiation may benefit with salvage surgery. Salvage prostatectomy is a complex procedure because prior radiation makes this procedure tenuous, but this procedure is offered in most major tertiary medical centers. (more…)
Author Interviews, Lancet, OBGYNE / 11.03.2016

MedicalResearch.com Interview with: Charles J. Lockwood, MD Member of of the March of Dimes Board of Trustees Dean at Morsani College of Medicine Senior Vice President, USF Health and Professor of Obstetrics & Gynecology, and Public Health The University of South Florida  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lockwood: There remain questions about the utility of vaginal progesterone therapy in asymptomatic women with singleton gestations at risk for preterm birth. The OPPTIMUM study investigators conducted a double-blind, randomized, placebo-controlled trial of vaginal progesterone delivered via a pessary releasing 200 mg per day (n=618) vs. placebo (n=610) from around 22 to 34 weeks gestation among women at high risk for prematurity on the basis of a characteristic history and/or the presence of cervicovaginal fetal fibronectin or a cervical length less than 25 mm in length on transvaginal ultrasound.  The primary endpoints were fetal death or preterm birth before 34 weeks (obstetrical outcome), or a composite of neonatal mortality or morbidities (neonatal outcome).  The authors found that progesterone had no significant impact on either primary endpoint, with an adjusted OR of 0·86, 95% CI: 0·61-1·22 for obstetrical outcomes and an OR of 0·62, 95% CI:0·38-1·03 for neonatal outcomes. (more…)
Author Interviews, Hospital Readmissions, JAMA, Orthopedics, Surgical Research / 11.03.2016

MedicalResearch.com Interview with: Ronald S. Chamberlain, MD, MPA, FACS Chairman and Surgeon-in-Chief Department of Surgery Saint Barnabas Medical Center Professor of Surgery New Jersey Medical School Rutgers University MedicalResearch.com: What is the background for this study? Dr. Chamberlain:  With the rapidly growing arthritic, aging, and obese population, total hip replacement (THR) has become the most commonly performed orthopedic procedure in the United States (US).  The Affordable Care Act signed by President Barack Obama imposed financial penalties for excess readmissions following certain procedures and diagnoses. While the initial program aimed to reduce readmissions for heart failure, pneumonia, and acute myocardial infarction (AMI), the program expanded to include THR in 2015. With current research estimating a 10%, 30-day readmission rate following a total or partial hip replacement, this study sought to identify factors associated with readmission and to create a scale which could reliably stratify preoperative readmission risk. (more…)
Author Interviews, Cancer Research, JAMA / 11.03.2016

MedicalResearch.com Interview with: Joseph Unger, PhD, MS SWOG Statistical Center Assistant Member, Public Health Sciences Division, Fred Hutchinson Cancer Research Center Affiliate Assistant Professor, Health Services Research, University of Washington Seattle, WA  98109-1024 MedicalResearch.com: What is the background for this study? Dr. Unger: The rate at which trials are positive has previously been examined, and the relationship between trial results and publication rates in the context of publication bias has also been studied. But the comparative scientific impact of positive vs negative clinical trials using citation data has not been investigated We used the phase III trial database of SWOG, a major national cooperative clinical trials group, in combination with its trial publication database and citation data from Google Scholar, to compare the scientific impact of positive vs negative phase III cancer clinical treatment trials. (more…)
Author Interviews, Heart Disease / 11.03.2016

MedicalResearch.com Interview with: Malin Inghammar, MD, PhD Department of Infectious Diseases Skåne University Hospital, Lund Sweden  MedicalResearch.com: What is the background for this study? Dr. Inghammar: Fluoroquinolones are a class of antibiotics with a widespread use in the treatment of common infections. Agents of this drug are generally well tolerated and have few side effects but in some people fluoroquinolones can prolong the QT-interval. QT-prolongation is a sort of electrical disturbance in the heart that can, in rare instances, lead to potentially life-threatening arrhythmia. Some drugs are well known to cause QT-prolongation and to be able to trigger arrhythmia. Fluoroquinolones however, have only weak effect on the QT-time. There have been a few previous studies published reporting an increased risk. Some of these, compared fluoroquinolone treated patients with people who were not treated with antibiotics at all. In these studies, it can’t be ruled out that the infection itself, rather than the antibiotic treatment could have influenced the risk of arrhythmia. In some other previous studies, there have been indications that the patients receiving fluoroquinolones were of poorer general health than the comparison group, which could also have affected the results. Therefore it is not clear if oral fluoroquinolone treatment leads to an increased risk of serious cardiac arrhythmia in an everyday clinical situation. (more…)
Author Interviews, Pain Research, Stanford / 11.03.2016

MedicalResearch.com Interview with: Eric Sun, MD/PhD Instructor Department of Anesthesiology, Perioperative and Pain Medicine Stanford University MedicalResearch.com: What is the background for this study?  Dr. Sun: Epidural steroid injections are frequently used to treat chronic low back pain.  While previous studies have shown they are effective at improving symptoms, whether they reduce spending is unknown.  These concerns are particularly salient because insurers are worried that epidural steroid injections are being overused. MedicalResearch.com: What are the main findings? Dr. Sun: Overall, we find that epidural steroid injections were associated with decreases in spending ranging from five to fifteen percent, depending on the specific indication.  These differences were largely driven by decreases in outpatient spending (e.g., spending on outpatient physician visits). (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Radiology / 10.03.2016

MedicalResearch.com Interview with: Guillermo J. Tearney, MD PhD Mike and Sue Hazard Family MGH Research Scholar Professor of Pathology, Harvard Medical School Wellman Center for Photomedicine Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Dr. Tearney: In this study, we investigated a new, advanced catheter-based imaging technology for identifying the coronary plaques that may potentially precipitate heart attack. The new technique combines intracoronary OCT, that provides images of tissue emicrostructure with near-infrared autofluorescence (NIRAF) that informs on the molecular/biological characteristics of plaque. MedicalResearch.com: What are the main findings? Dr. Tearney: Our main findings were that: 1) Intracoronary OCT-NIRAF is safe and feasible in patients 2) NIRAF was elevated focally in portions of the coronary artery that contained high risk OCT features, and 3) The findings are suggestive that NIRAF may be a new imaging feature that is indicative of inflammation in human coronary lesions in vivo. (more…)
Author Interviews, Diabetes, JAMA, Multiple Sclerosis / 10.03.2016

MedicalResearch.com Interview with: Jorge Correale MD Department of Neurology, Institute for Neurological Research Dr Raúl Carrea Buenos Aires, Argentina MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Correale: First it is now well known that in parallel to the specific treatment of Multiple Sclerosis, those comorbidities that worsen the course of the disease should be treated. For example, cardiovascular diseases. Moreover there are in vitro and in animal models evidence of an anti-inflammatory role of compounds investigated in this publication evidence. (more…)
Author Interviews, Brain Injury, Pediatrics / 10.03.2016

MedicalResearch.com Interview with: Roger Zemek, MD, FRCPC Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario Ottawa, ON MedicalResearch.com: What is the background for this study? Dr. Zemek: The number of concussions have dramatically increased over the past decade.  Not only are children and adolescents are at highest risk for getting concussions, they also take longer to recover.  As part of our background work, our team performed a systematic review (published in JAMA Pediatrics) confirming that validated, easy-to-use prognosticators did not exist for clinicians to identify children with concussion who are at the highest risk for persistent post-concussive symptoms (PPCS) and sequelae. MedicalResearch.com: What are the main findings? Dr. Zemek: In this, the largest concussion study in the world to-date, we derived and validated in a large, diverse cohort of children a clinical risk score that is significantly superior to clinicians’ ability to predict future PPCS at the time of ED presentation. Multivariate analysis revealed that age group, female sex, past history of migraine, prior concussion with symptom duration of >1 week, ED presentation with “answering questions slowly”, 4 or more errors on BESS Tandem stance, and the initial symptoms of headache, noise sensitivity and fatigue were all clinically significant and strongly associated with PCS at 1-month. We assigned points based on the adjusted multivariate odds ratio, and the rule incorporating patient demographic factors, past history, early cognitive deficits, balance (an physical exam finding), and early symptoms.  The rule has a maximum of 12 points.  We selected two cut-off points in order to yield three clinically relevant (low, intermediate and high risk) categories for the development of PPCS at one month. (more…)
Author Interviews, BMJ, Nutrition, Sugar, Weight Research / 10.03.2016

MedicalResearch.com Interview with: Euridice Martinez Steele  University of São Paulo, São Paulo MedicalResearch.com: What is the background for this study? Response: Several leading health bodies, including the World Health Organization, the Canadian Heart and Stroke Foundation, the American Heart Association, and the US Dietary Guidelines Advisory Committee have concluded that excess added sugar intake increases the risk not only of weight gain, but also of obesity and diabetes, which are associated with a heightened risk of cardiovascular disease, and tooth decay. All reports recommended limiting intake of added sugars. In the US, the USDGAC recommended limiting added sugars to no more than 10% of total calories. To design and implement effective measures to reduce added sugars, their dietary sources must be clearly identified. Added sugars can be consumed either as ingredients of dishes or drinks prepared from scratch by consumers or cook, or as ingredients of food products manufactured by the food industry. According to market disappearance data from 2014, more than three quarters of the sugar and high fructose corn syrup available for human consumption in the US were used by the food industry. This suggests food products manufactured by the industry could have an important role in the excess added sugars consumption in the US. However, to assess this role, it is essential to consider the contribution of manufactured food products to both total energy intake and the energy intake from added sugars, and, more relevantly, to quantify the relationship between their consumption and the total dietary content of added sugars. To address these questions, we performed an investigation utilizing 2009-2010 National Health and Nutrition Examination Survey (NHANES). (more…)
Author Interviews, JAMA, Rheumatology, Vitamin D / 10.03.2016

MedicalResearch.com Interview with: Changhai Ding, MBBS, MMED, MD Australian Research Council Future Fellow Associate Director (International), Menzies Institute for Medical Research Professor,  University of Tasmania, Australia Honorary Professor, University of Sydney, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ding: Vitamin D can reduce bone turnover and cartilage degradation, thus potentially preventing the development and progression of knee osteoarthritis. Observational studies suggest that vitamin D supplementation is associated with benefits for knee osteoarthritis, but current evidence from clinical trials is contradictory. We  conducted a randomised clinical trial in Hobart, Tasmania and Melbourne, Victoria in Australia. We randomly assigned 413 patients with symptomatic knee osteoarthritis and low 25-hydroxyvitamin D to receive monthly treatment with oral vitamin D3 (50,000 IU; n = 209) or an identical placebo (n = 204) for 2 years. Of 413 enrolled participants (average age, 63 years; 50 percent women), 340 (82 percent) completed the study. Vitamin D supplementation significantly increased blood 25-hydroxyvitamin D levels over 2 years compared with placebo treatment; however, vitamin D supplementation, compared with placebo, did not result in significant differences in change in MRI-measured tibial cartilage volume or a measure of knee pain over 2 years. There were also no significant differences in change of tibiofemoral cartilage defects or change in tibiofemoral bone marrow lesions. Post-hoc analyses indicated that vitamin D supplementation might improve knee physical function and reduce another measure of knee pain and increases in bone marrow lesion. (more…)
Author Interviews, Heart Disease, JACC / 10.03.2016

MedicalResearch.com Interview with: Cathy Handy, MD MPH  Fellow, Department of Oncology Johns Hopkins Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Handy: We explored the relationship between coronary artery calcium and age related diseases.  Coronary artery calcium refers to calcium deposits in the blood vessels of the heart.  It can be seen with a non invasive imaging test and is thought to be a biologic measure of aging.  Previous research has shown coronary artery calcium to be highly correlated with cardiovascular disease and mortality. We found that it is also associated with an increased risk of cancer, pneumonia, chronic kidney disease, chronic obstructive pulmonary disease and hip fractures. (more…)