Author Interviews, Kidney Disease, Lipids / 01.12.2014

Thomas Weichhart, PhD Associate Professor, Medical University of Vienna Institute of Medical Genetics Vienna AustriaMedicalResearch.com Interview with: Thomas Weichhart, PhD Associate Professor, Medical University of Vienna Institute of Medical Genetics Vienna Austria Medical Research: What is the background for this study? Dr.  Weichhart: Impairment of high-density lipoprotein (HDL) function has been associated with cardiovascular events in patients with kidney failure on hemodialysis. The protein composition of HDLs is altered in these patients presumably compromising the cardioprotective effects of HDLs. In an earlier study we found that two proteins in particular, namely Serum Amyloid A (SAA) and Surfactant Protein B (SP-B), are significantly raised in the HDL of dialysis patients, and these also contribute towards HDL losing its protective effect. In the current study we have now developed an novel test that can quickly and directly measure the SAA and SP-B bound to HDL. (more…)
Author Interviews, General Medicine, Heart Disease, JAMA, Kidney Disease / 30.11.2014

Giovanni Landoni, M.D. Head of Research,Department of Anesthesiology and Intensive Care Associate Professor at Università Vita-Salute San Raffaele, MilanMedicalResearch.com Interview with: Giovanni Landoni, M.D. Head of Research,Department of Anesthesiology and Intensive Care Associate Professor at Università Vita-Salute San Raffaele, Milan Medical Research: What is the background for this study? Dr. Landoni: The prevention and treatment of acute kidney injury after cardiac surgery is a major therapeutic goal, but no effective agents have yet been identified. Meta-analyses suggested that fenoldopam might be effective. Medical Research: What are the main findings? Dr. Landoni: We found that in cardiac surgery patients with early acute kidney injury (defined as a ≥50% increase of serum creatinine from baseline or oliguria for ≥6 hours), fenoldopam had no impact on the need for renal replacement therapy or 30-day mortality, while increasing the rate of hypotension. (more…)
Author Interviews, Cancer Research / 30.11.2014

Charles Brenner, PhD Roy J. Carver Chair & Head of Biochemistry Departments of Biochemistry & Internal Medicine Carver College of Medicine University of Iowa Iowa City, IA 52242MedicalResearch.com Interview with: Charles Brenner, PhD Roy J. Carver Chair & Head of Biochemistry Departments of Biochemistry & Internal Medicine Carver College of Medicine University of Iowa Iowa City, IA  52242 Medical Research: What is the background for this study? What are the main findings? Dr. Brenner: KRAS mutations are extremely common in human malignancies. The KRAS gene is an oncogene that drives cell growth pathways and that leads to silencing and inactivation of tumor suppressor genes. It was known that KRAS mutant cancer cells silence tumor suppressor genes but the precise mechanism for gene silencing was not known. In this study, we discovered that KRAS mutations turn off the TET1 gene. TET1 functions as an "eraser" of gene silencing marks. When KRAS mutations occur, the TET1 eraser isn't expressed any longer, and a series of tumor suppressor genes become silenced. This is an essential part of the aggressiveness of KRAS-dependent cancers and is controlled by the ERK pathway that is turned on by KRAS. In short, KRAS turns on ERK, which turns off TET1. When TET1 is off, a set of tumor suppressor genes are also turned off, which drives cancer formation. (more…)
Author Interviews, JAMA, Surgical Research / 30.11.2014

Hong Ryul Jin, MD Professor and Chair Department of Otorhinolaryngology-HNS Seoul National University Boramae Medical Center, Seoul, KoreaMedicalResearch.com Interview with: Hong Ryul Jin, MD Professor and Chair Department of Otorhinolaryngology-HNS Seoul National University Boramae Medical Center, Seoul, Korea Medical Research: What is the background for this study? What are the main findings? Response: Although autologous rib cartilage is a useful graft material for rhinoplasty, surgeons sometimes encounter unpleasant complication such as warping or donor-site morbidity. These complications are not infrequent, but there has been no systematic review with regarding this matter. For evidence-based practice, we aimed to assess the long-term safety of using rib cartilage by means of meta-analysis. By reviewing the 10 selected, eligible articles after extensive screening, we found that rates of warping, resorption, infection, and displacement were 3.1, 0.2, 0.6, and 0.4%, respectively. Hypertrophic scar at chest was found in 5.5%, with highest report of 23.8%. Warping and hypertrophic chest scarring showed relatively higher rates, warranting a surgeon’s attention (more…)
Author Interviews, CDC, Smoking / 30.11.2014

MedicalResearch.com Interview with: Darryl Konter Health Communications Specialist, Office on Smoking and Health at Centers for Disease Control and Prevention Medical Research: What is the background for this study? What are the main findings? Response: Tobacco use is the leading cause of preventable disease and death in the United States, resulting in more than 480,000 premature deaths and $289 billion in direct health care expenditures and productivity losses each year. Despite progress over the past several decades, millions of adults still smoke cigarettes, the most commonly used tobacco product in the United States. Cigarette smoking among U.S. adults declined from 20.9% in 2005 to 17.8% in 2013. Among cigarette smokers who smoke daily, the average number of cigarettes smoked per day declined from 16.7 in 2005 to 14.2 in 2013, and the proportions of daily smokers who smoked 20–29 or ≥30 cigarettes per day also declined. However, an estimated 42.1 million adults still smoked cigarettes in 2013. Moreover, cigarette smoking remains particularly high among certain groups, including adults who are male, younger, multiracial or American Indian/Alaska Native, have less education, live below the federal poverty level, live in the South or Midwest, have a disability/limitation, or who are lesbian, gay, or bisexual. (more…)
Cognitive Issues, Sleep Disorders / 30.11.2014

Daniel Sternberg PhD. Data Scientist at LumosityMedicalResearch.com Interview with: Daniel Sternberg PhD. Data Scientist at Lumosity Medical Research: What is the background for this study? What are the main findings? Dr. Sternberg: We were interested in examining how lifestyle factors such as sleep, mood and time of day impact cognitive game play performance. We analyzed game play performance data on Lumosity tasks from more than 60,000 participants and found that performance on the tasks designed to challenge memory, speed, and flexibility peaked in the morning, while performance on tasks designed to challenge aspects of crystallized knowledge such as arithmetic and verbal fluency peaked in the afternoon. Overall, game performance for most tasks was highest after seven hours of sleep and with positive moods, though performance on tasks that challenged crystallized knowledge sometimes peaked with less sleep. (more…)
Author Interviews, Prostate, Prostate Cancer, Testosterone / 29.11.2014

MedicalResearch.com Interview with: Prof. h.c.* Dr. Farid Saad on behalf of Dr. Haider and co-authors Global Medical Affairs, Andrology c/o Bayer Pharma AG, D-13342 Berlin *Gulf Medical University, Ajman, UAE Medical Research: What is the background for this study? Response: In early 1940s Dr. Charles Huggins demonstrated that in few men with metastatic prostate cancer, castration reduced tumor growth and androgen administration promoted tumor growth. This observation became the corner stone of androgen deprivation therapy (ADT) in men with prostate cancer for the past 7 decades without any clinical evidence to the contrary. Indeed, normal prostate growth depends on androgens and therefore testosterone and its metabolite DHT are responsible for the biochemical signaling in the prostate cells through interaction with the androgen receptor. Since tumor cells have been transformed from normal epithelial cells, it is no surprise that they retained the expression of the androgen receptor and continue to depend on their growth on the androgen signal. For the past 7 decades, physicians thought that testosterone is a carcinogen for the prostate, despite lack of any biochemical or clinical data. This long period of training physicians on this unproven concept, has precipitated in the minds of many clinicians that testosterone (T) causes prostate cancer. Based on a plethora of clinical data, there is no evidence to support such myth. In fact, many recent studies have debunked this hypothesis based on longitudinal and prospective studies. A newly advanced hypothesis was formulated suggesting that “T therapy does not pose a greater risk for development of PCa.” However this hypothesis is met with considerable skepticism. Interestingly, however, no new compelling evidence is available to discredit or dismiss this newly advanced hypothesis. (more…)
Author Interviews, Inflammation, Nutrition / 28.11.2014

Joana Alves Dias, MPH Department of Clinical Sciences in Malmö, Lund University Malmö, Sweden MedicalResearch.com Interview with: Joana Alves Dias, MPH Department of Clinical Sciences in Malmö, Lund University Malmö, Sweden Medical Research: What is the background for this study? What are the main findings? Response: The evidence that chronic inflammation may be in the genesis of diseases such as cardiovascular disease, type-II diabetes, and certain types of cancer is increasing. It is suggested that lifestyle factors such as diet, physical activity, smoking, and alcohol consumption could influence the inflammatory state. Instead of focusing on single nutrient effects, we used a hypothesis-driven approach to food pattern studies, and constructed a diet quality index based on the Swedish Nutrition Recommendations and Swedish Dietary guidelines (DQI-SNR). The DQI-SNR consisted of 6 components. Individuals were assigned 0 when not adhering to a recommendation and 1 when adhering, resulting in total scores ranging from 0 to 6. We classified individuals in low (0 or 1 points), medium (2 or 3) and high (4-6 points) diet quality. We explored the association between the index scores and low-grade inflammation. Our study indicates that adherence to a high quality diet is associated with lower systemic inflammation, as measured by several soluble and cellular biomarkers of inflammation, in middle-aged individuals. In other words, adherence to the general nutrition recommendations could help prevent the development of diseases associated with chronic inflammation. The anti-inflammatory effects of Mediterranean-like diets have been studied extensively, but this study focused on the Swedish dietary habits and recommendations for the Swedish population, and reached similar conclusions. (more…)
Author Interviews, Breast Cancer / 28.11.2014

Ben Ho Park, M.D., Ph.D. Associate Professor of Oncology, Breast Cancer Program Associate Director, Hematology/Oncology Fellowship Training Program The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore, MD 21287MedicalResearch.com Interview with: Ben Ho Park, M.D., Ph.D. Associate Professor of Oncology, Breast Cancer Program Associate Director, Hematology/Oncology Fellowship Training Program The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore, MD  21287 Medical Research: What is the background for this study? What are the main findings? ​Dr. Park: To discover genetic mediators of tamoxifen resistance in breast cancers, we used genetic screening of breast cancer cell line models and patient data to ​identify a new gene that can mediate drug resistance. We found that amplification and overexpression of this gene in estrogen receptor positive breast cancers results in resistance and is associated with worse outcomes in patients whose tumors demonstrate amplification/overexpression of this gene. (more…)
Allergies, Author Interviews, Genetic Research / 28.11.2014

Dr. Hakon Hakonarson MD PhD The Center for Applied Genomics, The Children’s Hospital of Philadelphia Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania Philadelphia, Philadelphia, PennsylvaniaMedicalResearch.com Interview with: Dr. Hakon Hakonarson MD PhD The Center for Applied Genomics, The Children’s Hospital of Philadelphia Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania Philadelphia, Philadelphia, Pennsylvania Medical Research: What is the background for this study? What are the main findings? Dr. Hakonarson: We have built the world’s largest pediatric biobank at the Center for Applied Genomics at CHOP. Eosinophilic esophagitis (EoE) is among the projects we have sampled in collaboration with the EoE Center in collaboration with Dr. Spergel. We have nearly 1,000 samples now of this relatively rare disorder, which is now well powered for GWAS.  We previously  reported association of the TSLP locus with Eosinophilic esophagitis. Here we report genome-wide significant associations at four additional loci; c11orf30 and STAT6, which have been previously associated with both atopic and autoimmune diseases, and two EoE-specific loci, ANKRD27 that regulates the trafficking of melanogenic enzymes to epidermal melanocytes and CAPN14, that encodes a calpain whose expression is highly enriched in the esophagus in EoE.  This discovery not only improves our understanding of the pathobiology of  EoE, but also represents novel targets for the development of new therapies to treat the disease. (more…)
Author Interviews, Cancer Research, Lancet / 28.11.2014

Dr Claudia Allemani PhD FHEA MFPH Senior Lecturer in Cancer Epidemiology Cancer Research UK Cancer Survival Group Department of Non-Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine, London UKMedicalResearch.com Interview with: Dr Claudia Allemani PhD FHEA MFPH Senior Lecturer in Cancer Epidemiology Cancer Research UK Cancer Survival Group Department of Non-Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine, London UK Medical Research: What is the background for this study? Dr. Allemani:  Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. The first CONCORD study was published in 2008.1 It brought together data from 101 cancer registries in 31 countries, and included 1.9 million patients diagnosed during 1990-94 with a cancer of the colon, rectum, breast or prostate and followed up to the end of 1999. It revealed very wide international differences in five-year survival, and it confirmed the well-known racial discrepancy in cancer survival in the USA. CONCORD-2 is the most comprehensive international comparison of trends in population-based cancer patient survival to date. It extends the first study in three ways:
  • it covers 10 common cancers: collectively, these account for almost two-thirds (63%) of all cancer patients diagnosed each year in both developed and developing countries
  • it includes data on more than 25 million cancer patients, provided by 279 cancer registries in 67 countries, in 40 of which the data provide complete (100%) coverage of the national population
  • it examines trends in cancer survival for patients diagnosed over the 15-year period 1995-2009 (more…)
Aging, Author Interviews / 28.11.2014

Prof. Takeo Watanabe The Fred M. Seed Professor Cognitive, Linguistic and Psychological Sciences Brown UniversityMedicalResearch.com Interview with: Prof. Takeo Watanabe The Fred M. Seed Professor Cognitive, Linguistic and Psychological Sciences Brown University Medical Research: What is the background for this study? What are the main findings? Prof. Watanabe: In the current study also supported by NIH, we obtained surprising results. That is, older people learn what younger people do not learn. We asked subjects to do a letter identification task at the center of a screen while another stimulus was presented in the background. This background stimulus contained a group of dots moving in one direction with noises and had nothing to do with the task. Therefore the motion was task-irrelevant. If the motion is clearly perceived, learning on the motion as task-irrelevant did not occur when subjects were college students. However, older people ended up increasing sensitivity to and, therefore learned, such task-irrelevant motion. This might sound as if the older brain worked better than the younger brain in visual perceptual learning. However, that may not be the case. Our brain capacity is limited. If our brain learned items that are not relevant to a given task and therefore are unimportant to us, there would be the risk of such unimportant items replacing important information which has already existed in the brain. Thus, learning of task-irrelevant and therefore unnecessary information could be harmful and decrease the efficiency of learning of what is important. (more…)
General Medicine / 28.11.2014

Dr. Norman Putzki, MD PhD Global Program Medical Director Neuroscience Development Franchise Novartis Pharma AG Basel, Switzerland MedicalResearch.com Interview with: Dr. Norman Putzki, MD PhD Global Program Medical Director Neuroscience Development Franchise Novartis Pharma AG Basel, Switzerland Medical Research: What is the background for this study? What are the main findings? Dr. Putzki: Herpes zoster (HZ) infections are increasingly reported in patients taking multiple sclerosis (MS) disease modifying treatments (DMTs). This has been a particular concern ever since more potent MS DMTs have become available. We have assessed the experience with oral fingolimod, a first in class S1P receptor modulator licensed for multiple sclerosis treatment in 2010, which has today more than 140,000 patient years of exposure in MS clinical trials and the post-marketing setting. Key findings include the fact that Herpes Zoster (HZ) infections occurred at a low rate in clinical trials but were more frequent than with placebo. In the post-marketing setting, Herpes zoster reporting rates have not increased over time versus clinical trials, and rates have remained stable over time (so there is no risk accumulation). Our article, which is the result of a consensus meeting with experts in the field of MS and infectious diseases, provides general guidance on risk mitigation; this includes vigilance and appropriate HZ infection management, relevant to physicians when prescribing MS DMTs. (more…)
Heart Disease / 28.11.2014

Concetta Crivera MPH, Pharm.D Associate Director, Outcomes Research Ortho-McNeil Janssen Scientific Affairs, LLCMedicalResearch.com Interview with: Concetta Crivera MPH, Pharm.D Associate Director, Outcomes Research Ortho-McNeil Janssen Scientific Affairs, LLC   Medical Research: What is the background for this study? What are the main findings? Response: Findings from the study presented at the American Heart Association (AHA) 2014 Scientific Sessions showed once-daily XARELTO® (rivaroxaban) is associated with significantly fewer hospitalization days and outpatient visits compared to warfarin in patients with non-valvular atrial fibrillation (NVAF). Corresponding hospitalization and outpatient healthcare costs were also significantly lower for XARELTO® compared to warfarin in NVAF patients, according to longitudinal, real-world findings from this observational study. (more…)
Author Interviews, Heart Disease / 28.11.2014

Dr. Roberta Williams MD Professor and Chair, Department of Pediatrics, Keck School of Medicine VP for Pediatrics and Academic Affairs, Childrens Hospital Los AngelesMedicalResearch.com Interview with: Dr. Roberta Williams MD Professor of Pediatrics Keck School of Medicine at the University of Southern California MedicalResearch.com: What is the background for this study? Dr. Williams: Although a large number of children with chronic disease are surviving into adulthood, the extent and type of health resource needs remains a mystery. Patients with congenital heart disease (CHD) require lifelong care, so it is important to understand present resource utilization both as a foundation for planning services and as a reference point to assess the changes that occur with presumed improved access to care due to health care reform. (more…)
Author Interviews, Dermatology / 28.11.2014

Univ.-Prof. Dr. med. Tilo Biedermann Klinikdirektor Klinik und Poliklinik für Dermatologie und Allergologie der Technischen Universität München Biedersteinerstr. MünchenMedicalResearch.com Interview with: Univ.-Prof. Dr. med. Tilo Biedermann Klinikdirektor Klinik und Poliklinik für Dermatologie und Allergologie der Technischen Universität München Biedersteinerstr. München Medical Research: What is the background for this study? What are the main findings? Prof. Biedermann: The skin is constantly exposed to microbes and skin developed during evolution under the constant influence of microbes. Tightly regulated communication between microbes and the skin can be expected and levels of regulation still needed to be explored. We found that Gram-positive bacteria when sensed by one certain innate immune receptor (hetero dimer TLR 2-6 suppresses immunity both in animal models and in humans. Following the sensing of lipoproteins by toll like receptor 2-6) skin produces high levels of InterleukinL6 that induce the accumulation of so called myeloid-derived suppressor cells. These cells can be found in the blood but also migrate to the skin suppressing T-cell-immunity allowing infections to spread on the skin. (more…)
Author Interviews, Diabetes, General Medicine / 28.11.2014

Longjian Liu, MD, PhD, MSc(LSHTM), FAHA Interim Chair, Department of Environmental and Occupational Health Associate Professor, Department of Epidemiology and Biostatistics Senior Investigator, Center for Health Equality Drexel University School of Public Health, and Adjunct Associate Professor of Medicine, Drexel U. College of Medicine MedicalResearch.com Interview with: Longjian Liu, MD, PhD, MSc(LSHTM), FAHA Interim Chair, Department of Environmental and Occupational Health Associate Professor, Department of Epidemiology and Biostatistics, Senior Investigator, Center for Health Equality Drexel University School of Public Health, and Adjunct Associate Professor of Medicine, Drexel U. College of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Liu: The prevalence of diabetes is increasing rapidly in the United States and worldwide. In 2010, 25.8 million Americans, or 8.3% of the population had diabetes in the United States. In 2012, these figures were 29.1 million, or 9.3% in the nation. Philadelphia, the largest city in PA, ranks as the 5th largest city in the nation. However, the city also had the highest prevalence of diabetes according to the national surveys in 2009. We face a great challenge to stop the epidemic of diabetes locally and nationally. It is well-known personal risk factors at individual level, including lifestyles, play a role in the prevention and control of diabetes. However very limited studies addressed the importance that physical and socioeconomic environmental factors at community level may also play a pivotal role in the prevention and control of the disease. This study aimed to quantitatively examine (1) the trend of diabetes from 2002 to 2010 in the city of Philadelphia, and (2) the impact of physical and socioeconomic environmental factors at community level (assessed using zip-codes based neighborhoods) on the risk of the prevalence of diabetes. The main findings support our hypotheses that
  • (1) the prevalence of diabetes significantly increased from 2002 to 2012.
  • (2) residents who lived in neighborhoods with physical and socioeconomic disadvantage had an increased risk of the prevalence of diabetes.
(more…)
Author Interviews, Heart Disease / 28.11.2014

MedicalResearch.com Interview with: Siobhan Brown, Ph.D. Biostatistician, ROC Clinical Trials Center University of Washington Medical Research: What is the background for this study? What are the main findings? Dr. Brown: There are several observational studies suggesting that patients with out-of-hospital cardiac arrest may be more likely to survive to hospital discharge when emergency medical service provides do not pause for ventilations while performing CPR (i.e., give continuous compressions); however, the American Heart Association recommends that rescuers pause after each 30 compression to give two ventilations (interrupted compressions). We designed and are conducting a randomized clinical trial comparing the two approaches to see which results in better survival. The trial is still ongoing, so watch for results in late 2015! (more…)
Author Interviews, JAMA, Johns Hopkins, Mental Health Research / 28.11.2014

Daniel Safer MD Department of Psychiatry Johns Hopkins University School of Medicine Baltimore, Maryland Medicalresearch.com with: Daniel Safer MD Department of Psychiatry Johns Hopkins University School of Medicine Baltimore, Maryland Medical Research: What is the nature of this study? Dr. Safer: A large national sample of annual physician office-based visits by youth (aged 2-19) covering 12 years (1999-2010), focusing on trends in psychiatric DSM-IV diagnoses, with psychiatric diagnostic data analyzed proportionally comparing diagnoses that were subthreshold (not otherwise specified) with those that met full diagnostic criteria. (more…)
Author Interviews, BMC, Brigham & Women's - Harvard, Diabetes, Nutrition / 27.11.2014

Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public HealthMedicalresearch.com with: Frank B. Hu, MD, PhD Professor of Nutrition and Epidemiology Harvard School of Public Health Professor of Medicine Harvard Medical School Boston, MA 02115 Medical Research: What is the background for this study? Dr. Hu: Type 2 diabetes (T2D) affects approximately 26 million people in the United States and 366 million people worldwide, and thus primary prevention of T2D has become a public health imperative. The relation between consumption of different types of dairy and risk of type 2 diabetes remains uncertain.  (more…)
Author Interviews, CMAJ, Orthopedics, Surgical Research / 27.11.2014

MedicalResearch.com Interview with: NatNathan Evaniew MD Division of Orthopaedics McMaster Universityhan Evaniew MD Division of Orthopaedics McMaster University   Medical Research: What is the background for this study? Dr. Evaniew: Symptomatic cervical and lumbar spinal disc diseases affect at least 5% of the population and they cause a great deal of pain, disability, social burden, and economic impact. For carefully selected patients that fail to improve with nonsurgical management, conventional open discectomy surgery often provides good or excellent results. Minimally invasive techniques for discectomy surgery were introduced as alternatives that are potentially less destructive, but they require specialized equipment and expertise, and they may involve increased risks for technical complications. (more…)
Author Interviews, CDC, HIV / 26.11.2014

MedicalResearch.com Interview with: Heather Bradley, PhD Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC Medical Research: What is the background for this study? What are the main findings? Dr. Bradley: The key to controlling the HIV epidemic is controlling the virus.  When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body (known as viral suppression), allowing people with HIV to live longer, healthier lives and reducing the likelihood they will transmit HIV to others. Yet, only one-third of the 1.2 million people with HIV in the U.S. have the virus under control.  Among those who did not have the virus under control, approximately two-thirds had been diagnosed but were not in medical care. Young people were least likely to have the virus under control.  Only 13 percent of 18 – 24 year olds were virally suppressed, primarily because half don’t know they are infected.  To close this gap among young people, increased HIV testing is critical. The study did not find statistically significant differences in viral suppression by race or ethnicity, sex, or risk group. (more…)
General Medicine / 26.11.2014

Michelle M. Mello, JD, PhD Professor of Law, Stanford Law School Professor of Health Research and Policy Stanford University School of MedicineMedicalResearch.com Interview with: Michelle M. Mello, JD, PhD Professor of Law, Stanford Law School Professor of Health Research and Policy Stanford University School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Mello: In this report, we examined trends in the volume and cost of medical liability claims in the US, as well as liability insurance costs, and reviewed current initiatives to reform the liability system. Examining publicly available data from the National Practitioner Data Bank, we found that the frequency and average cost of paid malpractice claims have been declining.  The rate of paid claims against physicians decreased from 18.6 to 9.9 paid claims per 1,000 physicians between 2002 and 2013, about a 6.3% annual average decrease for MDs. Among claims that resulted in a payment, the median payment increased from $133,799 in 1994 to $218,400 in 2007, but has been declining--by 1.1% annually, on average--since 2007.  In 2013 the median payment was $195,000. When we looked a trends in insurance premiums in several markets, using data from the Medical Liability Monitor’s Annual Rate Survey, we found greater variation from place to place.  However, the overall picture was favorable. None of the locations we examined showed large increases over the last 10 years, and most showed flat or declining premiums. (more…)
Author Interviews, Gastrointestinal Disease, Inflammation, Metabolic Syndrome / 26.11.2014

Dr. Andrew Gewirtz PhD Professor & Associate Chair Department of Biology Georgia State UniversityMedicalResearch.com Interview with: Dr. Andrew Gewirtz PhD Professor & Associate Chair Department of Biology Georgia State University Medical Research: What is the background for this study? Dr. Gewirtz: 2010 science paper that discovered that loss of toll-like receptor 5 altered gut microbiota to drive metabolic syndrome Medical Research: What are the main findings? Dr. Gewirtz: It is loss of tlr5 on epithelial cells that alters the microbiota to make it more pro-inflammatory that drives metabolic syndrome. (more…)
Author Interviews, Depression, Obstructive Sleep Apnea, PLoS / 26.11.2014

Dr. Marcus Povitz MD Department of Community Health Sciences University of Calgary, Calgary, Alberta, Canada Adjunct Professor and Clinical Fellow Western University Department of Medicine, Western University, London, Ontario, CanadaMedicalResearch.com Interview with: Dr. Marcus Povitz MD Department of Community Health Sciences University of Calgary, Calgary, Alberta, Canada Adjunct Professor and Clinical Fellow Western University Department of Medicine, Western University, London, Ontario, Canada Medical Research: What is the background for this study? What are the main findings? Dr. Povitz: Both depression and obstructive sleep apnea are important causes of illness and have overlapping symptoms. Both feature poor quality sleep, difficulty with concentration and memory as well as daytime sleepiness or fatigue. Previous research showed that depression is common in individuals with sleep apnea, but studies investigating the effect of treating sleep apnea on depressive symptoms have had conflicting results. Our study combined the results of all randomized controlled trials of participants who were treated for sleep apnea with CPAP or mandibular advancement devices where symptoms of depression were measured both before and after treatment. We found that in studies of individuals without a lot of symptoms of depression there was still a small improvement in these symptoms after treatment with CPAP or mandibular advancement device. In 2 studies of individuals with more symptoms of depression there was a large improvement in symptoms of depression. (more…)
Author Interviews, CHEST, Nutrition, Pulmonary Disease / 26.11.2014

Refaat Hegazi, MD, PhD, MS, MPH Medical Director, Abbott Nutrition Affiliate Research Associate Professor, The Brody School of Medicine at East Carolina UniversityMedicalResearch.com Interview with: Refaat Hegazi, MD, PhD, MS, MPH Medical Director, Abbott Nutrition Affiliate Research Associate Professor, The Brody School of Medicine at East Carolina University Medical Research: What is the background for this study? What are the main findings? Dr. Hegazi: This study stems from the need to address the financial and health burdens that Chronic Obstructive Pulmonary Disease (COPD) places on the United States. It is the third leading cause of death in the U.S. and costs us about $50 billion a year. It’s a devastating and chronic condition that plagues patients on a daily basis, and previous studies have shown that proper nutrition is essential for proper pulmonary function and rehabilitation. In a retrospective study of inpatient medical records, we found that by ensuring the nutritional needs of COPD patients were met with oral nutritional supplements (ONS), we were able to tackle the issue of cost, as well as better health outcomes. Specifically, the COPD patients that received oral nutritional supplements, experienced reduced length of hospitalization, lower average hospital costs, and lower readmission rates within 30 days, compared to those that did not. (more…)
Author Interviews, C. difficile, Gastrointestinal Disease, Mayo Clinic / 26.11.2014

Dr. John K. DiBaise MD Gastroenterology and Hepatology Mayo Clinic, Scottsdale ArizonaMedicalResearch.com Interview with: Dr. John K. DiBaise MD Gastroenterology and Hepatology Mayo Clinic, Scottsdale Arizona Medical Research: What is the background for this study? What are the main findings? Dr. DiBaise: Despite nearly 25 years of safe and effective use of proton pump inhibitors (PPI), in recent years there have been an increasing number of reports suggesting potentially harmful effects and harmful associations with their use.  One such association with PPI use has been Clostridium difficile infection (CDI) which can cause severe and recurrent episodes of diarrhea.  Previous reports evaluating the microbes present within the gastrointestinal tract (ie, gut microbiome) of individuals with CDI have shown a reduction in overall microbial community diversity.  We studied the gut microbiome in healthy individuals both before and after using a proton pump inhibitors for one month and found a similar reduction in microbial diversity while taking the PPI that did not entirely revert back to the ‘normal’ baseline after being off the medication for a month.  While this does not demonstrate a causal association between proton pump inhibitors use and CDI, it demonstrates that PPI use creates a situation in the gut microbial environment that may increase the individual’s susceptibility to CDI. (more…)
Author Interviews, Education, JAMA / 26.11.2014

Dr. Arthur Reynolds PhD, Professor Humphrey School of Public Affairs University of Illinois at ChicagoMedicalResearch.com Interview with: Dr. Arthur Reynolds PhD, Professor Institute of Child Development Humphrey School of Public Affairs University of Minnesota Medical Research: What is the background for this study? What are the main findings? Dr. Reynolds: Given the high national priority on enhancing early childhood development, evidence about the relationship between full-day preschool participation and school readiness is meager. The study found that among about 1000 children attending 11 schools in low-income neighborhood. participation in full-day preschool at ages 3 or 4 for 7 hours per day was associated with significantly higher school readiness skills at the end of preschool in language and literacy, socio-emotional development, math, and physical health than part-day participation for 3 hours per day.  This translate to about a half of a year of growth in learning. Full-day preschool was also associated with significantly higher attendance and lower rates of chronic absences. No differences were found in parent involvement in school. (more…)
Author Interviews, Heart Disease, JAMA / 26.11.2014

Dr. Mary T. Hawn Center for Surgical, Medical Acute Care Research, and Transitions, Birmingham Veterans Affairs Medical Center University of Alabama at Birmingham, BirminghamMedicalResearch.com Interview with Dr. Mary T.  Hawn MD Center for Surgical, Medical Acute Care Research, and Transitions, Birmingham Veterans Affairs Medical Center University of Alabama at Birmingham, Birmingham Medical Research: What are the main findings? Dr. Hawn: The main findings of the study are that the recommendations made in the guidelines published by the American College of Cardiology / American Heart Association in 2007 were effective at reducing postoperative major adverse cardiac events following noncardiac surgery in patients with a cardiac stent.1  These guidelines recommended the delay of noncardiac surgeries in patients with a drug-eluting stent for 365 days if the surgery was not emergent or the delay of surgery for 4 to 6 weeks among patients with a bare metal stent.  In addition to a 26% reduction in postoperative major adverse cardiac events, we also found an increase in the time between drug-eluting stent placement and non-cardiac surgery consistent with the guideline recommendations. (more…)