Author Interviews, Cost of Health Care / 02.12.2014

Dr. John Romley PhD Schaeffer Center for Health Policy and Economics Sol Price School of Public Policy, University of Southern California Los Angeles, CAMedicalResearch.com Interview with: Dr. John Romley PhD Schaeffer Center for Health Policy and Economics Sol Price School of Public Policy, University of Southern California Los Angeles, CA MedicalResearch: What is the background for this study? What are the main findings? Dr. Romley: We've known for a long time now that there is tremendous variation in how much Medicare spends across the country, and that these differences are not necessarily related to quality of care.  Researchers have devoted great time, energy and intellect to understanding the drivers of Medicare spending.  While progress has been made, our understanding remains limited.  We also have had less insight into how private health care varies across the country. We used new information on how much private health plans pay health care providers over and above cost, and found that areas with low private payment levels tended to have substantially higher Medicare spending and utilization.
Author Interviews, Ophthalmology, Statins / 02.12.2014

B. John Mancini, MD, FRCPC, FACP, FACC Professor of Medicine; University of British Columbia; Department of Medicine, Division of Cardiology; Research Director, Division of Cardiology; Director, Cardiovascular Imaging Research Core Laboratory (CIRCL); President, Vancouver Hospital Medical, Dental and Allied Staff; Staff Cardiologist, VH Cardiology Clinics and Cardiac Computed Tomographic Angiography Program; Staff Cardiologist, St. Paul's Hospital Healthy Heart/Prevention Clinic.MedicalResearch.com Interview with: B. John Mancini, MD, FRCPC, FACP, FACC Professor of Medicine; University of British Columbia; Department of Medicine, Division of Cardiology; Research Director, Division of Cardiology; Director, Cardiovascular Imaging Research Core Laboratory (CIRCL); President, Vancouver Hospital Medical, Dental and Allied Staff; Staff Cardiologist, VH Cardiology Clinics and Cardiac Computed Tomographic Angiography Program; Staff Cardiologist, St. Paul's Hospital Healthy Heart/Prevention Clinic. MedicalResearch: What are the main findings of this study? Dr. Mancini: The main findings are that we found evidence of a relationship between statin use and the need for cataract surgery. The unique nature of the study is that it looked for the association in two distinctly different populations (a Canadian database and a separate, American database) and found a consistent association in both populations.
Author Interviews, Infections / 02.12.2014

Jack A Gilbert PhD Department of Ecology & Evolution Graduate Program in Biophysical Sciences University of Chicago, Chicago, IL 60637,MedicalResearch.com Interview with: Jack A Gilbert PhD Department of Ecology & Evolution Graduate Program in Biophysical Sciences University of Chicago, Chicago, IL 60637 MedicalResearch: What is the background for this study? What are the main findings? Dr. Gilbert: We have performed extensive analysis of the microbial distribution between humans and home surfaces in peoples houses. And are still exploring how bacteria are distributed around hospitals. Here we wanted to explore how bacteria from humans were distributed into a space in real time. By taking samples every hour post sterilization and seeing how the community stabilized, who remained active and whether they were pathogenic. We found that communities stabilized on a skin-associated microbiome within 5 hours, that staphylococcus remained active and yet none of these were particularly pathogenic. Yet we were able to identify pathogenic MRSA on surfaces around the bathroom, but they were extremely rare.
Author Interviews, Cancer Research / 02.12.2014

Dr. Pan Pantziarka Anticancer Fund, Brussels Belgium The George Pantziarka TP53 Trust, London, UKMedicalResearch.com Interview with: Dr. Pan Pantziarka Anticancer Fund, Brussels Belgium The George Pantziarka TP53 Trust, London, UK MedicalResearch: What is the background for this study? Dr. Pantziarka: The background of this study is that it is part of a series of investigations by the Repurposing Drugs in Oncology (ReDO) project into well-known non-cancer drugs which have evidence of activity that may be useful in cancer therapies. These drugs include mebendazole, itraconazole, diclofenac, nitroglycerin and cimetidine.
Annals Internal Medicine, Author Interviews, Hospital Readmissions / 02.12.2014

Amy Jo Haavisto Kind, M.D., Ph.D. Assistant Professor, Division of Geriatrics University of Wisconsin School of Medicine and Public Health William S Middleton VA- GRECC Madison, WI 53705MedicalResearch.com Interview with: Amy Jo Haavisto Kind, M.D., Ph.D. Assistant Professor, Division of Geriatrics University of Wisconsin School of Medicine and Public Health William S Middleton VA- GRECC Madison, WI 53705 MedicalResearch: What is the background for this study? What are the main findings? Dr. Kind: By way of background: Socioeconomic disadvantage is a complex theoretical concept which describes the state of being challenged by low income, limited education and substandard living conditions for both the person and his or her neighborhood or social network. It is plausible that disadvantage would influence rehospitalization because vulnerable patients depend upon their neighborhood supports for stability, generally, and these needs are likely to be increased after a hospitalization. Yet, it is difficult to assess socioeconomic disadvantage during clinical encounters, yet the ADI provides an option for beginning such a discussion. ADI or Area Deprivation Index is a composite measure of neighborhood disadvantage, similar to other geographic measures of disadvantage employed in other countries for resource planning and health policy development.
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 02.12.2014

Prof. Denise Kendrick Professor of Primary Care Research Division of Primary Care, University Park Nottingham UKMedicalResearch.com Interview with: Prof. Denise Kendrick Professor of Primary Care Research Division of Primary Care, University Park Nottingham UK Medical Research: What is the background for this study? What are the main findings? Prof. Kendrick: More than 1 million US children aged 0-4 years attend emergency departments because of  a fall each year. Approximately half of all ED attendances in this age group are for falls, and most of these are falls from furniture, most commonly from beds, chairs , baby walkers, bouncers, changing tables and high chairs. In the US around 18,000 0-4 year olds are admitted to hospital following a fall each year  and in 2012 there were 31 deaths in the US in 0-4 year olds from falls. Healthcare costs for falls in the US  were estimated at $439 million for hospitalised children and $643 million for  ED attendances in 2005. We found that children were more likely to attend hospital because of a fall from furniture in families that did not use safety gates across doorways or on stairs. For infants (aged 0-12 months) we found they were more likely to attend hospital because of a fall from furniture if they had been left on a raised surface (e.g. beds, sofas, work tops etc), had diapers changed on a raised surface or been put in a car seat or bouncing cradle on a raised surface. We also found that children aged over 3 years who had climbed or played on furniture were more likely to have a fall requiring a hospital visit than children who had not. Finally we found that children whose parents had not taught their children rules about climbing on objects in the kitchen were more likely to have a fall needing a hospital visit than children whose parents had taught these rules.
Author Interviews, Opiods / 02.12.2014

Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University New York, NY 10032MedicalResearch.com Interview with: Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University New York, NY 10032 MedicalResearch: What is the background for this study? What are the main findings? Dr. Martins: While a large proportion of young adults, ages 18 to 22, are prescribed opiates, non-medical use of opioids is second only to marijuana as the most prevalent form of illegal drug use among young adults. Until this study, little was known about nonmedical use of prescription drugs among non-college-attending young adults in the United States. Approximately 70 percent of all U.S. young adults enroll in some form of college education, but around 30% do not. We analyzed public data for 36,781 young adults between the ages of 18 and 22 over a 12-month period in 2008 through 2010 from the National Survey on Drug Use and Health, an annual cross-sectional survey of the Substance Abuse and Mental Health Administration. Using the Kessler 6 screening instrument, we also measured past-year serious psychological distress as self-reported by the respondents. Among non-college-attending young adults with at least a high school degree, 13.1 percent reported using prescription opioids for non-medical reasons. The figure rose slightly to 13.2 percent for those who did not graduate from high school, and declined to 11.3 percent among college attendees.
Author Interviews, Dermatology, Ebola / 01.12.2014

Victoria Vaughan Medical College of Georgia, Augusta, GeorgiaMedicalResearch.com Interview with: Victoria Vaughan Medical College of Georgia, Augusta, Georgia Medical Research: What is the background for this study? What are the main findings? Response: The Global Mortality of Skin Disease study compares age adjusted mortality of disease with skin manifestations between developing and developed countries for the years 1990 and 2010. The main findings were that mortality from infectious conditions was greater in the developing world while melanoma contributed to mortality in the developed world. Ebola Virus Disease has cutaneous manifestations and affects the developing world preferentially. As of November 27, 2014, the mortality in West Africa totals 5444 according to the CDC. However, the United States has had only two deaths from Ebola Virus Disease.
Radiology, Transplantation / 01.12.2014

Frank J. Rybicki, MD PhD Director, Applied Imaging Science Laboratory Director, Cardiac CT and Vascular CT / MRI Brigham and Women's Hospital Associate Professor, Harvard Medical School Boston, MAMedicalResearch.com Interview with Frank J. Rybicki, MD PhD Director, Applied Imaging Science Laboratory Director, Cardiac CT and Vascular CT / MRI Brigham and Women's Hospital Associate Professor, Harvard Medical School Boston, MA Medical Research: What is the background for this study? What are the main findings? Dr. Rybicki: Face transplantation restores form and function to patients with catastrophic facial injuries. To date, surgical planning a vascular anastamoses have been well described. While all 7 patients at BWH have had 3d printed models from their CT scans, to date the findings and impact of 3D printing has not been described. Also, the role of printing the soft tissues of the face has not been described.
Author Interviews, Emergency Care, Stroke / 01.12.2014

Stroke Wasserman Perry 006768R PDF dr_karen_greenbergMedicalResearch.com Interview with: Karen Greenberg, DO, FACOEP Capital Health Center for Neurologic Emergencies 750 Brunswick Ave, NJ 08638   Medical Research: What is the background for this study? Dr. Greenberg: Capital Health Regional Medical Center in Trenton, NJ opened the first dedicated Neurologic Emergency Department in the country in January of 2011.  Dr. Veznedaroglu, our chief neurosurgeon, recognized the importance and emergent nature of patients with neurologic complaints.  He recruited dedicated Emergency Medicine Physicians, one of which is myself, who would be assigned to see patients with neurologic complaints during peak hours of 7a-6p daily seven days a week.  Having a section of the ED dedicated to identifying, triaging, and treating patients with neurologic emergencies has led to more advanced and efficient care.  Due to the initial success of the neuro ED, 5 dedicated physicians became educated and comfortable in administering IV-tPA to acute ischemic stroke patients.  This decision was made to eliminate delays associated with teleneurology or neurology consultation prior to administering thrombolytics in order to improve door-to-needle times and outcomes in acute stroke patients.  As far as we know, we are still the only dedicated Neuro ED in the country.
Author Interviews, Critical Care - Intensive Care - ICUs / 01.12.2014

Christopher E. Dandoy, MD, MSc Divisions of Bone Marrow Transplantation and Immunodeficiency, and James M. Anderson Center for Health Systems Excellence Cincinnati Children's Hospital Medical CenterMedicalResearch.com Interview with: Christopher E. Dandoy, MD, MSc Divisions of Bone Marrow Transplantation and Immunodeficiency, and James M. Anderson Center for Health Systems Excellence Cincinnati Children's Hospital Medical Center MedicalResearch.com Editor’s Note: Dr. Dandoy discusses a novel program to reduce the frequency of cardiac alarms in the setting of a large inpatient intensive care unit. Medical Research: What is the background for this study? Why did you decide to do this study? Dr. Dandoy: During our three month investigation period we had roughly a million alarms go off in our intensive care unit. Our unit nurses reported spending 30-40 minutes per day responding to the various alarms. We first looked to see if there were established guidelines in the literature for cardiac monitors and found there were none. The alarms were a source of frustration and anxiety not just for the unit staff but also for patients and family members. Medical Research: What are the elements of your alarm reduction program? Dr. Dandoy: The first element was simply to have a plan or a process for initial ordering of monitor parameters based on age-appropriate standards. In our case, we established a standard order set in Epic, our electronic records program. Epic Cardiac Monitor Order Set Epic Cardiac Monitor Order Set
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.
Author Interviews, General Medicine, Heart Disease, JAMA, Kidney Disease / 30.11.2014

MedicalResearch.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.
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.
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
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.
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.
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.
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.
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.
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.
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
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.
General Medicine / 28.11.2014

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.
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.
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.
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.
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.
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!