Author Interviews, Heart Disease, JAMA / 01.10.2014

MedicalResearch.com Interview with: Joanna Chikwe MD Associate Professor Department of Cardiovascular Surgery Mount Sinai Medical Center and Natalia N. Egorova, PhD Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai New York, New York Medical Research: What are the main findings of the study? Answer: This is one of the largest studies to date on the long-term outcomes of patients after aortic valve replacement. We found that bioprosthetic valves are as safe as mechanical valves in younger patients (age 50-69) - specifically, long-term death rates and stroke risk were very similar in patients who had either valve type. The main differences lay in the risk of other long-term complications: patients who had bioprosthetic valves were more likely to need repeat surgery in the long-term, whereas patients who had mechanical valves were more likely to experience a major bleeding event.
Author Interviews, Cancer Research, HPV, Vaccine Studies / 01.10.2014

Elmar A. Joura, MD Department of Gynaecology and Obstetrics Medical University of Vienna, Comprehensive Cancer Center Vienna, AustriaMedicalResearch.com Interview with: Elmar A. Joura, MD Department of Gynaecology and Obstetrics Medical University of Vienna, Comprehensive Cancer Center Vienna, Austria Medical Research: What are the main findings of the study? Dr. Joura: The upcoming ninevalent vaccine has the potential to prevent 85% of the cervical precancers and surgeries such as LEEP (conization)
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness, Genetic Research / 01.10.2014

Dr. Yann C Klimentidis, PhD Assistant professor of Epidemiology and Biostatistics Mel and Enid Zuckerman College of Public Health University of Arizona Medical CenterMedicalResearch.com Interview Invitation with: Dr. Yann C Klimentidis, PhD Assistant professor of Epidemiology and Biostatistics Mel and Enid Zuckerman College of Public Health University of Arizona Medical Center   Medical Research: What are the main findings of the study? Dr. Klimentidis: The main finding is that the association of physical activity with type-2 diabetes risk is weakest among those who are at high genetic risk for type-2 diabetes. Furthermore, we find that this trend is stronger among women as compared to men, and that it appears to be driven mainly by genetic risk to insulin resistance, as opposed to genetic risk for reduced beta-cell function.
Author Interviews, JAMA, Vitamin D / 01.10.2014

Karin Amrein, MD, MSc Assistant Professor Department of Internal Medicine Division of Endocrinology and Metabolism Medical University of Graz 8036 Graz, AustriaMedicalResearch.com Interview with: Karin Amrein, MD, MSc Assistant Professor Department of Internal Medicine Division of Endocrinology and Metabolism Medical University of Graz 8036 Graz, Austria Medical Research: What are the main findings of the study? Dr. Amrein: This is the first large clinical trial on vitamin D in critical care. In a double-blind, randomized, placebo-controlled clinical trial, a population of mixed adult ICU patients with vitamin D deficiency (defined as 25-hydroxyvitamin D [25(OH)D] level ≤ 20ng/ml) was assigned to receive either vitamin D3 or placebo. We used a high loading dose of vitamin D3 followed by monthly maintenance doses of 90,000 IU for a total of 5 months. Because of a substantially increased risk for skeletal complications below 12ng/ml of 25-hydroxyvitamin D, we used this threshold for a predefined subgroup analysis. Overall, high-dose vitamin D3 compared with placebo did not reduce hospital length of stay (primary endpoint), intensive care unit (ICU) length of stay, hospital mortality, or 6 month-mortality
Author Interviews, JAMA, Orthopedics, Pain Research / 01.10.2014

MedicalResearch.com Interview with: Ben Metcalf BsC (co-author) on behalf or A/Prof Rana Hinman PhD Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia Medical Research: What are the main findings of the study? Dr. Metcalf: This study investigated whether acupuncture is an effective treatment for people aged more than 50 years with chronic knee pain. Participants in our study were randomly assigned to one of four groups; needle acupuncture, laser acupuncture, sham laser acupuncture or no treatment. The people in the treatment groups received acupuncture treatment from a family physician for 12 weeks. Participants were assessed after treatment and again after one year. There were no significant differences in knee pain or physical function between active and sham laser acupuncture at 12 weeks or at one year. Both needle and laser acupuncture resulted in modest improvements in pain compared with no treatment at 12 weeks that were not maintained at one year. Needle acupuncture improved physical function at 12 weeks compared with no treatment but was not different from sham acupuncture and was not maintained at one year.
Author Interviews, Esophageal, JAMA, University of Michigan / 01.10.2014

Megan A. Adams, MD Gastroenterology Fellow University of MichiganMedicalResearch.com Interview with Megan A. Adams, MD Gastroenterology Fellow University of Michigan   Medical Research: What are the main findings of the study? Dr. Adams: Surveys of doctors indicate that their fear of a malpractice lawsuit for missing a diagnosis of esophageal cancer might drive the overuse of tests called upper endoscopies in patients who are at low risk for the cancer. To examine whether this perception of medical liability risk accurately reflects the real likelihood of a malpractice claim, we looked at a national database of malpractice claims, and compared the rate of claims for delay in diagnosis of esophageal cancer in patients without alarm symptoms (weight loss, dysphagia, iron deficiency anemia), with the rate of claims alleging performance of an upper endoscopy without a good reason for performing the procedure. The database contained 278,220 claims filed against physicians in 1985-2012. The incidence of reported medical liability claims for failure to screen for esophageal cancer in patients without alarm features was quite low (19 claims in 11 years, 4 paid). In contrast, there were 17 claims in 28 years for complications of upper endoscopies with questionable indication (8 paid).
Author Interviews, Heart Disease / 01.10.2014

MedicalResearch.com Interview with: Lior Yankelson, MD PhD Tel Aviv Medical Center MedicalResearch: What are the main findings of the study? Dr. Yankelson: The main findings of the study are that new onset atrial fibrillation after TAVI does not confer a significant risk for mortality , and confers somewhat increased risk for stroke. The latter issue is expected to become less significant with new technological advancements coming into the market, such as lower profile devices and emboli protection both mechanical and pharmaceutical. The more significant and alarming finding is that patients with atrial fibrillation have more than 4 fold risk for death at 1 year post TAVI compared to patients without afib. This is very significant and raises questions regarding the benefit for the procedure in these patients.
Author Interviews, Heart Disease, JAMA / 30.09.2014

MedicalResearch.com Interview with: Marwan Badri MBChB, MRCP Cardiovascular disease fellow Lankenau Medical Center Wynnewood Pa Medical Research : What is the background for this study? Dr. Badri: Recent years witnessed increased emphasis of the role of clinical guidelines in cardiovascular care. Physicians are encouraged to practice within the framework of major society guidelines to deliver better, more cost-effective patient care. It is therefore vital that the recommendations in these guidelines are applicable to most of the patient population. Since some clinical trials have been shown in the past to unfavorably exclude women, racial minorities and elderly patients, we conducted this study to see if the clinical trials used to form the American College of Cardiology/American Heart Association adequately represent these patient groups.
Alcohol, Author Interviews / 30.09.2014

Keren Lehavot, PhD Research Clinical Psychologist VA Puget Sound Health Care System Assistant Professor Department of Psychiatry & Behavioral Sciences University of WashingtonMedicalResearch.com Interview with: Keren Lehavot, PhD Research Clinical Psychologist VA Puget Sound Health Care System Assistant Professor Department of Psychiatry & Behavioral Sciences University of Washington Medical Research: What are the main findings of the study? Dr. Lehavot: Alcohol misuse is a significant public health concern among women living in the U.S. Women who have served in the military are a unique population who report relatively high rates of hazardous drinking, and those who identify as lesbian or bisexual (LB) may be at especially high risk for alcohol misuse. While previous research suggests that lesbian or bisexual veterans report higher rates of alcohol misuse than their heterosexual counterparts, mediators that might explain this disparity have not been identified. To that end, we examined the role of civilian and military traumas and mental health symptoms (i.e., depression, post-traumatic stress disorder) in explaining disparities in alcohol misuse between sexual minority and heterosexual women veterans across the U.S. Women veterans were recruited using the Internet to participate in an online, anonymous, national survey. Findings indicated that lesbian or bisexual veterans scored significantly higher on an alcohol misuse measure than heterosexual women veterans. LB veterans also reported higher rates of childhood trauma, physical victimization in adulthood both during the military and as a civilian, and mental health symptoms, partly accounting for their higher rates of alcohol misuse.
Author Interviews, C. difficile, Hand Washing / 30.09.2014

Kelly R. Reveles, PharmD, PhD The University of Texas College of PharmacyMedicalResearch.com Interview with: Kelly R. Reveles, PharmD, PhD The University of Texas College of Pharmacy Medical Research: What are the main findings of the study? Dr. Reveles: Our study utilized data from the Centers for Disease Control and Prevention’s National Hospital Discharge Surveys. Patients were selected for this study if they were at least 18 years of age and had an International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code for Clostridium difficile infection (CDI) (ICD-9-CM code 008.45). We found that Clostridium difficile infection incidence increased from 4.5 CDI discharges/1,000 total discharges in 2001 to 8.2 CDI discharges/1,000 total discharges in 2010. Mortality varied over the study period with peak mortality occurring in 2003 (8.7%) and the lowest rate occurring in 2009 (5.6%). Median hospital length of stay (LOS) was 8 days and remained stable over the study period. In summary, the incidence of Clostridium difficile infection in U.S. hospitals nearly doubled from 2001 to 2010, with little evidence of recent decline. Additionally, there does not appear to be a significant decline in mortality or hospital LOS among patients with Clostridium difficile infection.
Aging, Author Interviews, Exercise - Fitness / 30.09.2014

Associate Professor Dafna Merom Ph.D Physical Activity and Health University of Western Sydney Penrith NSW AustraliaMedicalResearch.com Interview with: Associate Professor Dafna Merom Ph.D Physical Activity and Health University of Western Sydney Penrith NSW Australia   Medical Research: What are the main findings of the study? Dr. Merom: In a cohort of 1667 older Australian men (mean age 76.8 years) data on incident falls were  collected every four months by telephone interview. We compared the rate of falling over 48 months of follow-up of  men who participated in  golf, Calisthenics, lawn balls, aerobic machines and swimming.  We  found that only swimming was associated with 33% reduction in falls occurrence. We also found that swimmers performed better on balance tests in our baseline measurements. In particular on the postural stability test and for  those whose leisure activity was  only swimming, apart from walking and other lifestyle activities.
Author Interviews, Melanoma, NEJM / 30.09.2014

Georgina Long BSc PhD MBBS FRACP Associate Professor of Melanoma Biology and Translational Research Melanoma Institute Australia and the University of Sydney MedicalResearch.com Interview with: Georgina Long BSc PhD MBBS FRACP Associate Professor of Melanoma Biology and Translational Research Melanoma Institute Australia and the University of Sydney Medical Research: Could you provide some background on this project? Why did you decide to do this research project? What prior work led up to this latest paper? Dr. Long: Pre-clinically, we had data that showed that the combination of BRAF inhibitor + MEK inhibitor
  • Decreased skin proliferative toxicity seen with BRAF inhibitors alone (seen as hyperproliferative lesions in rats)
  • and delayed the emergence of resistance I.e. The tumours in the mice reduced in size more, and stayed reduced for longer.We then confirmed this concept in a randomised phase 2 study, although it was not powered for a definitive progression free survival (PFS_ difference like a phase 3 trial is, we saw a strong difference in response rate and in PFS, yet there were only 54 patients per arm.
Author Interviews, Dermatology, Kidney Disease / 30.09.2014

MedicalResearch.com Interview wth: Mei-Ju Ko, MD, PhD Department of Dermatology, Taipei City Hospital Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Medical Research: What are the main findings of the study? Dr. Ko: In this study, not only did we find that serum levels of interleukin (IL)-31 were significantly higher in hemodialysis patients with pruritus symptoms, but we also demonstrated a positive exposure-response relationship between IL-31 levels and visual analog scale (VAS) scores of pruritus intensity. We also noted an inverse correlation between the severity of pruritus and the dialysis dose assessed by Kt/V.
Author Interviews, Case Western, Heart Disease, Scripps / 29.09.2014

MedicalResearch.com Interview with: Philip Gorelick, M.D., M.P.H, F.A.C.P. Medical Director of the Hauenstein Neuroscience Center Saint Mary’s Health Care, Grand Rapids, MI; Professor, Translational Science and Molecular Medicine Michigan State University College of Human Medicine; Board member of the National Stroke AssociationPhilip Gorelick, M.D., M.P.H, F.A.C.P. Medical Director of the Hauenstein Neuroscience Center Saint Mary’s Health Care, Grand Rapids, MI; Professor, Translational Science and Molecular Medicine Michigan State University College of Human Medicine; Board member of the National Stroke Association and Judy Lenane, R.N., M.H.A. Chief Clinical Officer of iRhythm Technologies, Inc. Judy Lenane, R.N., M.H.A. Chief Clinical Officer of iRhythm Technologies, Inc.   Medical Research: What is atrial fibrillation and how common a problem is it among US adults? Dr. Gorelick: Nearly 3 million people in the US suffer from Atrial Fibrillation or “Afib,” an abnormal heart rhythm that causes the heart to beat rapidly and irregularly. While Afib can occur at any age, the incidence increases with age and the number of cases is expected to increase significantly in the coming years as the population ages. Approximately 5 percent of people 65 years and older and one in every 10 people over 80 years of age have Afib. It is more common in those with high blood pressure, heart disease or lung disease.
Author Interviews, Diabetes, Heart Disease / 29.09.2014

MedicalResearch.com Interview with: Jorge F. Saucedo MD Allstate Foundation, Judson B. Branch Chair of Cardiology Head, Division of Cardiology Co-Director Cardiovascular Institute NorthShore University HealthSystem Clinical Professor of Medicine University of Chicago Pritzker School of Medicine Talla A. Rousan, MD Oklahoma City, OK. First author of study. Medical Research: What are the main findings of the study? Answer: It was found that patients with diabetes mellitus (DM) presenting with acute myocardial infarction (AMI) have a higher in-hospital mortality rate compared to patients without DM. Patients with insulin-requiring diabetes mellitus presenting with non-ST-segment elevation myocardial infarction had higher in-hospital mortality rate than patients with non-insulin requiring diabetes mellitus.
Chemotherapy / 29.09.2014

Giuseppe Curigliano M.D. Ph.D. Medico Direttore, Director Divisione Sviluppo Nuovi Farmaci per Terapie Innovative Early Drug Development for Innovative Therapies Division Via Ripamonti, MilanoMedicalResearch.com Interview with: Giuseppe Curigliano M.D. Ph.D. Medico Direttore, Director Divisione Sviluppo Nuovi Farmaci per Terapie Innovative Early Drug Development for Innovative Therapies Division Via Ripamonti,  Milano Medical Research: What are the main findings of the study? Dr. Curigliano: In the CLEOPATRA study, 808 patients from 25 countries with HER2-positive metastatic breast cancer were randomised to receive first-line placebo/trastuzumab/docetaxel or pertuzumab/trastuzumab/docetaxel. Randomisation was stratified by geographic region and neo/adjuvant chemotherapy. At ESMO 2014 the CLEOPATRA researchers reported results of a final prespecified OS analysis (February 2014). This overall survival (OS) analysis was planned when ≥385 deaths were reported. The log-rank test, stratified by prior treatment status and geographic region, was used to compare OS between arms, applying the threshold of p ≤ 0.0456. Subgroup analyses of OS were performed for stratification factors and other key baseline characteristics.At median follow-up of 50 months (range 0 to 70 months), the statistically significant improvement in OS in favour of pertuzumab/trastuzumab/docetaxel arm was maintained (HR = 0.68, p = 0.0002). Median OS was 40.8 months in the placebo arm and 56.5 months in the pertuzumab arm, with difference of 15.7 months. The PFS in pertuzumab arm was 18.7 vs 12.4 months in placebo arm, HR 0.68 (p < 0.0001).
Allergies, Author Interviews, Kaiser Permanente / 29.09.2014

Eric Macy, MS, MS Allergy & Immunology Kaiser Permanente Medical Group-AllergyMedicalResearch.com Interview with: Eric Macy, MS, MS Allergy & Immunology Kaiser Permanente Medical Group-Allergy   Medical Research: What are the main findings of the study? Dr. Macy:
  • Cephalosporins are currently widely and relatively safely used in individuals with a history of a penicillin "allergy" in their medical record.
  • Cephalosporin associated anaphylaxis is very rare, even in individuals with a history of penicillin "allergy".
  • Cephalosporin associated serious cutaneous adverse reactions are extremely rare.
  • Cephalosporin associated Clostridium difficile and serious nephropathy are relatively common.
AHA Journals, Author Interviews, Heart Disease, Karolinski Institute / 29.09.2014

dr_iffat_rahmanMedicalResearch.com Interview Invitation with: Dr. Iffat Rahman Ph.D. Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Rahman: Our study suggests that moderate to high level of physical activity could protect against heart failure in women.
Author Interviews, BMJ, Breast Cancer, Weight Research / 29.09.2014

MedicalResearch.com Interview with: Professor Usha Menon,  Evangelia-Ourania Fourkala PhD and Matthew Burrell PhD Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, University College London, UK Medical Research: What are the main findings of the study? Response: Our study has shown that skirt size is a good proxy for central obesity. Each unit increase in UK skirt size every ten years between the age of 20 and 60 was associated with a 33% increase in postmenopausal breast cancer in our cohort.
Author Interviews, Blood Pressure - Hypertension, BMC / 29.09.2014

MedicalResearch.com Interview with: Prof. Dr. med. Alain Nordmann Innere Medizin FMH Basel, Switzerland Medical Research: What are the main findings of the study? Dr. Nordmann: Based on available randomised controlled trials, garlic preparations seem to lower blood pressure in individuals with hypertension in the short term. However, the quality of the studies and the lack of long-term data preclude the routine use of garlic preparations to lower blood pressure in individuals qualifying for antihypertensive drug therapy.
Author Interviews, Heart Disease, JACC / 29.09.2014

MedicalResearch.com Interview with: Katharina Mayer MD Deutsches Herzzentrum München, Technische Universität München, Munich, Germany Medical Research: What are the main findings of the study? Dr. Mayer: Patients whose platelets do not respond well to aspirin carry a higher risk of death or stent thrombosis. Platelet response to aspirin is an independent predictor of ischemic events in patients undergoing percutaneous coronary interventions (PCI).
Author Interviews, Cancer Research, Esophageal, Gastrointestinal Disease / 28.09.2014

Dr. Aaron P. Thrift PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA.MedicalResearch.com: Interview with: Dr. Aaron P. Thrift PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA. Medical Research: What are the main findings of the study? Dr. Thrift: We conclude that height is inversely associated with risk of esophageal adenocarcinoma, both in men and women. The association is not due to confounding from known risk factors or bias.
Author Interviews, JAMA, Mental Health Research, Weight Research / 27.09.2014

Stewart Agras, M.D. Professor of Psychiatry Emeritus Stanford University School of MedicineMedicalResearch.com Interview with: Stewart Agras, M.D. Professor of Psychiatry Emeritus Stanford University School of Medicine MedicalResearch: What was the study about? Dr. Agras: Family-based treatment (FBT) has been shown to be more effective than individual psychotherapy for the treatment of adolescent anorexia nervosa. This treatment focuses on helping the family to re-feed their child. The question posed in this study was whether Family-based treatment would have any advantages over Systemic family therapy (SyFT) focusing on family interactions that may affect the maintenance of the disorder. The participants were 164 adolescents with anorexia nervosa and their families – one of the largest studies of its type.
Author Interviews, Cost of Health Care, JAMA, Pharmacology / 27.09.2014

Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163MedicalResearch.com Interview with: Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163 Medical Research: What are the main findings of the study? Dr. Hong: Use of GDDP (generic drug discount programs) increased to 23.1% in 2010 from 3.6% of patients receiving any prescription drugs in 2007. Generic drug discount programs were more valued among the elderly, sicker and uninsured populations. The lower use of Generic drug discount programs among racial/ethnic minorities observed when the program was deployed no longer existed when the program matured.
Author Interviews, Exercise - Fitness, Kidney Disease / 27.09.2014

Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome ItalyMedicalResearch.com Interview with: Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome Italy Medical Research: What are the main findings of the study? Dr. Ferraro: We analyzed the association between physical activity and energy intake and the risk of developing kidney stones in three large cohorts of U.S. health professionals. The 215,133 participants included did not have any history of kidney stones when follow-up began. During 20 years of follow-up, 5,355 of them developed a kidney stone. Initially, we found that participants with higher physical activity levels had a reduced risk of developing stones in two of the three cohorts. However, after accounting for a number of factors that could potentially confound the association such as age, body mass index and dietary intake, the association was no longer significant. Similarly, energy intake was not associated with a reduced risk of developing kidney stones.
Author Interviews, Cognitive Issues, General Medicine, Mental Health Research, Neurology / 26.09.2014

Richard J. Kryscio, PhD, Professor Sanders-Brown Center on Aging University of KentuckyMedicalResearch.com Interview with: Richard J. Kryscio, PhD, Professor Sanders-Brown Center on Aging University of Kentucky Medical Research: What are the main findings of the study? Dr. Kryscio:  We followed 531 elderly over time assessing their cognition annually; of these 105 (about 20%) eventually were diagnosed with a serious cognitive impairment (either a mild cognitive impairment or a dementia) and 77% of the latter declared a subjective memory complaint prior to the diagnosis of the impairment.  In brief, declaration of a memory problem put a subject at three times the risk of a future impairment.
Author Interviews, Exercise - Fitness, General Medicine, Metabolic Syndrome, Weight Research / 26.09.2014

MedicalResearch.com Interview with: Tuomo Tompuri, MD Clinical Physiology and Nuclear Medicine Kuopio University Hospital, Finland Medical Research: What are the main findings of the study? Dr. Tompuri: Measures of the cardiorespiratory fitness should be scaled by lean mass instead of body weight, while aiming to enable comparison between the subjects. Our result is physiologically logical and confirms earlier observations of the topic. Scaling by body weight has been criticized, because body fat, per se, does not increase metabolism during exercise. We did observe that scaling by body weight introduces confounding by adiposity.
Author Interviews, Autism, General Medicine, OBGYNE / 26.09.2014

Rebecca J. Schmidt, M.S., Ph.D. Assistant Professor Department of Public Health Sciences The MIND Institute School of Medicine University of California Davis Davis, California 95616-8638MedicalResearch.com Interview with: Rebecca J. Schmidt, M.S., Ph.D. Assistant Professor Department of Public Health Sciences The MIND Institute School of Medicine University of California Davis Davis, California 95616-8638 MedicalResearch: What are the main findings of the study? Dr. Schmidt: Women who had children with autism reported taking iron supplements during pregnancy and breastfeeding less often than women who children who were typically developing.  Mothers of children with autism also had lower average iron intake.