Author Interviews, Cost of Health Care, Global Health, Lancet / 01.07.2014

MedicalResearch.com Interview with:  M Luca Lorenzoni OECD Organisation for Economic Co-operation and Development Health Accounts, Asian Health and Social Policy Outreach ELS/Health Division MedicalResearch: What are the main findings of the study? Answer: 
  • The United States is an outlier in the scenery of OECD as it ranks first for health care expenditure, but last for coverage.
  • The slowdown in US health care spending during the past decade brought the growth rate closer to that of other high-spending countries -Canada, France, Germany, the Netherlands and Switzerland- at around 1%. Previously in 2002, the US's health expenditure growth was around 7%, much higher than the approximate 3% which was the average for the other countries examined in the study
  • Higher health-sector prices (e.g., hospital care and prescription drugs) are thought to be the main driver of expenditure differences between the US and other high-spending countries, and recent price dynamics largely explain declines in health expenditure growth. (more…)
Author Interviews, Diabetes, JAMA / 01.07.2014

MedicalResearch.com Interview with:Sandeep Vijan, MD, MS Center for Clinical Management Research Ann Arbor Veterans Affairs Hospital, Department of Internal Medicine, University of Michigan, Ann Arbor Michigan Sandeep Vijan, MD, MS Center for Clinical Management Research Ann Arbor Veterans Affairs Hospital, Department of Internal Medicine, University of Michigan, Ann Arbor Michigan MedicalResearch: What are the main findings of the study? Dr. Vijan: The main finding was that the burdens and side effects of intensive glycemic treatment significantly detract from the overall benefit of lower risks of diabetes complications, often to the point where the treatments cause more loss than gain in quality of life. It takes many (often 15-20) years to gain benefit from treatment, but the burdens begin right away and continue throughout treatment. By the time you might experience treatment benefit in terms of reduced complication risk, you've had a lot of years to have the downsides of treatment - which commonly include significant weight gain, low blood sugars, gastrointestinal symptoms, not to mention having to take multiple pills or injections on a daily basis. (more…)
Annals Internal Medicine, Author Interviews, Herpes Viruses, HIV / 01.07.2014

Connie Celum, MD, MPH Professor of Global Health and Medicine Director, International Clinical Research Center University of Washington Harborview Medical Center Seattle WA 98104MedicalResearch.com: Interview with Connie Celum, MD, MPH Professor of Global Health and Medicine Director, International Clinical Research Center University of Washington Harborview Medical Center Seattle WA  98104 MedicalResearch: What are the main findings of the study? Dr. Celum: We conducted a randomized, double blind study of daily oral tenofovir and tenofovir combined with emtricitabine (FTC) as oral pre-exposure prophylaxis (PrEP) for HIV among HIV serodiscordant couples (in which onepartner had HIV and the other partner did not) in Kenya and Uganda. Because of recent studies showing that tenofovir gel could reduce the chances of becoming HSV-2 infected, we studied the subset of HIV-uninfected partners who did not have HSV-2 and compared the rates who became HSV-2 infected during follow-up among those  who received oral pre-exposure prophylaxis versus those who received placebo.  We found that oral pre-exposure prophylaxis reduced HSV-2 acquisition by 30%. (more…)
Author Interviews, Diabetes, Genetic Research, Nature / 30.06.2014

Dr. Domenico Accili MD Professor of Medicine Department of Medicine Columbia University College of Physicians and Surgeons New York, New York 10032MedicalResearch.com: Interview with Dr. Domenico Accili MD Professor of Medicine Department of Medicine Columbia University College of Physicians and Surgeons New York, New York 10032 MedicalResearch: What are the main findings of the study? Dr. Accili: By switching off a single gene (foxo1), scientists at Columbia University’s Naomi Berrie Diabetes Center have converted human gastrointestinal cells into insulin-producing cells, demonstrating in principle that a drug could retrain cells inside a person’s GI tract to produce insulin. (more…)
Author Interviews, Rheumatology, Surgical Research / 30.06.2014

Daniel L. Riddle, PT, Ph.D., F.A.P.T.A. Otto D. Payton Professor Assistant department chair Department of Physical Therapy Virginia Commonwealth UniversityMedicalResearch.com Interview with: Daniel L. Riddle, PT, Ph.D., F.A.P.T.A. Otto D. Payton Professor Assistant department chair Department of Physical Therapy Virginia Commonwealth University MedicalResearch: What are the main findings of the study? Dr. Riddle: We used a classification system developed by researchers in Spain in the late 1990s and found that classifications of appropriate, inappropriate and inclusive ratings for persons undergoing knee replacement surgery were  44.0%, 21.7%, and 34.3%, respectively. We studied 175 persons who underwent unilateral total knee replacement in the Osteoarthritis Initiative study, an NIH and privately funded multi-year cohort study of persons with are at high risk for knee osteoarthritis. These findings need to be considered cautiously because the classification system was developed more than 15 years ago and was designed to place greatest priority on persons with end stage knee osteoarthritis and severe pain and functional loss. (more…)
Author Interviews, Electronic Records / 30.06.2014

John D’Amore, President & CTO Diameter Health 1005 Boylston St #304 Newton MA 02461MedicalResearch.com Interview with John D’Amore, President & CTO Diameter Health 1005 Boylston St #304 Newton MA 02461   MedicalResearch: What are the main findings of the study? Answer: We examined C-CDA (Consolidated Clinical Document Architecture) documents from electronic health records and other health information technology vendors. C-CDA documents are an XML format for transmitting patient data (e.g. problems, allergies, medications, results, vital signs, smoking status). Usage of C-CDA documents is required for Stage 2 of Meaningful Use in the United States. Overall, we were readily able to extract data elements from these documents, but we found many places where clinical content could be improved. This leads to policy recommendations on improving C-CDA production and consumption. Since thousands of hospitals and many more physicians will be required to exchange these documents in the coming year, we believe our findings to be important and timely for those seeking to improve care continuity and information exchange. (more…)
AHA Journals, Author Interviews, Heart Disease / 30.06.2014

MedicalResearch.com Interview with: Eddie Hulten, MD MPH FACC FSCCT Eddie Hulten, MD MPH FACC FSCCT and Ron Blankstein, MD FACCRon Blankstein, MD FACC Cardiovascular Imaging Noninvasive Cardiovascular Imaging Walter Reed National Military Medical Center Brigham and Women’s Hospital Bethesda, MD Boston, MA MedicalResearch: What are the main findings of the study? Answer:  Although any medical test should be used to change management, the extent to which CCTA (Cardiac computed tomography angiography) findings are associated with medication changes (aspirin and lipid lowering) is not previously extensively studied. Thus, we conducted the largest and one of the longest follow up studies of preventive cardiovascular medications before and after coronary computed tomography angiography (CCTA).  We demonstrated that CCTA findings are associated with significant changes in preventive medications after CCTA. (more…)
Author Interviews, Mental Health Research, Pediatrics / 29.06.2014

Johanna Petzoldt Institute of Clinical Psychology and Psychotherapy Chemnitzer Straße Dresden, GermanyMedicalResearch.com Interview with: Johanna Petzoldt Institute of Clinical Psychology and Psychotherapy Chemnitzer Straße Dresden, Germany MedicalResearch: What are the main findings of the study? Answer: We investigated 286 mother-infant couples from the Maternal Anxiety in Relation to Infant Development (MARI) Study from Dresden (Germany) via standardized interview and questionnaire. We found a robust relation from maternal lifetime anxiety disorders as early as prior to pregnancy to excessive crying in the offspring. Also, the association increased when considering incident anxiety disorders during pregnancy and after delivery. (more…)
Allergies, Author Interviews, BMJ, Smoking / 29.06.2014

Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, PolandMedicalResearch.com Interview with Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, Poland MedicalResearch: What are the main findings of the study? Dr. Feleszko: We combined data from nineteen population-based cohort studies of 24 000 children and we found that household exposure to tobacco smoke after birth has immunomodulating effects.  We demonstrated an increased sensitivity to allergens, measured by serum IgE and skin testing which may contribute to the increased development of allergy in children exposed postnatally to household tobacco smoke. (more…)
Author Interviews, Nutrition, Weight Research / 28.06.2014

Kathryn A. Kaiser, Ph.D. Department of Biostatistics Ryals Public Health Bldg, University of Alabama at Birmingham Birmingham, AL 35294MedicalResearch.com Interview with: Kathryn A. Kaiser, Ph.D. Department of Biostatistics Ryals Public Health Bldg, University of Alabama at Birmingham Birmingham, AL 35294 MedicalResearch: What are the main findings of the study? Dr. Kaiser: Recommendations to increase or home delivery of fruits and vegetables to increase intake results in no significant weight loss or gain in adults studied over 8-16 weeks. (more…)
Diabetes, Weight Research / 27.06.2014

Su Ann Ding, MBBS Research Fellow Joslin Diabetes Center Boston, MassachusettsMedicalResearch.com Interview with: Su Ann Ding, MBBS Research Fellow Joslin Diabetes Center Boston, Massachusetts MedicalResearch: What are the main findings of the study? Answer: We conducted a randomized controlled trial comparing the effectiveness of Roux-en- Y gastric bypass with an intensive diabetes and weight management program. We recruited 38 obese individuals (BMI 30-42 kg/m2) with type 2 diabetes. Participants had suboptimal glucose control and mean diabetes duration of 10 years. Both surgical and non-surgical interventions led to patients losing a clinically significant amount of weight and keeping it off for 2 years, with average loss of approximately 57 pounds (25% of initial body weight) for the surgery group and 13 pounds (6% of initial weight) for the lifestyle and medication modification group. Other important health goals also improved more in the surgical group, including improvements in blood sugar control, blood pressure and lipid levels which together may contribute to reducing risk of developing coronary heart disease. (more…)
Author Interviews, CHEST, Critical Care - Intensive Care - ICUs / 27.06.2014

MedicalResearch.com Interview with: James R. Klinger, MD, FCCP Professor of Medicine, Brown University Darren Taichman, MD, PhD, FCCP Adjunct Associate Professor of Medicine, University of Pennsylvania Greg Elliott, MD, MACP, FCCP Professor of Medicine, University of Utah School of Medicine Background: The authors discuss the June 17, 2014 CHEST publication: Pharmacological Therapy for Pulmonary Arterial Hypertension in Adults: CHEST Guideline MedicalResearch: How widespread is the problem of Pulmonary Arterial Hypertension (PAH)? Greg Elliott: PAH is an uncommon, but important disorder because untreated it is usually progressive and fatal, AND there are effective treatments. This makes the guidelines important for physicians, patients and insurers. MedicalResearch: What are the most common causes of PAH? Greg Elliott: Common causes are connective tissues diseases like scleroderma, toxins like methamphetamine and cases for which the cause is not known, i.e. idiopathic. Some (about 20 %) idiopathic cases are caused by gene mutations. (more…)
Author Interviews, Cancer Research, Mayo Clinic / 27.06.2014

dr_john-coplandMedicalResearch.com Interview with: Dr. John A. Copland, PhD Associate Professor of Biochemistry/Molecular Biology Professor of Cancer Biology Cancer Basic Science Mayo Clinic, Jacksonville, Florida MedicalResearch: What are the main findings of the study? Dr. Copland: In our study we identified a pro-cancerous role for a novel protein- neuronal pentraxin 2 (NPTX2). This protein, normally found expressed in brain and nervous system tissues, is highly overexpressed in kidney tumors at all stages of disease. It has never previously been associated with kidney cancer, nor has it been associated with an oncogenic function in any other cancer. NPTX2 appears to play a significant role in not only tumor cell survival, but it also promotes tumor cell migration through activation of the ionotropic glutamate receptor 4 (GluR4). GluR4, also commonly associated with nervous system tissues, appears to be manipulating the flow of calcium into the tumor cell. Both NPTX2 and GluR4 are not components of normal kidney cell function. Because calcium is an important co-factor for many signaling pathways controlling cell growth, survival, and mobility, unconstrained calcium levels in a cell can promote malignancy. We show that calcium calmodulin kinase and AKT, two oncogenic signaling pathways are activated by NPTX2 via calcium influx. (more…)
Author Interviews, Pulmonary Disease / 27.06.2014

MedicalResearch.com Interview with: Dr. Juan P de Torres Pulmonary Department Clínica Universidad de Navarra Pamplona, Spain;MedicalResearch.com Interview with: Dr. Juan P de Torres Pulmonary Department Clínica Universidad de Navarra Pamplona, Spain; MedicalResearch: What are the main findings of the study? Dr. Torres: The BODE Index (BMI, Obstruction, Dyspnea, Exercise ) predicts mortality better than the GOLD ABCD (The Global Obstructive Lung Disease) grading and adding the COTE (Copd cO-morbidity TEst ) comorbidity Index to the BODE Index is complementary and provides an excellent predictive capacity for all-cause mortality in COPD patients. (more…)
Author Interviews, BMJ, Endocrinology, Weight Research / 27.06.2014

MedicalResearch.com Interview with: Mojca Jensterle Department of Endocrinology. Diabetes and Metabolic Diseases. University Medical Centre. Zaloska 7. Slovenia. MedicalResearch: What are the main findings of the study? Answer: This is the first report demonstrating that selective phosphodiesterase enzyme (PDE) 4 inhibitor roflumilast added to metformin (MET) was superior to metformin alone in reducing mean body weight after 12 weeks of treatment in obese women with polycystic ovary syndrome (PCOS), primarily due to a loss of fat mass. 31 women with PCOS diagnosed by the National Institute of Child Health and Human Development criteria aged 33.8 ± 7.4 years with BMI 36.4 ± 5.1 kg/m2concluded the study. They were randomized to MET 1000 mg BID or combined treatment (COM) with MET 1000 mg BID and roflumilast 500 mcg QD. The primary outcome were changes in anthropometric measures of obesity. At study endpoint subjects treated with COM lost on average 4.2 ± 2.8 kg compared to a 0.9± 2.5 kg weight gain in METgroup (p<0.001). BMI decreased for 1.6 ± 1.1 kg/m2 in COM arm compared to increase for 0.9 ± 2.4 kg/m2 in MET arm (p= 0.001). Total body fat decreased for 0.7±0.4 % in COM as opposed to 0.2 ± 0.1 % increase in MET and visceral adipose tissue (VAT) area as assessed by DXA decreased for 15.5 ± 1.6 cm2 in COM as opposed to 11.4 ± 5.3 cm2 increase in MET. The greater waist circumference reduction was noted in COM (4.2 ± 1 cm) compared with MET (0.8 ± 0.7 cm). The improvements of obesity measures were associated with beneficial effects on fasting glucose levels, insulin resistance and resolution of metabolic syndrome in affected women. The hypothesis behind the weight decrease and beneficial metabolic impact observed with roflumilast is based on the PDE4 regulation of signaling pathways linked to GLP-1 release. In experimental rodent model a single treatment with roflumilast enhanced plasma GLP-1 levels up to 2.5 -fold. (more…)
Author Interviews, BMJ, Disability Research / 27.06.2014

MedicalResearch:com Interview with: Stephen Honeybul FDS RCS (Eng), FRCS (SN), FRACS Consultant Neurosurgeon Sir Charles Gairdner Hospital HOD Royal Perth Hospital Perth WA Australia MedicalResearch: What are the main findings of this study?  Dr. Honeybul: Amongst those patients who had been adjudged severely disabled or in a vegetative state at 18 months, remained as such at the three years follow up. Most patients who were able to provide a response said that they would have provided consent to the "life saving" intervention even if they had known their final outcome (more…)
Author Interviews, Autism, Lancet, Mental Health Research / 26.06.2014

Dr Sarah Cassidy PhD Autism Research Centre,Department of Psychiatry University of Cambridge, Cambridge, UKMedicalResearch.com Interview with: Dr Sarah Cassidy PhD Autism Research Centre,Department of Psychiatry University of Cambridge, Cambridge, UK MedicalResearch.com: What are the main findings of the study? Dr. Cassidy: We found that adults with late diagnosis of Asperger Syndrome (31 years on average), were at significantly higher risk of contemplating suicide during their lifetime (66%) than those from the general UK population (17%), and a sample of patients with Psychosis (59%). We also found that adults diagnosed with Asperger Syndrome with a history of depression, were significantly more likely to experience suicidal thoughts, and suicide plans or attempts, than those with Asperger Syndrome without a history of depression.  A higher level of autistic traits was also a significant risk factor for having planned or attempted suicide. (more…)
Author Interviews, JAMA, Pediatrics, Surgical Research / 26.06.2014

Frank H. Morriss, Jr., MD, MPH Professor of Pediatrics - Neonatology University of Iowa Carver College of MedicineMedicalResearch.com Interview with: Frank H. Morriss, Jr., MD, MPH Professor of Pediatrics  - Neonatology University of Iowa Carver College of Medicine   MedicalResearch: What are the main findings of the study? Dr. Morriss: Our aim was to assess the association between surgery performed during the initial hospitalization of very low- birth-weight infants and subsequent death or neurodevelopmental impairment at 18-22 months’ corrected age. We conducted a retrospective cohort analysis of patients who were prospectively enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 to 2009. Surgery was classified by the expected anesthesia type as either major surgery that likely would have been performed under general anesthesia; or minor surgery, that is, procedures that could have been performed under non-general anesthesia and in general were shorter in duration. There were 2,186 major surgery patients and 784 minor surgery patients and more than 9,000 patients who did not undergo surgery. We found that any surgical procedure  increased the adjusted risk of death or neurodevelopmental impairment in low birth weight infants by about 30%. Not all surgical procedures were associated with increased risk, however. Compared with those who did not undergo surgery, patients  who were classified as having major surgery had a risk-adjusted odds ratio of death or neurodevelopmental impairment of 1.52 (95% confidence interval 1.24-1.87). However, those who were classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who did not undergo surgery the risk-adjusted odds ratio for neurodevelopmental impairment was 1.56 (95% confidence interval 1.26-1.93), and the risk-adjusted mean Bayley II Mental Developmental Index and mean Psychomotor Developmental Index values were significantly lower. (more…)
Diabetes, Endocrinology, OBGYNE / 26.06.2014

MedicalResearch.com Interview with: Dr Anju Joham PhD student, SPHPM Endocrinologist, Monash Health MedicalResearch: What is the background for your study? Dr. Joham: This research led by Professor Helena Teede and Dr Anju Joham, from the School of Public Health and Preventive Medicine at Monash University analysed a large-scale epidemiological study, called the Australian Longitudinal Study of Women’s Health (ALSWH). Polycystic Ovary Syndrome (PCOS) is a condition affecting nearly 20% of Australian women. Women with PCOS may experience irregular menstrual cycles, reduced fertility, increased risk of diabetes, high cholesterol and psychological features such as depression and reduced quality of life. MedicalResearch: What are the main findings of the study? Dr. Joham:   Approximately 6000 women aged between 25-30 years were monitored for nine years, including nearly 500 women with diagnosed PCOS. Our research found that there is a clear link between PCOS and type 2 diabetes. The incidence and prevalence of type 2 diabetes was three to five times higher in women with PCOS. In analysing the key contributing factors to the increased diabetes risk, we found that having PCOS was in itself a key contributing factor. (more…)
Author Interviews, Dartmouth, Hospital Readmissions, Neurological Disorders, Neurology / 25.06.2014

MedicalResearch.com Interview with: Tracie A. Caller, MD , MPH Neurophysiology Fellow Dartmouth-Hitchcock Medical Center 1 Medical Center Dr., Lebanon NH 03756, USA MedicalResearch: What are the main findings of the study? Dr. Caller: We identified factors that appeared to increase the risk for a 30 day readmissions in the epilepsy population, which included refractory seizures but also coexistence of nonepileptic seizures and psychiatric comorbidities. (more…)
Author Interviews, BMJ, Infections, Pediatrics, Vaccine Studies / 25.06.2014

Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UKMedicalResearch.com: Interview with Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UK MedicalResearch: What are the main findings of the study? Dr. Wang: We have found evidence of recent whooping cough infection in 1 in 5 school age children who see their doctor with a persistent cough and in 1 in 6 children who have been fully vaccinated against whooping cough.  We have also shown that whooping cough can still cause clinically significant cough in fully vaccinated children. (more…)
Author Interviews, Dermatology / 25.06.2014

MedicalResearch.com Interview with Chenjie Xu PhD Assistant Professor of Bioengineering Nanyang Technological University Singapore 637457 MedicalResearch: What are the main findings of the study? Answer: Keloid is a long-term dermatological scarring disease characterized by disfiguring lesions resulting from overgrowth of dense fibrous tissue. It is also unsightly and can even lead to disfigurement and psychological problems of affected patients. This study investigated the use of microneedle technology in the self-management of keloid lesions. Briefly, we have developed a “wearable” microneedle device for transdermal delivery of an anti-metabolite drug (5-FU) to inhibit the proliferation activity of keloid fibroblast. This study has provided evidence for effective inhibition of keloid fibroblasts in vitro and successful translation of this platform can significantly reduce the cost of keloid treatment and improve the patient compliance. (more…)
Author Interviews, CMAJ, Compliance, Pharmacology, Statins / 25.06.2014

Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, FinlandMedicalResearch.com Interview with: Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, Finland MedicalResearch: What are the main findings of the study? Dr. Halava: The associations between lifestyle factors and nonadherence to statin therapy varied by cardiovascular comorbidity status. Of the participants without cardiovascular comorbidities (n = 6458), 3171 (49.1%) were nonadherent with their statin therapy. Of the participants with cardiovascular comorbidities (n = 2827), 1155 (40.9%) were nonadherent. People with cardiovascular comorbidities who had risky drinking behaviours or a cluster of lifestyle risks were at increased risk of nonadherence. (more…)
Breast Cancer / 25.06.2014

Dorothy N. Pierce, DNP, MSN, RN, NP-C, CRN, OCN, CBCN Advanced Practice Nurse Rutgers Cancer Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ 08901MedicalResearch.com Interview With Dorothy N. Pierce, DNP, MSN, RN, NP-C, CRN, OCN, CBCN Advanced Practice Nurse Rutgers Cancer Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ  08901 MedicalResearch: What are the main findings of the study? Answer: The main findings from the study were:
  1. Nineteen patients out of 24 (79%) reported lymphedema (LE) symptoms. Majority reporting symptoms received chemotherapy and were 50 years of age and older.
  2. The most commonly reported symptoms were limb tenderness (n=10), swelling (n=9), firmness/tightness (n=8), numbness (n=6), heaviness (n=5), impaired movement of the shoulder (n=5), and finger (n=4).
  3. Overall, the participants had low to moderate lymphedema knowledge. The mean knowledge score was 11.9 with a range from zero to 20.
  4. Patients beginning radiation therapy for breast cancer often had not received any lymphedema information from health care providers prior to therapy; Lymphedema knowledge is moderate to weak.
(more…)
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke / 25.06.2014

Wuwei (Wayne) Feng MD MS FANA Assistant Professor, Department of Neuroscience Department of Health Science & Research Medical University of South Carolina Stroke Center The Center of Rehabilitation Research in Neurological ConditionsMedicalResearch.com Interview with: Wuwei (Wayne) Feng MD MS FANA Assistant Professor, Department of Neuroscience Department of Health Science & Research Medical University of South Carolina Stroke Center The Center of Rehabilitation Research in Neurological Conditions MedicalResearch: What are the main findings of the study? Dr. Feng: Stroke hospitalization rate is decreasing in the elderly, but increasing in the young/middle aged population, but this increase is mainly driven by the increase in blacks (not in whites) which incurred persistent racial disparity in stroke. It has tremendous economic impact as outlined in the paper. Of hospital charges totaling $2.8 billion over 10-year period, $453.2 million (16.4%) are associated with racial disparity (79.6% from patients <65 years). By way of background: 84,179 stroke hospitalizations occurred in South Carolina from 2001 to 2010. Blacks accounted for 29,846 (35.5%) and whites accounted for 54,333 (64.5%) of the strokes. Among blacks, 50.4% were <65 years of age compared to 29.6% among whites. The overall stroke hospitalization rate decreased over the 10-year period. There was a significant reduction in stroke hospitalization rate in the older (≥65 years old) populations, for both blacks and whites. Whereas, in the younger populations (<65 years old), the overall rate of stroke hospitalizations actually increased significantly; however this increase was only associated with black patients. For example, the hospitalization rate per 100,000 for young blacks was 121 in 2001, 139 in 2005 and 142 in 2010 (a 17.3% increase from 2001). This racial disparity was more severe in the younger group with the highest disparity seen in the 45-54 year age groups for both ischemic strokes (having a clot) and intra-cerebral hemorrhagic strokes. (more…)
Author Interviews, Gender Differences, Heart Disease, JAMA / 25.06.2014

MedicalResearch.com Interview with: David Strauss, M.D., Ph.D., Senior Author Medical Officer Center for Devices and Radiological Health U.S. Food and Drug Administration, Silver Spring, Md MedicalResearch: What are the main findings of the study? Dr. Strauss: The underrepresentation of women in clinical trials for cardiac resynchronization therapy (CRT) devices, as with other devices, has made it difficult to assess differences in the safety and effectiveness of these devices for women vs. men. The FDA is exploring the potential of pooling and analyzing data from multiple trials to bridge the knowledge gap for certain subpopulations (such as women) often underrepresented in medical device clinical trials. By conducting one such meta-analysis, the FDA found that women benefit from cardiac resynchronization therapy (CRT) significantly more than men do. (more…)
Author Interviews, Cancer Research, Exercise - Fitness, Mayo Clinic / 24.06.2014

Xuemei Sui, MD, MPH, PhD Assistant Professor Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208MedicalResearch.com Interview with:  Xuemei Sui, MD, MPH, PhD Assistant Professor, Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208 MedicalResearch: What are the main findings of the study? Dr. Sui: In the present study, cancer survivors who reported performing resistance exercise (RE) at least 1 day of the week had a 33% lower risk of all-cause mortality compared with individuals who did not report participation in resistance exercise.  Further, there was an inverse relationship between resistance exercise and all-cause mortality in those who were physically active, but not in those who were physically inactive.  Although leisure-time physical activity was not associated with a lower risk of all-cause mortality, the present results support the benefits of resistance exercise and physical activity was during cancer survival. (more…)
Author Interviews, Heart Disease, Lancet / 24.06.2014

Professor Lixin Jiang MD, PhD, F.A.C.C. National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital, National Center for Cardiovascular Diseases Beijing , ChinaMedicalResearch.com Interview with: Professor Lixin Jiang MD, PhD, F.A.C.C. National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital, National Center for Cardiovascular Diseases Beijing , China MedicalResearch: What are the main findings of the study? Professor Jiang: In this first representative nationwide assessment of quality of care in China, we studied 13,815 hospital admissions for STEMI in 162 hospitals across China over the past decade. We found that the incidence of hospital admission for STEMI quadrupled from 3.7 per 100,000 in 2001 to 15.8 per 100,000 in 2011. There were substantial changes in testing and treatment patterns. Over the study period, the rate of testing for troponin increased from 21.4% in 2001 to 66.5% in 2011. Additionally, based at the ideal patients’ analysis, the use of several highly effective treatments for STEMI, including aspirin, clopidogrel and statins, improved over the study period. However, other therapies known to reduce mortality in STEMI patients – such as β-blockers and ACE inhibitors – were underused with only 57.7% of patients receiving beta-blockers and 66.1% ACE inhibitors respectively in 2011. While the proportion of patients receiving reperfusion therapy remained constant, there was a notable shift away from fibrinolysis, which was the primary means of reperfusion in 2001, towards primary PCI. However, in 2011, only 27.6% of patients admitted to Chinese hospitals for STEMI received primary PCI, the gold standard of treatment, while 27.4% received fibrinolytic therapy in the ideal patients. Despite increasing overall intensity of treatment, procedure use, and testing, no significant change in the rate of in-hospital death from STEMI was seen over the study period. (more…)
Author Interviews, Hospital Readmissions, JAMA, Surgical Research / 24.06.2014

Benjamin S. Brooke, M.D., Ph.D. Assistant Professor of Surgery Division of Vascular Surgery University of Utah School of MedicineMedicalResearch.com Interview with: Benjamin S. Brooke, M.D., Ph.D. Assistant Professor of Surgery Division of Vascular Surgery University of Utah School of Medicine MedicalResearch: What are the main findings of the study? Dr. Brooke: This study was designed to evaluate whether high-risk surgical patients who visit a primary care provider (PCP) during the early period following hospital discharge are less likely to be readmitted within 30-days.  We examined this question by performing a retrospective cohort analysis of Medicare beneficiaries (2003-2010) who underwent a high risk surgery (open thoracic aortic aneurysm repair) as well as a control group of patients who underwent a lower risk surgical procedure (open ventral hernia repair), and then determining whether there was evidence of early PCP follow-up. In risk-adjusted analyses, we found that early primary care provider-follow-up was associated with a significant lower likelihood of 30-day readmission for high-risk patients undergoing open thoracic aortic aneurysm repair, particularly if a post-operative complication had occurred.  In comparison, early primary care provider follow-up did not have a significant effect on lowering readmissions in uncomplicated patients and those undergoing lower-risk operations such as ventral hernia repair. (more…)