Author Interviews, Cost of Health Care, Diabetes, JAMA / 28.04.2014

Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong.MedicalResearch.com Interview with: Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong. MedicalResearch.com: What are the main findings of the study? Dr. Chan: In this 1-year randomized study, we asked the question whether type 2 diabetic patients receiving team-based integrated care augmented by information technology would further improve in their glycemic control if given additional peer support through the telephone. All patients underwent comprehensive risk assessment guided by the web-based JADE portal which generated personalized risk report with attained treatment targets and decision support. After 1 year, all patients improved significantly in all risk factors including A1c with improved treatment adherence, self efficacy and psychological wellbeing. Although the peer support group did not further improve in A1c, short-stay hospitalization rates were substantially reduced by 50% , especially amongst those with emotional distress. These patients accounted for 20% of the intervention group, in whom peer support further reduced psychological distress and treatment non-adherence. (more…)
Author Interviews, CMAJ, OBGYNE / 28.04.2014

Professor Khalid Khan MMEd, MRCOG, MSc, FCPS, MBBS Women's Health Research Unit | Multi-disciplinary Evidence Synthesis Hub The Blizard Institute | 58 Turner Street | London | E1 2ABMedicalResearch.com Interview with: Professor Khalid Khan MMEd, MRCOG, MSc, FCPS, MBBS Women's Health Research Unit | Multi-disciplinary Evidence Synthesis Hub The Blizard Institute | 58 Turner Street | London | E1 2AB MedicalResearch.com: What are the main findings of the study? Prof. Khan: The risk of cesarean section was 12% lower among women undergoing induction of labor in comparison to the one that were managed expectantly. The subgroup comparison showed that the effect was significant in term and post-term however not in preterm gestations. Furthermore, induction of labor was associated with 50% and 14% reduction in risk of fetal death and admission to a neonatal intensive care unit, respectively. (more…)
Author Interviews, Endocrinology, JCEM / 28.04.2014

Dr. Dorte Glintborg PhD Senior Hospital Physician, PhD Dorte Glintborg, Department of Endocrinology, OUH Odense University HospitalMedicalResearch.com Interview with: Dr. Dorte Glintborg PhD Senior Hospital Physician, PhD Dorte Glintborg, Department of Endocrinology, OUH Odense University Hospital MedicalResearch.com: What are the main findings of this study? Dr. Glintborg: The main finding of the study is that one year’s metformin treatment is associated with a minor but significant weight loss in patients with PCOS irrespective of BMI at study inclusion. Treatment with oral contraceptives improves sex-hormone levels but is associated with at minor weight gain. Based on the study results, clinicians should consider the combined treatment with metformin and oral contraceptives in patients with PCOS. (more…)
Author Interviews, CMAJ, Cost of Health Care, Prostate Cancer / 26.04.2014

MedicalResearch.com Interview with: Alice Dragomir, MSc, PhD Assistant Professor, Urology/Surgery, McGill University Scientist, RI-MUHC MedicalResearch.com: What are the main findings of the study? Authors’ response: Our study demonstrates that for eligible patients, active surveillance could offer not only the known clinical advantages from the patient’s perspective, but also economic benefits from the health care system’s perspective. At the national level, the cost savings of an annual cohort of incident prostate cancers managed with active surveillance over a first year and 5 years of follow-up could be substantial. These are estimated at $96 million. (more…)
Author Interviews, JAMA / 26.04.2014

MedicalResearch.com Interview Invitation Karin J. H. Verweij, PhD Department of Developmental Psychology and EMGO Institute for Health and Care Research,  VU University Amsterdam, the Netherlands MedicalResearch.com: What are the main findings of the study? Dr. Verweij: We performed a twin study using over 10,000 adult Australian twins to determine the relative importance of genetic and environmental influences on individual differences in non-suicidal self-injury (NSSI) and suicidal ideation and their covariation. We found that individuals that report self-harm are approximately eight times more likely to also report suicidal ideation. Results from the bivariate genetic model indicated that the substantial correlation between non-suicidal self-injury and suicidal ideation (r=0.49 for males and 0.61 for females) is largely explained by overlapping genetic factors: 62% and 76% for males and females, respectively. Overlapping residual influences, including nonshared environmental influences and measurement error, also explain part of the covariance between the two traits. These findings suggest that the two behaviors share similar biological underpinnings. (more…)
Author Interviews, Brain Injury, CMAJ / 26.04.2014

Jane Topolovec-Vranic, PhD Clinical Researcher, Trauma and Neurosurgery Program Associate Scientist, Li Ka Shing Knowledge Institute Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto Associate Member, Graduate Department of Rehabilitation Sciences, University of Toronto MedicalResearch.com Interview with: Jane Topolovec-Vranic, PhD Clinical Researcher, Trauma and Neurosurgery Program Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto Associate Member, Graduate Department of Rehabilitation Sciences, University of Toronto MedicalResearch.com What are the main findings of the study? Answer: In our study we found that almost half of the men interviewed in a homeless shelter in Toronto had experienced a traumatic brain injury in their past, and that most of them had experienced their first brain injury prior to becoming homeless, usually in the early teenage years. (more…)
Author Interviews, Erasmus, Neurology, Stroke / 25.04.2014

M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the NetherlandsMedicalResearch.com Interview with: M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the Netherlands MedicalResearch.com: What are the main findings of this study? Dr. Ikram: We show that the risk of stroke might be increased due to an increased risk of ischemic stroke or increased risk of hemorrhagic stroke. Because these subtypes of stroke require different -often opposite- clinical management, currently available prediction rules for any stroke are insufficient. We propose a novel prediction rule that provides separate risks for ischemic stroke and hemorrhagic stroke. (more…)
Author Interviews, JAMA, Ophthalmology / 25.04.2014

Michael Wall, MD Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins D Iowa City, IA 52242-1091MedicalResearch.com Interview with: Michael Wall, MD Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins D Iowa City, IA 52242-1091 MedicalResearch.com: What are the main findings of the study? Dr. Wall: We studied patients with idiopathic intracranial hypertension (formerly called pseudotumor cerebri) with mild visual loss. We found that subjects taking acetazolamide, a type of diuretic, along with a low sodium weight loss program had significantly better visual outcomes than those taking placebo along with the diet. (more…)
Alzheimer's - Dementia, Author Interviews, Geriatrics, Mental Health Research / 24.04.2014

Ziad Nasreddine MD FRCP(C) Professeur adjoint Université de Sherbrooke et McGill University Neuro Rive-Sud/CEDRA: Centre Diagnostique et Recherche sur la Maladie d'Alzheimer Québec, CanadaMedicalResearch.com Interview with: Ziad Nasreddine MD FRCP(C) Professeur adjoint Université de Sherbrooke et McGill University Neuro Rive-Sud/CEDRA: Centre Diagnostique et Recherche sur la Maladie d'Alzheimer Québec, Canada MedicalResearch.com: What are the main findings of this study? Dr. Nasreddine: The Montreal Cognitive Assessment (MoCA) total score (MoCA-TS) and Memory Index Score (MoCA-MIS) are useful in predicting conversion to Alzheimer’s disease (AD) in individuals with mild cognitive impairment (MCI). Identifying individuals with MCI at high of conversion to Alzheimer’s disease is important clinically and for selecting appropriate subjects for therapeutic trials. (more…)
Author Interviews, JAMA, Stroke, UCLA / 24.04.2014

Dr. Gregg C. Fonarow MD Director, Ahmanson-UCLA Cardiomyopathy Center UCLA CHAMP - Cholesterol, Hypertension, and Atherosclerosis Management Program Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine Los Angeles, CAMedicalResearch.com Interview with: Dr. Gregg C. Fonarow MD Director, Ahmanson-UCLA Cardiomyopathy Center Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine Los Angeles, CA MedicalResearch.com: What are the main findings of the study? Dr. Fonarow: This study examined data from hospitals that have adopted the American Heart Association/ American Stroke Association’s national quality initiative, Target: Stroke, which aims to increase the number of stroke patients treated with clot-busting drugs for ischemic stroke within 60 minutes or less after hospital arrival.  Initiated nationwide in 2010, Target: Stroke provided 10 key strategies as well as tools to facilitate timely tPA administration, as well as additional approaches to improve stroke care and outcome. Data from 71,169 tPA-treated stroke patients at 1,030 hospitals participating in Target: Stroke were analyzed to compared the time to treatment and incidence of complications before implementation, from 2003 to 2009, to the post-implementation years, from 2010 to 2013. This study found that the percentage of patients treated within the recommended timeframe increased from less than one-third before Target: Stroke to more than half afterwards. The Target: Stroke program goal of 50 percent or more of patients having door-to-needle times within 60 minutes was successfully achieved. In addition, the average time to treatment dropped by 15 minutes, from 74 to 59 minutes. Faster treatment was associated with lower rates of complications, including death. Before Target: Stroke, 9.9% of stroke patients died in the hospital, compared to 8.3% of patients treated after the initiative started, a difference which was statistically significant. In addition, patients treated by Target: Stroke strategies were less likely to develop the complication of symptomatic intracranial hemorrhage. (more…)
Author Interviews, Dengue, Ebola, Genetic Research, Infections, NEJM, NIH / 24.04.2014

Sergio D. Rosenzweig, MD, PhD Director, Primary Immunodeficiency Clinic (PID-C) LHD, NIAID, NIH Head of the Infectious Diseases Susceptibility Unit at the Laboratory of Host Defenses, National Institutes of Allergy and Infectious Diseases National Institutes of Health Bethesda, MD, 20892MedicalResearch.com Interview with: Sergio D. Rosenzweig, MD, PhD Director, Primary Immunodeficiency Clinic (PID-C) Head of the Infectious Diseases Susceptibility Unit at the Laboratory of Host Defenses, National Institutes of Allergy and Infectious Diseases National Institutes of Health Bethesda, MD, 20892 MedicalResearch.com: What are the main findings of the study? Dr. Rosenzweig: We diagnosed a disease called CDG-IIb in two siblings with severe development issues and very low levels of immunoglobulins, which include infection-fighting antibodies. These children were referred to the NIAID Primary Immunodeficiency Clinic through the NIH Undiagnosed Diseases Program. CDG-IIb is an extremely rare congenital disorder of glycosylation (CDG), with only one other case reported. The genetic defect of the disease disrupts glycosylation, the process for attaching and trimming sugars from proteins. Almost 50% of our proteins have sugars attached, and these are called glycoproteins. They include immunoglobulins and also some viral glycoproteins that are made when cells are infected by a virus. The spread of some viruses, including HIV and influenza, depend on viral glycoproteins in order to infect additional cells and form viral protective shields. We found that this type of virus was less able to replicate, infect other cells, or create adequate protective shields in CDG-IIb patient cells because of the glycosylation defect. In comparison, adenovirus, poliovirus, and vaccinia virus, which either do not rely on glycosylation or do not form protective glycoprotein shields, replicated normally when added to both CDG-IIb and healthy cells. (more…)
Author Interviews, Diabetes, Heart Disease / 24.04.2014

Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K.MedicalResearch.com Interview with: Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K. MedicalResearch.com: What are the main findings of the study? Prof. Heller: We explored the potential to hypoglycaemia to cause cardiac arrhythmias since we have previously shown that a low glucose can alter the electrocardiogram.  We had a hypothesis that alterations in heart rhythm or ectopic beats might contribute to cardiac mortality and in part explain the association between intensive diabetic therapy and increased mortality.  We therefore undertook continuous glucose monitoring and 12 lead EKG monitoring for a period of 5 days in individuals with Type 2 diabetes at increased CV risk.  We found that hypoglycaemia was fairly common and that nocturnal episodes in particular, were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept.  These periods of hypoglycemia were associated with a high risk of marked slow heart rates (bradycardia) accompanied by ectopic beats.  Our data suggest that this was due to overactivity of the vagus nerve.  We have therefore identified a mechanism which might contribute to increased mortality in individuals with Type 2 diabetes and high CV risk during intensive insulin therapy. (more…)
Author Interviews, Frailty, Lancet, Vitamin D / 23.04.2014

MedicalResearch.com Interview with: Dr Mark Bolland, PhD Bone and Joint Research Group, Department of Medicine University of Auckland, Auckland, New Zealand MedicalResearch.com: What are the main findings of the study? Prof. Bolland: In a meta-analysis of 20 randomized clinical trials, there was no effect of vitamin D with or without calcium on falls.  In a trial sequential analysis of these trials, the effect estimate for vitamin D with or without calcium on falls lay within the futility boundary, providing reliable evidence that vitamin D supplementation does not alter the relative risk of falls by ≥15% and suggesting that future trials that are similar in design to current trials are unlikely to change that conclusion. (more…)
AHA Journals, Author Interviews, Cannabis, Heart Disease / 23.04.2014

Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France.MedicalResearch.com Interview with: Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France. MedicalResearch.com: What are the main findings of the study? Dr. Jouanjus: Our study emphasizes that cardiovascular complications make up 1.8 percent of cannabis-related health complications reported in France. These were cases of peripheral arteriopathies, and cardiac and cerebrovascular disorders, some of which resulted in the death. These findings conducted us to conclude that marijuana is a possible risk factor for cardiovascular disease in young adults. (more…)
Author Interviews, CMAJ, Cost of Health Care, Orthopedics / 23.04.2014

MedicalResearch.com Interview with: Susan Jaglal, PhD Senior Scientist Toronto Rehabilitation Institute University of Toronto, Toronto, Ontario MedicalResearch.com: What are the main findings of the study? Dr. Jaglal: Bone Mineral Density (BMD) tests are used to both diagnose osteoporosis and assess and individual’s risk of fracture. While the tests play an important role in bone health, they are sometimes ordered inappropriately. For example, while women age 40-44 are typically not at risk of fragility fracture or in need of Bone Mineral Density testing, these individuals received almost half the Bone Mineral Density tests performed in Ontario in 2007/2008. Policy changes have been made in recent years in an effort to curb unnecessary testing of low risk individuals in both the United States and Canada. Policy efforts in Ontario included a 2008 fee schedule change that limited repeated testing among low-risk patients and included a new fee code for a “baseline” tests. Patients were limited to 1 baseline test in their lifetime. The goal of the present study was to determine the impact of this fee schedule change on Bone Mineral Density testing rates. The study was based on an analysis of provincial administrative data including physician billings, hospital discharges, and emergency department visits. Results demonstrated that while fee schedule changes were associated with a decrease in BMD testing rates, the decreases affected both low and high-risk patients. Most decreases were seen in testing rates of low-risk women. However, the associated decrease in testing among high-risk patients (e.g., those over 65 or with a recent fracture) is concerning, as high-risk patients benefit from screening and monitoring of Bone Mineral Density. (more…)
Author Interviews, Geriatrics, Mental Health Research / 23.04.2014

Helen C. Kales MD Professor of Psychiatry Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan Research Scientist, VA Center for Clinical Management Research and Geriatric Research Education and Clinical Center VA Ann Arbor Healthcare SysteMedicalResearch.com Interview with Helen C. Kales MD Professor of Psychiatry Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan Research Scientist, VA Center for Clinical Management Research and Geriatric Research Education and Clinical Center VA Ann Arbor Healthcare System Please note that this paper is the result of the deliberations of a multi-disciplinary national expert panel, not a specific study. MedicalResearch.com: What were the main findings of the expert panel? Dr. Kales: Often more than memory loss, behavioral symptoms of dementia are among the most difficult aspects of caring for people with dementia. These symptoms are experienced almost universally, across dementia stages and causes, and are often associated with poor outcomes including early nursing home placement, hospital stays, caregiver stress and depression, and reduced caregiver employment.  Doctors often prescribe these patients psychiatric medications like antipsychotics, despite little hard evidence that they work well in this population and despite the risks they pose including hastening death.  Meanwhile, studies show promise for non-medication behavioral and environmental approaches (such as providing caregiver education/support, creating meaningful activities and simplifying/enhancing the environment), but too few health providers are trained in their use.  The method created by the national multidisciplinary group of experts (DICE which stands for Describe, Investigate, Create and Evaluate) represents a comprehensive approach to assessment and management of behavioral symptoms in dementia.  For example, a new report of “agitation” from a caregiver, should be fully understood and described (e.g. who/what/when/where/risk/safety); underlying causes should be investigated (e.g. pain, changes in medications, medical conditions, poor sleep, fear); a treatment plan should be created (e.g. responding to physical problems, working collaboratively with the caregiver and other team members to institute non-pharmacologic interventions); and evaluating whether the interventions tried were effective. (more…)
Author Interviews, Autism, JAMA, Johns Hopkins / 22.04.2014

Li-Ching Lee, PhD, ScM Associate Scientist, Departments of Epidemiology and Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205MedicalResearch.com Interview with: Li-Ching Lee, PhD, ScM Associate Scientist, Departments of Epidemiology and Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205 MedicalResearch.com: What are the main findings of the study? Dr. Li-Ching Lee: This population-based case-control study in young children provides evidence that prenatal selective serotonin reuptake inhibitor (SSRI) use may be a risk factor for autism and other developmental delays (DD). Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with autism spectrum disorder (ASD) relative to children with typical development; the strongest association occurred with first-trimester exposure. Exposure was also elevated among boys with DD and was strongest in the third trimester. (more…)
Author Interviews, JAMA, Outcomes & Safety, Stroke / 22.04.2014

Priv.-Doz. Dr. med. Dr. phil. Martin Ebinger Oberarzt der Klinik und Hochschulambulanz für Neurologie am Campus Charité Mitte Center for Stroke Research Berlin (CSB) Charité - Universitätsmedizin Berlin | CCM Charitéplatz 1 | 10117 Berlin | GermanyMedicalResearch.com Interview with: Priv.-Doz. Dr. med. Dr. phil. Martin Ebinger Oberarzt der Klinik und Hochschulambulanz für Neurologie am Campus Charité Mitte Center for Stroke Research Berlin (CSB) Charité - Universitätsmedizin Berlin | CCM Charitéplatz 1 | 10117 Berlin | Germany MedicalResearch.com: What are the main findings of the study? Dr. Ebinger: The main findings of our study was a significant time reduction during randomized weeks with prehospital thrombolysis compared to control weeks with regular care. (more…)
Author Interviews, JAMA, Surgical Research / 22.04.2014

MedicalResearch.com Interview with: Rustam Al-Shahi Salman Professor of clinical neurology and MRC senior clinical fellow, University of Edinburgh Honorary consultant neurologist, NHS Lothian upcoming JAMA publication:MedicalResearch.com Interview with: Rustam Al-Shahi Salman Professor of clinical neurology and MRC senior clinical fellow University of Edinburgh Honorary consultant neurologist, NHS Lothian MedicalResearch.com: What are the main findings of the study? Prof. Al-Shahi Salman: Patients with arteriovenous malformations (abnormal connection between arteries and veins) in the brain that have not ruptured had a lower risk of stroke or death for up to 12 years if they received conservative management of the condition compared to an interventional  treatment. Interventional treatment for brain arteriovenous malformations (bAVMs) with procedures such as neurosurgical excision, endovascular embolization, or stereotactic radiosurgery can be used alone or in combination to attempt to obliterate bAVMs. Because interventions may have complications and the untreated clinical course of unruptured bAVMs can be benign, some patients choose conservative management (no intervention). Guidelines have endorsed both intervention and conservative management for unruptured brain arteriovenous malformations. Whether conservative management is superior to interventional treatment for unruptured bAVMs is uncertain because of the lack of long-term experience, according to background information in the article. (more…)
Cancer Research, Journal Clinical Oncology / 22.04.2014

Danielle Blanch Hartigan, PhD, MPH Cancer Prevention Fellow National Cancer InstituteMedicalResearch.com Interview with: Danielle Blanch Hartigan, PhD, MPH Cancer Prevention Fellow National Cancer Institute MedicalResearch.com: What are the main findings of the study? Dr. Blanch-Hartigan: Results from this nationally-representative survey of oncologists and PCPs suggest that discussion of survivorship care planning with cancer survivors does not always occur. Training and knowledge specific to survivorship care and coordinated care between PCPs and oncologists were associated with increased survivorship discussions with survivors. (more…)
Author Interviews, CHEST, Menopause, Obstructive Sleep Apnea / 20.04.2014

MedicalResearch.com Interview with: Rodrigo Pinto Pedrosa, MD, PhD Sleep and Heart Laboratory, Pronto Socorro Cardiológico de Pernambuco Pernambuclo, Brazil MedicalResearch.com: What are the main findings of the study? Dr. Pedrosa: Perimenopause is associated with increased cardiovascular risk. This study evaluated the association between obstructive sleep apnea (OSA) and arterial stiffness and hypertension in perimenopausal women. OSA (apnea-hypopnea index: ≥5 events/hour) and moderate/severe OSA (apnea-hypopnea index: ≥15 events/h) were diagnosed in 111 (40.1%) and 31 (11.1%) of women, respectively.  Women with moderate/severe obstructive sleep apnea  had a higher prevalence of hypertension, were prescribed more medications for hypertension, had higher awake blood pressure,  nocturnal blood pressure,  diastolic blood pressure, as well as higher arterial stiffness (pulse wave velocity: 11.5 [10.1 to 12.3] vs 9.5 [8.6 to 10.8] m/s, p<0.001) than women without obstructive sleep apnea, respectively. Oxygen desaturation index during the night was independently associated with 24h arterial blood pressure and with arterial stiffness. (more…)
Author Interviews, Biomarkers, CHEST, Cleveland Clinic, Lung Cancer / 20.04.2014

Daniel I. Sessler, M.D. Michael Cudahy Professor and Chair, Department of Outcomes Research Cleveland Clinic, Cleveland,MedicalResearch.com Interview with: Daniel I. Sessler, M.D. Michael Cudahy Professor and Chair, Department of Outcomes Research Cleveland Clinic, Cleveland, OH MedicalResearch.com: What are the main findings of the study? Dr. Sessler: Free fatty acids, arachidonic acid and linoleic acid, and their metabolites hydroxyeicosatetraenoic acids (5-HETE, 11-HETE, 12-HETE, and 15-HETE) were 1.8 to 5.7-fold greater in 37 patients with adenocarcinoma versus 111 patients without cancer (all P<0.001). Areas under the receiver operating characteristics (ROC) curve were significantly greater than 0.50 discriminating lung cancer patients and controls for all biomarkers and phospholipids, and ranged between 0.69 and 0.82 (all P<0.001) for lung cancer patients versus controls. Arachidonic acid, linoleic acid, and 15-HETE showed sensitivity and specificity >0.70 at the best cutpoint. Concentrations of free fatty acids and their metabolites were similar in 18 squamous-cell carcinoma patients and 54 non-cancer controls. (more…)
Author Interviews, Cancer Research, Genetic Research, Journal Clinical Oncology / 20.04.2014

MedicalResearch.com Interview with: Allison W. Kurian, M.D., M.Sc. Assistant Professor of Medicine and of Health Research and Policy Divisions of Oncology and Epidemiology Allison W. Kurian, M.D., M.Sc. Assistant Professor of Medicine and of Health Research and Policy Divisions of Oncology and Epidemiology and James M. Ford, MD Associate Professor of Medicine Pediatrics and Genetics, Division of Oncology, Stanford University School of MedicineJames M. Ford, MD Associate Professor of Medicine Pediatrics and Genetics, Division of Oncology, Stanford University School of Medicine MedicalResearch.com: What are the main findings of the study? Answer: We found that 11% of women who met standard clinical criteria for BRCA1 and BRCA2 (BRCA1/2) mutation testing, yet had tested negative, actually carried an actionable mutation in another cancer-related gene.  We found that patients were highly motivated to learn about their genetic test results and new recommendations for cancer risk reduction.  Over a short follow-up period, colonoscopy screening resulted in early detection of a tubular adenoma in a patient found to have a high-risk MLH1 mutation, and thus the multiple-gene testing in our study has likely prevented at least one cancer to date.  We conclude that multiple-gene sequencing can benefit appropriately selected patients. (more…)
Author Interviews, Lancet, Mental Health Research / 20.04.2014

Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, AustraliaMedicalResearch.com Interview with: Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia MedicalResearch.com: What are the main findings of the study? Dr. Patton: Although there has been wide acceptance that the teens are a time when emotional problems are common, views have been polarized about their significance. Some have viewed these problems are usual for this phase of life with little significance for later life mental health; others have argued that early psychiatric intervention was essential given the risks of ongoing disorders. In this sample almost two thirds of girls and a third of boys had an episode of emotional troubles (anxiety and depression) at a level that would concern a family physician. For those where the episode were brief lasting weeks to months, recovery without further later life episodes was common. In contrast those with persistent (longer than 6 months) or recurrent emotional problems during the teens had a high likelihood of similar problems with depression and anxiety in their twenties. In general these emotional problems persisted more in females than in males. (more…)
Author Interviews, Bipolar Disorder, JAMA / 19.04.2014

John I. Nurnberger, Jr., M.D., Ph.D. Professor of Psychiatry Joyce and Iver Small Professor of PsychiatryMedicalResearch.com Interview with: John I. Nurnberger, Jr., M.D., Ph.D. Professor of Psychiatry Joyce and Iver Small Professor of Psychiatry Indiana University School of Medicine   MedicalResearch.com: What are the main findings of this study? Dr. Nurnberger: The main findings of the study are the biological pathways identified to be associated with bipolar disorder, including those involved in hormonal regulation, calcium channels, second messenger systems, and glutamate signaling. Gene expression studies implicated neuronal development pathways as well. These findings highlight the role of certain neurobiological processes that have been considered in prior hypotheses of bipolar disorder. They underline a role for calcium signaling, which has only been clearly implicated in the genetics of bipolar disorder in recent years. They also feature hormonal processes such as the hypothalamic-pituitary-adrenal axis, which has been known to be involved in stress responses, but has not been prominent in many recent theories of the pathogenesis of bipolar disorder. (more…)
Exercise - Fitness, Orthopedics, Pediatrics / 19.04.2014

MedicalResearch.com Interview with: Neeru Jayanthi, MD Associate Professor Medical Director, Primary Care Sports Medicine Loyola University Medical Center study MedicalResearch.com: What are the main findings of the study? Dr. Jayanthi: We surveyed a cohort of 1,190 athletes ages 7 to 18, including 1,121 for whom insurance status could be determined. Our main findings were: 1. The rate of serious overuse injuries in athletes who come from families that can afford private insurance is 68 percent higher than the rate in lower-income athletes who are on public insurance (Medicaid). 2. Privately insured young athletes are twice as likely as publicly insured athletes to be highly specialized in one sport. MedicalResearch.com: Were any of the findings unexpected? Dr. Jayanthi: The findings confirmed our hypothesis that higher-income students would be more likely to specialize in one sport, and also more likely to suffer serious overuse injuries. MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Jayanthi: Specializing in one sport at an early age increases the risk of serious overuse injuries. Here are evidence-based tips to reduce the risk of overuse injuries: • Increase the amount of unstructured free play, while limiting the amount of time spent in organized sports and specialized training. Do not spend more than twice as much time playing organized sports as you spend in unstructured play. • Do not spend more hours per week than your age playing sports. For example, a 10-year-old should not spend more than 10 hours per week playing sports. • Do not specialize in one sport before late adolescence. • Do not play sports competitively year round. Take a break from competition for one to three months each year (not necessarily consecutively). • Take at least one day off per week from sports training. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Dr. Jayanthi: We are doing a pilot study this summer comparing parent/child dyads of high competitive young athletes and recreationally active children with parent dyad to see differences based on sports participation of child and adult, as well as based on socioeconomic status. This may lead to a much larger study. Citation: Abstract presented at the American Medical Society for Sports Medicine Annual Meeting in New Orleans, LA.MedicalResearch.com Interview with: Neeru Jayanthi, MD Associate Professor Medical Director, Primary Care Sports Medicine Loyola University Medical Center study MedicalResearch.com: What are the main findings of the study? Dr. Jayanthi: We surveyed a cohort of 1,190 athletes ages 7 to 18, including 1,121 for whom insurance status could be determined. Our main findings were: 1. The rate of serious overuse injuries in athletes who come from families that can afford private insurance is 68 percent higher than the rate in lower-income athletes who are on public insurance (Medicaid). 2. Privately insured young athletes are twice as likely as publicly insured athletes to be highly specialized in one sport. (more…)
Author Interviews, Cancer Research, Johns Hopkins, Prostate Cancer / 19.04.2014

Angelo M. De Marzo MD PhD Professor of Pathology Johns Hopkins School of Medicine Baltimore, MD 21231MedicalResearch.com Interview with: Angelo M. De Marzo MD PhD Professor of Pathology Johns Hopkins School of Medicine Baltimore, MD 21231 MedicalResearch.com: What are the main findings of the study? Dr. De Marzo: Working as a team with Dr. Elizabeth Platz and a group of other investigators we found that men with chronic inflammation in their benign areas of their prostate biopsies had a higher chance of prostate cancer,  and especially higher grade cancers, which are associated with disease aggressiveness. A key unique aspect of the study is that the samples were taken from man who were enrolled in the Prostate Cancer Prevention Trial (PCPT), a trial in which all men entering the study had a relatively low PSA, and, all men at the end of study who did not already have a diagnosis of prostate cancer were offered a prostate biopsy regardless of their PSA. This study design, unlike a standard association study, allowed us to minimize the potential bias whereby inflammation is associated itself with elevations in PSA. In this standard design approach, when cancer is detected it could artifactually appear that inflammation is associated with cancer because the inflammation was in part driving the PSA elevation, which prompted the biopsy in which cancer was detected. (more…)
Author Interviews, Cancer Research, MD Anderson, Race/Ethnic Diversity / 18.04.2014

Dr. Lorraine R. Reitzel Ph.D Associate Professor in the Health Program of the Department of Educational Psychology College of Education, University of Houston in Houston, Texas.MedicalResearch.com Interview with: Dr. Lorraine R. Reitzel Ph.D Associate Professor in the Health Program of the Department of Educational Psychology College of Education, University of Houston in Houston, Texas. MedicalResearch.com: Please tell us about your study. Dr. Reitzel: The current study represented a secondary analysis of data that were collected by Dr. Lorna McNeill and colleagues at The University of Texas MD Anderson Cancer Center. The parent study was focused on better understanding factors associated with cancer risk among African American adults, and several faculty members including myself contributed ideas about the variables we thought might play a role. The current study represents one of several studies emerging from these data. The current study was led by Ms. Pragati S. Advani, a graduate student on my research team, who was interested in better understanding the associations between financial strain and modifiable behavioral risk factors for cancer among African American adults. Financial strain represents an unfavorable income to needs ratio and was assessed using a questionnaire that tapped into current difficulty affording things that represent pretty basic components of life, including suitable food, clothing, and housing for the respondent and their family. The modifiable behavioral risk factors for cancer examined included smoking cigarettes, at-risk alcohol use, being overweight/obese, getting insufficient physical activity, and having inadequate fruit and vegetable intake. We also included a tally of the total number of these factors (0 to 5) as an outcome variable of interest. (more…)
Author Interviews, Nutrition / 18.04.2014

Dr. Annette Dickinson PhD Consultant to the Council for Responsible Nutrition.MedicalResearch.com Interview with: Dr. Annette Dickinson PhD Consultant to the Council for Responsible Nutrition.   MedicalResearch.com: What are the main findings of the study?   Dr. Dickinson: “A five-year series of consumer surveys (2007 to 2011) consistently found that about half of adult consumers use dietary supplements on a regular basis, and a higher percentage (about 2/3) report using dietary supplements when occasional as well as regular use is taken into account.  Over the five years, there was a shift in the pattern of supplement use, with the percentage of respondents who said they regularly used mostly a multivitamin declining, and the percentage who said they regularly used a variety of products increasing.  The top 7 products used were:  multivitamins, omega-3 fatty acids, calcium, vitamin D, vitamin C, B vitamins, and vitamin E.  The main reasons given for supplement use were for overall health and wellness (58% of users) and to fill nutrient gaps in the diet (42%).  Supplement users were more likely than nonusers to say they try to eat a balanced diet, visit their doctor regularly, get a good night's sleep, exercise regularly, and maintain a healthy weight.  This indicates that supplement use is part of an overall approach to seeking a healthy lifestyle.” (more…)