Author: Marie Benz MD FAAD

11 Jun

Posted at 19:49h in Author Interviews, Gastrointestinal Disease, NEJM, Pain Research, University of Michigan
William D. Chey, MD, AGAF, FACG, FACP, RFF Professor of Medicine Director, GI Physiology Laboratory Co-director, Michigan Bowel Control Program University of Michigan Health SystemMedicalResearch.com Interview with: William D. Chey, MD, AGAF, FACG, FACP, RFF Professor of Medicine Director, GI Physiology Laboratory Co-director, Michigan Bowel Control Program University of Michigan Health System MedicalResearch: What are the main findings of the study? Dr. Chey: Opiate analgesics are the most commonly prescribed medications in the US. GI side effects are common in patients who opiates. Constipation is the most common and most bothersome GI side effect of opiates. Peripherally acting mu opioid antagonists have been shown to benefit a subset of patients with opiate induced constipation. In 2 large, randomized, placebo controlled phase III trials, the peripherally acting, mu-opioid antagonist naloxegol was found to improve constipation in patients taking opioid analgesics for noncancer pain. Response rates were significantly higher with 25 mg of naloxegol than with placebo (intention-to-treat population: study 04, 44.4% vs. 29.4%, P = 0.001; study 05, 39.7% vs. 29.3%, P = 0.02) in both studies. Benefits were seen with the lower 12.5 mg dose in one of the studies (intention-to-treat population, 40.8% vs. 29.4%, P = 0.02). An interesting aspect of this study was the a priori inclusion of patients who had tried and failed to respond to other laxatives prior to enrollment. Response rates in this population were similar to the overall population (patients with an inadequate response to laxatives: study 04, 48.7% vs. 28.8%, P = 0.002; study 05, 46.8% vs. 31.4%, P = 0.01). Pain scores and daily opioid dosing were similar among the three groups before and after treatment.

11 Jun

Posted at 19:42h in Accidents & Violence, Author Interviews, Mayo Clinic
MedicalResearch.com Interview with: Stephanie F. Polites, MD Department of Surgery and Michael B. Ishitani, MD Department of Pediatric Surgery Mayo Clinic, Rochester, Minnesota MedicalResearch: What are the main findings of the study? Answer: Though most injuries were in boys, 20% of the injuries occurred in girls. Extremity fractures and head injuries were the most common injuries with older children and boys more likely to sustain extremity fractures while younger children and girls were more likely to have head injuries or concussions. Life threatening injuries were rare, which is reassuring.

11 Jun

Posted at 19:16h in Author Interviews, Heart Disease
Laurie Lambert, PhD Unité d'évaluation en cardiologie Institut national d'excellence en santé et en services sociaux (INESSS) Montréal, QuébecMedicalResearch.com Interview with: Laurie Lambert, PhD Unité d'évaluation en cardiologie Institut national d'excellence en santé et en services sociaux (INESSS) Montréal, Québec MedicalResearch: What are the main findings of the study? Dr. Lambert: Patients with ST-elevation myocardial infarction (STEMI) are frequently transferred for percutaneous coronary reperfusion from a hospital without this capability. Favourable outcomes depend on minimizing delays to treatment. A major component of delay is the time from the patient’s arrival at the first hospital’s emergency department to departure to the hospital where percutaneous reperfusion will be performed, the ‘door-in-door-out’ time or DIDO. We characterized this component of delay in a systematic field evaluation of STEMI treatment over a large and populous geographic area. The major contributors to DIDO time were the delays
  • (1) from the initial in-hospital ECG acquisition to transfer activation by the emergency physician and
  • (2) from arrival of the transfer ambulance at the first hospital to departure of the ambulance for the primary percutaneous coronary intervention center. When the DIDO interval was timely (30 minutes or less as recommended by guidelines), reperfusion treatment was far more frequently within guideline-recommended delays (90 minutes or less). In fact, this benchmark of DIDO time was met in only 14% of cases. We identified a number of factors associated with untimely DIDO, an important one being an ambiguous presenting ECG. DIDO times were faster when patients arrived at the first hospital by ambulance particularly when retransfer to the second hospital was with the same ambulance that had remained on standby.

11 Jun

Posted at 11:14h in Author Interviews, Breast Cancer, MD Anderson, Surgical Research
Dr. Benjamin D. Smith MD Associate Professor Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch.com Interview with: Dr. Benjamin D. Smith MD Associate Professor Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch: What are the main findings of the study? Dr. Smith: Although use of needle biopsy to diagnose breast cancer increased during the time period we studied, it remained lower than targeted benchmarks. The patient’s surgeon seemed to exert a major influence on use of needle biopsy.

11 Jun

Posted at 10:51h in Author Interviews, Genetic Research, Mayo Clinic, Schizophrenia
Dr. Anders Nykjaer MD, PhD Mayo Clinic in Florida and Aarhus University in DenmarkMedicalResearch.com Interview with: Dr. Anders Nykjaer MD, PhD Mayo Clinic in Florida and Aarhus University in Denmark MedicalResearch: What are the main findings of the study? Dr. Nykjaer: It is well known that ADHD is a complex condition caused by a number of factors including genetic and environment. However, approximately 75% etiology is considered to be genetic and a large body of investigations suggests that it is multiple genes each with a moderate effect that is responsible for conferring susceptibility to ADHD. We have here found one single gene the dysfunction of which is sufficient to trigger the disease.  The gene encodes a receptor, SorCS2, which ensures correct wiring our reward system during embryonic development. Malfunction of the receptor causes ADHD-like symptoms in mice. It is well accepted that ADHD predisposes to psychiatric disorders and genetic reports have linked variations in the SorCS2 gene with schizophrenia. Studies are currently ongoing to evaluate if mutations disrupting the function of SorCS2 may also result in schizophrenia. If this is the case we have come closer to an explanation for the link between ADHD and psychiatric disorders. In the future when prenatal genetic screening becomes established, non-sense mutations in the SorCS2 gene can be used to predict that the child will develop ADHD with 100% certainty.  

11 Jun

Posted at 02:01h in Author Interviews, Dartmouth, OBGYNE
Rachel Thompson PhD Postdoctoral Research Fellow The Dartmouth Center for Health Care Delivery Science Dartmouth CollegeMedicalResearch.com: Interview with Rachel Thompson PhD Postdoctoral Research Fellow The Dartmouth Center for Health Care Delivery Science Dartmouth College MedicalResearch: What are the main findings of the study? Dr. Thompson: This study, which surveyed 417 women aged 15-45 years and 188 contraceptive care providers in 2013, found important differences in what matters most to these two groups when it comes to discussing and deciding on a contraceptive method. Women’s most important question when choosing a contraceptive was “Is it safe?” – this was in the top three questions for 42% of women but only 21% of providers. Alternatively, providers’ most important question was “How is it used?”. Information on side effects and how a method actually works to prevent pregnancy was also a higher priority for women than for providers.

11 Jun

Posted at 01:41h in Author Interviews, Cancer Research, Occupational Health
Gabriella Johansson Occupational and Environmental Medicine Lund University Hospital Lund, SwedenMedicalResearch.com Interview with: Gabriella Johansson Occupational and Environmental Medicine Lund University Hospital Lund, Sweden   MedicalResearch: What are the main findings of the study? Answer: Our main focus was to study hairdressers’ exposure to carcinogenic aromatic amines. We found that the concentrations of the carcinogenic compound o-toluidine in blood increased with the number of treatments per week of light color permanent hair dyeing and hair waving treatments. Another aromatic amine, m- toluidine (assessed as not classifiable as carcinogenic to humans owing to a lack of data) in blood, increased with the number of treatments per week of light color hair dyeing and all other hair dyeing.

11 Jun

Posted at 01:25h in Author Interviews, Lancet, Parkinson's
Richard Gray Professor of Medical Statistics Clinical Trial Service Unit Richard Doll Building, OxfordMedicalResearch Interview with: Richard Gray Professor of Medical Statistics Clinical Trial Service Unit Richard Doll Building, Oxford MedicalResearch: What are the main findings of the study? Prof. Gray: We found that, when we asked patients with Parkinson’s disease how their drugs affected their overall quality of life, the older drug levodopa was better than newer, more expensive drugs and that this benefit persisted for at least seven years from starting treatment.

11 Jun

Posted at 00:27h in Author Interviews, BMJ, Breast Cancer, Brigham & Women's - Harvard, Nutrition
MedicalResearch.com Interview with Dr. Maryam Farvid MSc, Ph.D. Takemi fellow, and Associate ArofessorMedicalResearch.com Interview with Dr. Maryam Farvid MSc, Ph.D. Takemi fellow, and Associate Arofessor Senior author: Prof Walter Willett Department of Nutrition, Harvard School of Public Health, Boston, MA, MedicalResearch: What are the main findings of the study? Dr. Farvid: Compared to women who had one serving per week red meat, those who consumed 1.5 serving per day red meat had a 22 percent higher risk of breast cancer. Red meat intake is associated with breast cancer risk in a dose-response manner. Each additional serving/day increase in total red meat was associated with a 13% increase in risk of breast cancer. Furthermore, each additional serving/day of poultry was associated with a 25% lower risk of postmenopausal breast cancer. Substituting one serving/day of legumes for one serving/day of red meat was associated with a 15% lower risk of breast cancer, substituting one serving/day of poultry for one serving/day of red meat was associated with a 17% lower risk of breast cancer overall, and substituting one serving/day of combined legumes, nuts, poultry, and fish for one serving/day of red meat was associated with a 14% lower risk of breast cancer.

10 Jun

Posted at 20:07h in Author Interviews, Diabetes, Heart Disease, JAMA, Vanderbilt
MedicalResearch.com Interview with: Christianne L. Roumie, MD MPH Associate Professor Internal Medicine and Pediatrics Institute for Medicine and Public Health Vanderbilt University Staff Physician VA Tennessee Valley Healthcare System Nashville TN 37212MedicalResearch.com Interview with: Christianne L. Roumie, MD MPH Associate Professor Internal Medicine and Pediatrics Institute for Medicine and Public Health Vanderbilt University Staff Physician VA Tennessee Valley Healthcare System Nashville TN 37212 MedicalResearch: What are the main findings of the study? Dr. Roumie: This retrospective cohort study compared time to acute myocardial infarction (AMI), stroke, or death among Veterans with diabetes that were initially treated with metformin, and subsequently added either insulin or sulfonylurea. Among 178,341 Veterans on metformin monotherapy, 2,948 and 39,990 added insulin or sulfonylurea, respectively. Patients were about 60 years old, about 35% had history of heart disease or stroke, had been on metformin for an average of 14 months and their hemoglobin A1c was 8.1% at the time of addition of the second medication. Compared to those who added a sulfonylurea, those who added insulin to metformin had a 30% higher risk of the combined outcome of heart attack, stroke, and all-cause mortality. Although new heart attacks and strokes occurred at similar rates in both groups, mortality was higher in patients who added insulin.

10 Jun

Posted at 20:04h in Author Interviews, Diabetes, JAMA, Surgical Research, Weight Research
Lars Sjöström, MD, PhD Professor Department of Body Composition and Metabolism Sahlgrenska University Hospital Göteborg, SwedenMedicalResearch Interview with: Lars Sjöström, MD, PhD Professor Department of Body Composition and Metabolism Sahlgrenska University Hospital Göteborg, Sweden   MedicalResearch: What are the main findings of the study? Prof. Sjöström: In obese diabetic subjects, the 2-year diabetes remission was 72% in bariatric surgery patients but only 16% in obese controls obtaining conventional obesity and diabetes treatment. After 15 years, 30% were in remission in the surgery group and 6.5% in the control group. In addition, the 20-year incidence of diabetes complication was 30 -55% lower in surgery than control patients.

10 Jun

Posted at 16:21h in Author Interviews
Fergus Shanahan, MD, DSc Professor and Chair, Department of Medicine, and Director, Alimentary Pharmabiotic Centre University College Cork, National University of IrelandMedicalResearch.com Interview Fergus Shanahan, MD, DSc Professor and Chair, Department of Medicine, and Director, Alimentary Pharmabiotic Centre University College Cork, National University of Ireland MedicalResearch: What are the main findings of the study? Professor Shanahan: We already know that most (if not all) of the elements of a modern lifestyle in socio-economically developed societies influence the composition and performance of the microbiota colonising the human body. The composition of the microbiota or disturbances of it have been linked with an increased risk of various chronic non-communicable diseases including immune-allergic disorders and metabolic diseases including obesity. In particular, loss of microbial diversity is a feature of many of these disorders. The most important aspect of our study is that draws attention to the possibility that exercise may have a beneficial effect on the microbiota and is associated with a more diverse microbiota.

10 Jun

Posted at 11:42h in Author Interviews
Mike Morgan, MD R2 Division of Emergency Medicine University of Utah School of MedicineMedicalResearch.com Interview with: Mike Morgan, MD R2 Division of Emergency Medicine University of Utah School of Medicine MedicalResearch: What are the main findings of the study? Dr. Morgan: Our paper is a review of the literature. So we do not present original data or findings. What we do is present new ideas about what drove the evolution of the hominin (bipedal ape) face. Studies of injuries resulting from fights show that when modern humans fight the face is the primary target. The bones of the face that suffer the highest rates of fracture from fights are the bones that show the greatest increase in robusticity during the evolution of early bipedal apes, the australopiths. These are also the bones that show the greatest difference between women and men in both australopiths and modern humans. What needs to be explained about facial differences in women and men is that in both apes and humans, males are much more violent than females and most male violence is directed at other males. Because males are the primary target of violence, one would expect more protective buttressing in males and that is what we find.  

10 Jun

Posted at 00:42h in Author Interviews, BMJ, Diabetes
Arch G. Mainous III, PhD Chair and Florida Blue Endowed Professor Department of Health Services Research, Management and Policy Professor of Community Health and Family Medicine University of Florida Health Science Center Gainesville, FL 32610MedicalResearch.com Interview with: Arch G. Mainous III, PhD Chair and Florida Blue Endowed Professor Department of Health Services Research, Management and Policy Professor of Community Health and Family Medicine University of Florida Health Science Center Gainesville, FL 32610 MedicalResearch: What are the main findings of the study? Professor Arch Mainous: This study focused on prediabetes, which is a high risk state for developing diabetes and associated complications. We investigated the national prevalence of prediabetes in England between 2003 and 2011. We found that the prevalence of prediabetes rose substantially in that time period from 11.6% to 35.3%. Further, by 2011 more than half of the population who were 40 years of age and older and were overweight had prediabetes. Minority ethnic groups are particularly affected.

10 Jun

Posted at 00:36h in Author Interviews, Exercise - Fitness, JAMA, Statins
MedicalResearch.com Interview with David S.H. Lee, Pharm.D., Ph.D. Assistant Professor Department of Pharmacy Practice College of Pharmacy Oregon State University/Oregon Health and Science University Portland OR, 97239MedicalResearch.com Interview with David S.H. Lee, Pharm.D., Ph.D. Assistant Professor Department of Pharmacy Practice College of Pharmacy Oregon State University/Oregon Health and Science University Portland OR, 97239 MedicalResearch: What are the main findings of the study? Dr. Lee: We found that older men taking a statin were less physically active and had more sedentary behavior. They had about 37 minutes of less moderate exercise per week. For comparison, the American heart Association recommends about 40 minutes of moderate activity 3-4 times per week. We also found that those that started using a statin during the study had the largest drop in physical activity.

09 Jun

Posted at 14:57h in Author Interviews, Cost of Health Care, Pharmacology, University of Pittsburgh
MedicalResearch.com Interview with: Yuting Zhang, Ph.D. Associate professor Graduate School of Public Health Department of Health Policy and Management. University of Pittsburgh MedicalResearch: What are the main findings of the study? Dr. Zhang: Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live. If low-income Medicare Part D enrollees were assigned to the least expensive plan instead of a random plan, the government and beneficiaries could save more than $5 billion in the first year.

09 Jun

Posted at 12:03h in Author Interviews, Melanoma
Dr. Juliet A. Usher-Smith Clinical Lecturer in Primary Care The Primary Care Unit, University of Cambridge Strangeways Research Laboratory Cambridge, United Kingdom MedicalResearch.com Interview with: Dr. Juliet A. Usher-Smith Clinical Lecturer in Primary Care The Primary Care Unit, University of Cambridge Strangeways Research Laboratory Cambridge, United Kingdom MedicalResearch: What are the main findings of the study? Dr Usher-Smith: Our systematic review identified 25 risk models that have the potential to identify individuals at higher risk of developing melanoma. Comparison between the different models was difficult due to the lack of validation studies and heterogeneity in choice and definition of variables. We were, however, able to show that most include well established risk factors and that, despite including a range of different variables, there is very little heterogeneity in the discriminatory ability of the models. There was also little difference in model performance between those scores suitable for self-assessment and those requiring a health care professional, suggesting potential for use at a population level to identify people at higher risk of melanoma.

09 Jun

Posted at 11:48h in Author Interviews, Cancer Research, Cost of Health Care, Journal Clinical Oncology
Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MAMedicalResearch Interview with: Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MA MedicalResearch: What are the main findings of the study? Dr. Aizer: We studied Americans between the ages of 20-40 using the SEER Database (a national cancer registry) and found that patients who had insurance were more likely to present with localized (curable) versus metastatic (generally incurable) cancer. Patients with localized tumors were more likely to receive the appropriate treatment and, most importantly, survived longer than patients without insurance. Our analysis accounted for demographic and socioeconomic differences between patients who were insured versus uninsured. Our results indicate that insurance status is a powerful predictor of outcome among young adults with cancer. The Affordable Care Act, which will likely improve insurance coverage nationally, may yield improved cancer outcomes among Americans.

09 Jun

Posted at 09:55h in Author Interviews, BMC, Mediterranean Diet
Rosa M. Lamuela-Raventos, PhD Associate Professor Department of Nutrition and Food Science School of Pharmacy, University of BarcelonaMedicalResearch.com Interview with: Rosa M. Lamuela-Raventos, PhD Associate Professor Department of Nutrition and Food Science School of Pharmacy, University of Barcelona MedicalResearch: What are the main findings of the study? Dr. Lamuela-Raventós: We have found an inverse relationship between polyphenol intake and risk of overall mortality among elderly subjects at high cardiovascular risk. Adjusting for confounders and comparing the highest versus the lowest quintiles of intake, total polyphenols were inversely associated with total mortality (HR=0.63, 95 CI=0.41-0.97, P-trend=0.12), as well as stilbenes (HR=0.48, 95 CI=0.25-0.91, P-trend=0.04) and lignans (HR=0.60, 95 CI=0.37-0.97, P-trend=0.03). In fact, our results showed that all polyphenols subgroups, except for dihydrochalcones, trended to be protective although their intake did not reach statistical significance. In stratified analyses we also found a stronger association between total polyphenol intake and mortality risk for women and for those who did not drink alcohol.

09 Jun

Posted at 01:15h in Author Interviews, Geriatrics, Heart Disease
Mauro Di Bari, MD, PhD Associate Professor of Medicine - Geriatrics Director, School of Geriatrics Vice-president, School of Physiotherapy University of Florence and Azienda Ospedaliero-Universitaria Careggi Florence ItalyMedicalResearch Interview with: Mauro Di Bari, MD, PhD Associate Professor of Medicine - Geriatrics Director, School of Geriatrics Vice-president, School of Physiotherapy University of Florence and Azienda Ospedaliero-Universitaria Careggi Florence Italy MedicalResearch: What are the main findings of the study? Professor Di Bari: This study is based on the AMI-Florence 2 registry, which recorded all acute coronary syndromes (ACS) occurring in one year in the metropolitan area of Florence, Italy. This area has one of the top prevalence figures in the country for application of percutaneous coronary intervention (PCI) to treat ACS, at least in cases with ST-segment elevation myocardial infarction (STEMI). Nevertheless, in our study the procedure turned out to be largely underused in older, complex patients, who mostly had NSTEMI: the greater the background risk (as expressed by the Silver Code, a simple, validated prognostic tool based of administrative data), the lower the chances for application of PCI, independent of possible contraindications to PCI, such as anaemia or renal insufficiency. At the same time, the long-term survival advantage offered by PCI increased with increasing background risk: when comparing patients receiving and not receiving PCI across strata identified on the basis of the Silver Code, one-year survival was only marginally greater in patients treated with PCI when their Silver Code score suggested low background risk, whereas the mortality gradient increased progressively along with Silver Code score, to reach its maximum in patients with the greatest values of Silver Code score. Within the limits of an observational study, cardiac and non-cardiac comorbidities, contraindications to PCI, clinical characteristics of the ACS and hospital of admission could not justify these findings.

08 Jun

Posted at 10:38h in Author Interviews, Cancer Research, HPV
Dr. Christian S Hinrichs MD Assistant Clinical Investigator Center for Cancer Research National Cancer Institute Bethesda, MD 20814MedicalResearch.com Interview with: Dr. Christian S Hinrichs MD Assistant Clinical Investigator Center for Cancer Research National Cancer Institute Bethesda, MD 20814 MedicalResearch: What are the main findings of the study? Dr. Hinrichs: Objective tumor regression occurred in 3/9 patients with metastatic cervical cancer. Two responses were complete and are ongoing 22 and 15 months after treatment with a single infusion of T cells targeting the HPV oncoproteins.

08 Jun

Posted at 10:25h in Breast Cancer, Mayo Clinic
Dr. Barbara Pockaj, MD Professor of Surgery Mayo Clinic, ArizonaMedicalResearch.com Interview Invitation Dr. Barbara Pockaj, MD Professor of Surgery Mayo Clinic, Arizona   MedicalResearch: What are the main findings of the study? Dr. Pockaj: The study analyzed 515 triple negative breast cancer samples using a multi-platform approach including whole genome mRNA expression, protein expression, gene copy number changes and gene sequencing for immune markers. The study found that a cohort of the triple negative breast cancer patients had high expression of PD-L1 (program death ligand) and other immune regulators such as CTLA-4 (Cytotoxic T-lymphocyte Antigen) and IDO-1 (indoleamine 2,3-dioxygenase).  High PD-L1 expression was found in patients whose tumors were triple negative and androgen receptor negative.  High PD-L1 expression was related to DNA repair gene abnormalities including BRCA1.

08 Jun

Posted at 09:58h in Author Interviews, Cancer Research, Vitamin D
Adetunji Toriola, MD, PhD, MPH Assistant Professor Division of Public Health Sciences Department of Surgery Washington University School of Medicine Siteman Cancer Center St. Louis, MO MedicalResearch.com Interview with: Adetunji Toriola, MD, PhD, MPH Assistant Professor Division of Public Health Sciences Department of Surgery Washington University School of Medicine Siteman Cancer Center St. Louis, MO MedicalResearch: What are the main findings of the study? Dr. Toriola: Very little is known about the impact of vitamin D in prognosis among cancer patients. This knowledge is of importance because of the increasing number of people living cancer and the high prevalence of vitamin D deficiency among cancer patients. We conducted a systematic review of studies published to date on the association of circulating vitamin D (25-OHD) levels with prognosis among cancer patients. This review suggests that higher circulating vitamin D levels may improve overall survival among breast and colorectal cancer patients but there is paucity of information on the role of circulating vitamin D levels in prognosis among patients with other cancer types.

08 Jun

Posted at 09:46h in Author Interviews, BMJ, Electronic Records
Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MIMedicalResearch.com Interview with: Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MI   MedicalResearch: What are the main findings of the study? Dr. Hanauer: In this study we analyzed requests made by patients who wanted to make changes to their medical record. The goal was to develop an understanding of what the main reasons were for making a request to change the medical record, and what types of information they wanted changed. One of the main findings was that about half of all requests were ultimately approved.  This suggests that patients reviewing their records can detect errors and have them corrected, which could ultimately lead to a more accurate record for a patient. In essence, giving patients the opportunity to further participate in their care by allowing them to review their record can lead to the identification and correction of errors or omissions.

07 Jun

Posted at 11:40h in Author Interviews, Cost of Health Care
http://www.ncbi.nlm.nih.gov/pubmed/24889948?dopt=AbstractMedicalResearch.com Interview with Katherine Neuhausen, MD, MPH Director of Delivery System Transformation, Office of Health Innovation Clinical Assistant Professor, Department of Family Medicine and Population Health Virginia Commonwealth University MedicalResearch: What are the main findings of the study? Dr. Neuhausen: Medicaid Disproportionate Share Hospital (DSH) payments keep safety-net hospitals financially viable because these hospitals play such a critical role caring for the uninsured and Medicaid patients, providing trauma care and other vital community services, and training future health providers.  The Affordable Care Act (ACA) reduces these DSH payments because the ACA's authors assumed that safety-net hospitals would receive increased revenue from Medicaid expansion and therefore, have less need for DSH payments.  However, we found that California’s DSH need will actually increase because of medical cost inflation, low Medicaid payment rates, and the high number of people who will remain uninsured.  As a result, the DSH reductions will create funding gaps that must be filled to ensure the financial stability of safety-net hospitals.  The financial outlook for California’s safety-net hospitals is still much better under ACA than it would have been without the ACA.  In the absence of the ACA, California’s public hospitals would have had an additional $1.5 billion in costs for uncompensated care for the uninsured and would be facing a financial crisis.

07 Jun

Posted at 11:16h in Author Interviews, Nutrition, PLoS
Professor Marion M. Hetherington BSc (Hons) DipEd DPhil Institute of Psychological Sciences University of Leeds , Leeds, EnglandMedicalResearch.com Interview with: Professor Marion M. Hetherington BSc (Hons) DipEd DPhil Institute of Psychological Sciences University of Leeds , Leeds, England MedicalResearch: What are the main findings of the study? Professor Hetherington: This study was part of a much larger, funded project called HabEat (European Community’s Seventh Framework Programme (FP7/2007-2013) under the grant agreement n°245012. In this study we investigated the effects of offering a new vegetable (artichoke puree) to 332 children in the UK, Denmark and France from weaning age to 38 months. During the experiment each child was given between five and 10 servings of at least 100g of the artichoke puree in one of three versions: basic; sweetened, with added sugar; or added energy, where vegetable oil was mixed into the puree. There was a strong effect of repeated exposure with no additional, clear benefit of adding sweetness or energy. Thus little difference in how much was eaten between children fed basic puree and those who ate the sweetened puree. This suggests that making vegetables sweeter does not make a significant difference to the amount children eat.

07 Jun

Posted at 11:05h in Author Interviews, Diabetes, PNAS
Wouter De Haes Functional Genomics and Proteomics (Schoofs lab) Zoological Institute Leuven BelgiumMedicalResearch.com Interview with: Wouter De Haes Functional Genomics and Proteomics (Schoofs lab) Zoological Institute Leuven Belgium MedicalResearch: What are the main findings of the study? Answer: We discovered that the lifespan-extending effect of metformin is dependent on the increased production of reactive oxygen species in the roundworm Caenorhabditis elegans. Antioxidants, compounds that remove these reactive oxygen species, abolished the lifespan-extending effect of metformin, adding to the growing body of evidence that anti-oxidants are not as beneficial for health as generally assumed. We also identified the protein, belonging to the group of peroxiredoxins, that seems responsible for translating this increase in reactive oxygen species production into longevity.

06 Jun

Posted at 11:07h in Ovarian Cancer
Sean C. Dowdy, MD, FACS Professor and Chair, Division of Gynecologic Surgery Vice-Chair for Research, Department of Obstetrics and Gynecology Co-Leader, Women’s Cancer Program Mayo Clinic College of Medicine MedicalResearch.com Interview with: Sean C. Dowdy, MD, FACS Professor and Chair, Division of Gynecologic Surgery Vice-Chair for Research, Department of Obstetrics and Gynecology Co-Leader, Women’s Cancer Program Mayo Clinic College of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Dowdy: This study was a collaboration between four groups in 3 countries to determine if a genetic “signature” could predict which patients with ovarian cancer benefit from Bevacizumab (a very expensive drug with marginal benefit in patients with ovarian cancer). We hypothesized that while benefit may be marginal in a large group, patients with specific genetic changes could derive significant benefit from it. Using gene expression arrays (analyzing over 18,000 genes) we separated patients into four subgroups as described by The Cancer Genome Atlas (TCGA). We show that patients in the proliferative and mesenchymal groups had a 8-10 month improvement in outcome compared to a 3 month improvement for the other two groups (immunoreactive and differentiated).

06 Jun

Posted at 10:56h in Weight Research
Dr. Charoula Nikolaou University of Glasgow Graduate StudentMedicalResearch. com Interview with Dr. Charoula Nikolaou University of Glasgow Graduate Student MedicalResearch: What are the main findings of the study? Answer: Obese people gain most of their excess weight during young adulthood. This study describes how regular, daily, exposure to prominent calorie labeling of main meals, in a residential catered setting, abolished the expected weight gain usually seen in young adults. The mean weight gain observed in 120 residents the year before (without calorie-labeling) was similar to that found in other studies of young adults at 3.5 kg. In a second year with calorie labeling, there was no weight gain at all. In addition, catering costs were 33% lower during the year with calorie labeling so the intervention could be sustainable as well as easy to implement.