Annals Internal Medicine, Author Interviews, Electronic Records / 10.01.2014

Robert S. Rudin, Ph.D. Associate Policy Researcher RAND Corporation 20 Park Plaza, Suite 920 Boston, MA 02116MedicalResearch.com Interview with: Robert S. Rudin, Ph.D. Associate Policy Researcher RAND Corporation Boston, MA 02116 MedicalResearch.com: What are the main findings of the study? Dr. Rudin: We found that most published health IT implementation studies report positive effects on quality, safety, and efficiency. Most evaluations focus on clinical decision support and computerized provider order entry. However, not all studies report equally positive results, and differences in context and implementation are one likely reason for these varying results, yet details of context and implementation are rarely reported in these studies. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA / 10.01.2014

Maurice Dysken, MD Professor, School of Medicine Department of Psychiatry Minneapolis VA Health Care System, Minneapolis, MinnesotaMedicalResearch.com Interview Invitation Maurice Dysken, MD Professor, School of Medicine Department of Psychiatry Minneapolis VA Health Care System, Minneapolis, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Dysken: In patients with mild-to-moderate Alzheimer’s disease who were taking an acetylcholinesterase inhibitor, a dosage of 2000 IU/d of vitamin E significantly slowed functional decline compared to placebo by 6.2 months over the mean follow-up period of 2.27 years.  Over this period of time caregiver time increased least in the vitamin E group compared to the other three groups (memantine alone, vitamin E plus memantine, and placebo) although the only statistically significant difference was between vitamin E alone and memantine alone.  There were no significant safety concerns for vitamin E compared to placebo and mortality was lowest in the vitamin E alone group.  It should be noted that patients who were on warfarin were excluded from the study because of a possible interaction with vitamin E that could have possibly increased bleeding events. (more…)
Annals Internal Medicine, Author Interviews, Diabetes, Mediterranean Diet / 10.01.2014

Jordi Salas-Salvadó, MD, PhD Human Nutrition Unit, Faculty of Medicine and Healthy Sciences Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, SpainMedicalResearch.com Interview with: Jordi Salas-Salvadó, MD, PhD Human Nutrition Unit, Faculty of Medicine and Healthy Sciences Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, Spain MedicalResearch.com: What are the main findings of the study? Answer: Randomized trials have shown that lifestyle interventions promoting weight loss can reduce the incidence of type-2diabetes, however, whether dietary changes without calorie restriction or increased physical activity also protect from diabetes development has not been evaluated in the past. In our study, we found that a long-term adherence to a high-quality dietary pattern akin to the traditional MedDiet and rich in extra-virgin olive oil was able to reduce the incidence of new cases of diabetes in older individuals at high cardiovascular risk. We have demonstrated for the first time that a beneficial effect on diabetes prevention could be obtained witha healthy dietary pattern (without calorie restriction, increased physical activity or weight loss). These benefits have been observed in participants between 55 to 80 years-old at high cardiovascular risk; therefore,the message is that it is never too late to switch to a healthy diet like the Mediterranean. (more…)
Addiction, Author Interviews, JAMA, Mental Health Research / 10.01.2014

Sarah M. Hartz, MD, PhD Assistant Professor of Psychiatry Washington University in St. Louis, MissouriMedicalResearch.com Interview with: Sarah M. Hartz, MD, PhD Assistant Professor of Psychiatry Washington University in St. Louis, Missouri MedicalResearch.com: What are the main findings of this study? Dr. Hartz: This is the first large-scale study to comprehensively evaluate substance use in people with schizophrenia, bipolar disorder, and other severe mental illness.We found that people with severe mental illness have rates of smoking, alcohol use, and other substance use that are 3 to 5 times higher than people in the general population. (more…)
Author Interviews, Endocrinology, Testosterone / 10.01.2014

J. Bradley Layton, PhD Postdoctoral Research Associate University of North Carolina at Chapel HillMedicalResearch.com Interview with: J. Bradley Layton, PhD Postdoctoral Research Associate University of North Carolina at Chapel Hill MedicalResearch.com: What are the main findings of the study? Dr. Layton: Use of testosterone testing and treatment had greatly increased over the past decade, with more pronounced increases seen in the United States than in the United Kingdom. The increases in testing in the UK seem to be targeted, identifying more men with reduced testosterone levels, but the increases in the US seem to be identifying more and more men with normal levels. Many of the men who begin testosterone treatment in the US appear to have normal testosterone levels to begin with. (more…)
Author Interviews, General Medicine, Hand Washing / 10.01.2014

Caroline Landelle, PharmD, PhD Infection Control Unit, Centre Hospitalier Universitaire (CHU) Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris–Est Créteil, FranceMedicalResearch.com Interview with: Caroline Landelle, PharmD, PhD Infection Control Unit, Centre Hospitalier Universitaire (CHU) Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris–Est Créteil, France MedicalResearch.com: What are the main findings of the study? Dr. Landelle: The main findings point to the fact that nearly one in four healthcare workers’ hands are contaminated with Clostridium difficile spores after routine care of patients infected with the bacteria, before performing hand hygiene. This is the first study focusing upon the carriage of viable C. difficile spores on healthcare workers’ hands. C. difficile exist in 2 possible forms: vegetative and spore. Vegetative forms of C. difficile are killed when exposed to air, whereas their spores are resistant to oxygen, desiccation, and most disinfectants, and may persist in the hospital environment for long periods of time; thus, bacterial spores could be the principal form of transmission. Furthermore, contamination of exposed healthcare workers’ hands is statistically associated with direct exposure to fecal soiling and contact without the use of gloves. (more…)
Asthma, Author Interviews, Biomarkers, CHEST / 10.01.2014

Dr. Lawrence M. Lewis, MD Professor, Emergency Medicine and Medicine Washington University School of Medicine in St. LouisMedicalResearch.com Interview with: Dr. Lawrence M. Lewis, MD Professor, Emergency Medicine and Medicine Washington University School of Medicine in St. Louis MedicalResearch.com: What are the main findings of the study? Dr. Lewis: The main finding of the study is that there is a dose-dependent increase in serum lactate concentration with increasing amounts of nebulized albuterol administered. This hyperlactatemia did not portend a worse prognosis, and was not associated with worse FEV1 or dyspnea scores. (more…)
Author Interviews, MRSA, OBGYNE / 10.01.2014

MedicalResearch.com Interview with: Dr. Andrea Parriott MPH, PhD Department of Epidemiology Fielding School of Public Health University of California Los Angeles

MedicalResearch.com: What are the main findings of the study? Dr. Parriott:  We wanted to know whether hospital and provider volume (i.e. the number of deliveries performed by each hospital and provider per quarter) and cesarean section rates were predictors of the risk of methicillin-resistant Staphylococcus aureus (MRSA) infection before discharge from the hospital (after delivering a baby). We did not find an association between any of these variables and risk of MRSA infection. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Stroke / 08.01.2014

Dr. James Sheppard MRC Research Fellow Department of Primary Care Health Sciences University of OxfordMedicalResearch.com Interview with Dr. James Sheppard MRC Research Fellow Department of Primary Care Health Sciences University of Oxford MedicalResearch.com: What are the main findings of the study? Dr. Sheppard: The aim of our study was to develop a decision-tree model which estimates the cost-effectiveness and potential implementation costs of a series of interventions which increase thrombolysis rates in acute stroke. The model examined all possible acute stroke patient pathways and was based on real life patient data. We found all proposed interventions to be cost saving whilst increasing patient quality of life after stroke. We estimate that, assuming a "willingness-to-pay"  of USD $30,000 per quality adjusted life year gained, the potential budget available to deliver interventions which improve acute stroke care range from USD $50,000 to USD $144,000. (more…)
Author Interviews, Depression, JAMA, Johns Hopkins, Mental Health Research, Pain Research / 07.01.2014

Madhav Goyal MD, MPH  Assistant Professor General Internal Medicine Johns Hopkins School of MedicineMedicalResearch.com Interview with: Madhav Goyal MD, MPH  Assistant Professor General Internal Medicine Johns Hopkins School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Goyal:
  • The evidence is moderately strong that there is a small but consistent benefit for mindfulness meditation programs to improve 3 symptoms: anxiety, depression, and pain.  We found low level evidence that mindfulness meditation helps with symptoms of stress and distress, as well as with the mental health dimension of quality of life.
  • For the symptoms of anxiety and depression for which we find moderate evidence of benefit, we need to keep in mind that most of the trials didn't study people with a clinical diagnosis of anxiety or depression (although a few did).  Most were studying diverse patient populations who may have had a low level of these symptoms, such as those with  breast cancer, fibromyalgia, organ transplant recipients, and caregivers of people with dementia.
  • We found about a 5-10% improvement in anxiety symptoms compared to placebo groups.  For depression, we found a roughly 10-20% improvement in depressive symptoms compared to the placebo groups. This is similar to the effects that other studies have found for the use of antidepressants in similar populations.
  • While we found that the evidence was moderately strong that mindfulness meditation programs may improve pain, there weren't as many trials evaluating chronic pain, and so we don't understand what kinds of pain this type of meditation may be most useful for.
(more…)
Author Interviews, Autism / 07.01.2014

Dr. Lisa Croen, PhD Senior Research Scientist Director, Autism Research Program Division of Research Kaiser Permanente Northern CaliforniaMedicalResearch.com Interview with Dr. Lisa Croen, PhD Senior Research Scientist Director, Autism Research Program Division of Research Kaiser Permanente Northern California MedicalResearch.com: What are the main findings of the study? Dr. Croen: Researchers found that hospital-diagnosed maternal bacterial infections during pregnancy were associated with an increased risk of autism spectrum disorders (ASD) in children. While infections are fairly common in pregnant women, this study only found increased risks in cases of bacterial infections. Women with bacterial infections diagnosed during a hospitalization (including of the genitals, urinary tract and amniotic fluid) had a 58 percent greater risk of having a child with ASD. Also of note, bacterial infections diagnosed during a hospitalization in the second trimester, while not very common in any of the mothers studied, were associated with children having more than a three-fold increased risk of developing ASD. These findings resulted from a study of 407 children with autism and 2,075 matched children who did not have autism. The study included infants born between January 1995 and June 1999 who remained members of the Kaiser Permanente health plan for at least two years following birth. (more…)
Author Interviews, Brain Injury, Pediatrics / 07.01.2014

William P. Meehan III, MD Director, Micheli Center for Sports Injury Prevention Director, Sports Concussion Clinic, Boston Children?s Hospital 9 Hope Avenue, Suite 100 Waltham, MA 02453MedicalResearch.com Interview with: William P. Meehan III, MD Director, Micheli Center for Sports Injury Prevention Director, Sports Concussion Clinic, Boston Children?s Hospital Waltham, MA 02453 MedicalResearch.com: What are the main findings of this study? Dr. Meehan: The study has 2 findings that I believe are the most worthy of attention.  First, although cognitive rest has been recommended as a therapy for concussion for several years now, there has been little data showing its effect. This lack of data has led to variability in the recommendations for cognitive rest, with some experts not recommending it all, and others recommending athletes avoid all cognitive activity, lying alone in a dark room even, until they are completely recovered.  As you can imaging, this has generated controversy.  We believe this is the first study showing the independent, beneficial effect of limiting cognitive activity on recovery from concussion. (more…)
Author Interviews, Frailty / 06.01.2014

MedicalResearch.com Interview with: Arun Kumar Research Fellow ,School of Medicine Division of Primary Care University of Nottingham University Park Nottingham NG7 2RD MedicalResearch.com: What are the main findings of the study? Answer: A simpler model (socio-demographic + falls risk factors) correctly classified as many observations (82%) as a more complex model (socio-demographic + falls risk factors + functional measures) with similar values for sensitivity and specificity in both models. There were significantly raised odds of FOF in the simpler model in those unable to rise from a chair of knee height (OR 7.39 (CI 2.48-22.07)), with a lower household income (4.58 (CI 1.23-17.07)), use of a walking aid (OR 4.32 (CI 2.29-8.17)), difficulty in using public transport (OR 4.02 (CI 1.77-9.11)), poorer perceived physical health (OR 2.85 (CI 1.35-6.04)), from a black/ minority ethnic group (OR 2.42 (CI 1.29-4.52)), with self-reported balance problems (OR 2.17 (CI 1.29-3.64)), with lower educational level (OR 2.01 (CI 1.20-3.37)), and a higher BMI (OR 1.06 (CI 1.02-1.09)). (more…)
Author Interviews, Biomarkers, Sleep Disorders / 05.01.2014

Jonathan Cedernaes PhD Department of Neuroscience Uppsala University  SwedenMedicalResearch.com Interview with: Jonathan Cedernaes PhD Department of Neuroscience Uppsala University  Sweden   MedicalResearch.com: What are the main findings of this study? Dr. Cedernaes:  We found that two peripheral blood markers were modestly but significantly increased in healthy young participants after a single night of sleep deprivation, as compared with a normal night of sleep. These two markers, S-100B and NSE, are for example used as markers of acute ischemic injury in the brain, and are also increased following concussions. S-100B is produced mainly by glial cells and also increases after injury to the blood brain barrier. NSE is instead produced by neurons and is regarded as being more specific for neuronal damage, although it can also be produced by peripheral cells. (more…)
Author Interviews, Lancet, Pulmonary Disease / 05.01.2014

Prof Sirpa Jalkanen MD, PhD MediCity Research Laboratory and Department of Medical Microbiology University of Turku Turku, FinlandMedicalResearch.com Interview with: Prof Sirpa Jalkanen MD, PhD MediCity Research Laboratory and Department of Medical Microbiology University of Turku Turku, Finland MedicalResearch.com: What are the main findings of the study? Answer: Pulmonary vascular leakage occurs early in acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Mortality is high (35-45%), but no effective pharmacotherapy exists. Production of anti-inflammatory adenosine by ecto-5’-nucleotidase (CD73) maintains endothelial barrier function. Interferon-beta-1a (IFN-beta) increases CD73 synthesis and might thus reduce vascular leakage and mortality in ALI/ARDS. We tested this hypothesis and the findings were as follows: 1.IFN-beta increased the number of CD73-positive vessels in human lung culture (4- and 14.3-fold on days 1 and 4 respectively, p=0.04 and 0.004). 2. The optimal tolerated FP-1201 dose (a unique intravenous formulation of interferon-beta 10 μg /day for six days) caused a significant rise in serum MxA (a marker for interferon response) and CD73 levels and a fall in interleukin-6 (an inflammatory cytokine) concentration. 3. Most importantly, odds of 28-day mortality was 81% lower in the treated than untreated subjects (8% vs 32%, OR[95% CI]0.19[0.03 to 0.72], p=0.01). (more…)
Author Interviews, Menopause, NEJM, Osteoporosis / 04.01.2014

Michael McClung, MD Founding Director, Oregon Osteoporosis Center 5050 NE Hoyt Street, Suite 626 Portland, OR 97213MedicalResearch.com Interview with Michael McClung, MD Founding Director, Oregon Osteoporosis Center 5050 NE Hoyt Street, Suite 626 Portland, OR 97213 MedicalResearch.com: What are the main findings of the study? Dr. McClung: In this Phase 2 trial, each of five romosozumab dose regimens significantly increased BMD compared with pooled placebo groups at the lumbar spine, total hip and femoral neck regions (all p<0.001). The largest increases were observed with the romosozumab 210 mg once-monthly dose, with mean increases, compared with baseline, of 11.3 percent at the lumbar spine, 4.1 percent at the total hip and 3.7 percent at the femoral neck. (more…)
Author Interviews, CMAJ, Heart Disease / 02.01.2014

MedicalResearch.com Interview with: Laura Maclagan, MSc. Epidemiologist, Cardiovascular Program ICES Central Toronto, Ontario M4N 3M5 MedicalResearch.com: What are the main findings of the study? Answer: We developed the CANHEART health index in order to measure the cardiovascular health of the Canadian population. The index is based on the prevalence of six health factors and behaviours known to be associated with cardiovascular health; being a non-smoker, being physically active, consuming at least 5 fruits and vegetables per day, having a low body mass index (BMI <25 kg/m²) and being free of diabetes and hypertension. The factors were summed to create an index ranging from 0 (worst) to 6 (best/ideal). We found that only 9.4% of Canadian adults age 20 and older met our definition of ideal cardiovascular health. 53.3% of adults were in intermediate cardiovascular health (4-5 healthy behaviours/factors) and 37.3% were in poor cardiovascular health (0-3 healthy behaviours). We found that the cardiovascular health of Canadians was stable over the 2003-2011 study period. (more…)
Author Interviews, CHEST, Obstructive Sleep Apnea, Respiratory / 02.01.2014

Dr. Peter Lindenauer MD MS Director, Center for Quality of Care Research Baystate Medical Center, Springfield, MA, USMedicalResearch.com Interview Invitation with: Dr. Peter Lindenauer MD MS Director, Center for Quality of Care Research Baystate Medical Center, Springfield, MA, US MedicalResearch.com: What are the main findings of the study? Answer: Among a cohort of 250,000 patients hospitalized for pneumonia at 347 US hospitals, those with a diagnosis of obstructive sleep apnea were twice as likely to be intubated at the time of hospital admission than patients without sleep apnea.  In addition, patients with sleep apnea had approximately 50% higher risk of needing to be transferred to the ICU after initial admission to a regular bed, and a 70% increased risk of requiring intubation later in the hospital stay.  Patients with sleep apnea stayed longer in the hospital and incurred higher costs than those without sleep apnea. (more…)
Author Interviews, Blood Pressure - Hypertension, Gender Differences, Wake Forest / 02.01.2014

Carlos M Ferrario, MD, FAHA, FASH, FACC Dewitt-Cordelll Professor of Surgical Sciences Professor, Internal Medicine-Nephrology Professor, Physiology-Pharmacology Wake Forest University School of Medicine Winston-Salem, NC 27157-1032 Vice-President, Consortium Southeastern Hypertension Control Editor-in-Chief Therapeutic Advances in Cardiovascular DiseaseMedicalResearch.com Interview with: Carlos M Ferrario, MD, FAHA, FASH, FACC Dewitt-Cordelll Professor of Surgical Sciences Professor, Internal Medicine-Nephrology Professor, Physiology-Pharmacology Wake Forest University School of Medicine Winston-Salem, NC 27157-1032 Vice-President, Consortium Southeastern Hypertension Control Editor-in-Chief, Therapeutic Advances in Cardiovascular Disease MedicalResearch.com: What are the main findings of the study? Dr. Ferrario: A significant and unexpected difference in the hemodynamic mechanisms that account for the elevated blood pressure between untreated hypertensive men and women. The main findings were: "Despite there being no differences between women and men in terms of office blood pressure, heart rate and body mass index, men demonstrated lower values of pulse pressure, systemic vascular resistance, brachial artery pulse wave velocity and augmentation index. In each of the three hypertension categories, the increased blood pressure in men was associated with significant augmentations in stroke volume and cardiac output compared with women. Sex-related hemodynamic differences were associated in women with higher plasma levels of leptin, hs-CRP, plasma angiotensin II and serum aldosterone. In women but not men, hs-CRP correlated with plasma concentrations of transforming growth factor β1 (TGFβ1) and body weight; in addition, plasma TGFβ1 correlated with levels of serum vascular cell adhesion molecule 1." (more…)
Accidents & Violence, Author Interviews, NEJM / 02.01.2014

MedicalResearch.com Interview with: Sheila G. Klauer, Ph.D Virginia Tech Transportation Institute MedicalResearch.com: What are the main findings of the study? Dr.Klauer: We found that novice drivers are especially at risk of crash/near-crash involvement when engaging in secondary tasks that take their eyes off of the forward roadway.  This includes tasks with wireless devices such as texting, dialing, and reaching for the device as well as reaching for any object, eating, and looking at objects along the roadway.  We also found that the prevalence of engaging in these high risk tasks increases over time which concerns traffic safety researchers.  This is particularly concerning with the proliferation of highly capable smart phones where teens can do not only texting but also sending pictures, watching video, skype, etc. (more…)
Author Interviews, Education, Nutrition, Sugar / 02.01.2014

Sohyun Park, PhD, Division of Nutrition, Physical Activity, and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta, GA 30341MedicalResearch.com Interview with: Sohyun Park, PhD, Division of Nutrition, Physical Activity, and Obesity National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta, GA 30341 MedicalResearch.com:  What are the main findings of the study? Dr. Park: Nearly 1 out of 3 U.S. adults (30.5%) consumed sugar-sweetened beverages at least 1 time per day; 20% consumed sugar-sweetened beverages at least 2 times per day. About 8 out of 10 adults agreed that drinking sugar-sweetened beverages can contribute to weight gain. However, 8 of 10 adults also did not know the actual calorie content of a 24-oz fountain soda. After controlling for sociodemographic factors, adults who were neutral (neither agreed nor disagreed) that drinking sugar-sweetened beverages can contribute to weight gain were more than 1-and-a-half times more likely to consume sugar-sweetened beverages at least 2 times per day. Conversely, knowledge about the calorie content of a 24-oz fountain soda was not associated with sugar-sweetened beverage intake. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Lipids / 02.01.2014

MedicalResearch.com Interview with: Dr. Bruce Reed PhD Professor of Neurology, Associate Director UC Davis Alzheimer's Disease Center Davis, CA 95616 Dr. Bruce Reed PhD Professor of Neurology, Associate Director UC Davis Alzheimer's Disease Center Davis, CA 95616 MedicalResearch.com: What are the main findings of the study? Dr. Reed: We found that high LDL cholesterol and low HDL cholesterol in blood  were both associated with higher amyloid deposition in the brain.  This is potentially very important because the deposition of amyloid seems to be a critical step that kicks off a whole chain of events that eventually lead to Alzheimer's disease.  It is widely believed (although not proven) that if this deposition of amyloid could be blocked that we could greatly decrease the incidence of Alzheimer's.  The connection to cholesterol is exciting because we know a fair amount about how to change cholesterol levels.  A great deal more research needs to be done, but this does suggest a potential new path toward trying to prevent AD. (more…)
Author Interviews, CHEST, Critical Care - Intensive Care - ICUs, Respiratory / 02.01.2014

MedicalResearch.com Interview with: Dr Simone Gattarello Vall d’Hebron Hospital, Critical Care Department Universitat Autonoma de Barcelona and Medicine Department, Spain MedicalResearch.com: What are the main findings of the study? Dr. Gattarello: The main findings from the present study are a 15% decrease in ICU mortality due to severe community-acquired pneumonia caused by Streptococcus pneumoniae in the last decade; moreover, several changes in antibiotic prescription practices were detected and an association between improved survival and both earlier antibiotic administration and increased combined antibiotic therapy were identified. In summary, in severe pneumococcal pneumonia combined antibiotic therapy and early antibiotic administration are associated with lower mortality. (more…)
Author Interviews, Duke, JAMA, Pediatrics, Sexual Health / 31.12.2013

Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North CarolinaMedicalResearch.com Interview with: Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North Carolina MedicalResearch.com: What are the main findings of the study? Dr. Alexander: Adolescents are reluctant to talk about sex with their doctors and won't raise the topic with their doctors. For physicians, there are common and valid barriers to talking about sexuality with adolescents, including time pressures and discomfort with the topic. Two-thirds of adolescents in our study had some sexuality talk during their annual visit, lasting 36 seconds long. Girls, African Americans, and older teens were more likely to receive sexuality talk. Additionally, longer visits and visits where the physician talked confidentially with their adolescent patient were more likely to have sexuality talk. Our study suggest that sexuality conversations in annual visits can be improved. (more…)
Author Interviews, Heart Disease, Kidney Disease / 31.12.2013

Dr Amitava Banerjee NIHR Clinical Lecturer in Cardiovascular Medicine University of Birmingham UK MedicalResearch.com Interview with: Dr Amitava Banerjee NIHR Clinical Lecturer in Cardiovascular Medicine University of Birmingham UK MedicalResearch.com: What are the main findings of the study? This was the first long-term study in individuals with atrial fibrillation to consider the impact of renal function, as measured by eGFR, on stroke/thromboembolism, mortality and bleeding in the same population concurrently. Answer: There were three main findings of our study.
  • First, patients with worsening renal function had more severe risk factor profiles and had higher rates of stroke/thromboembolism, mortality and bleeding.
  • Second, individuals receiving oral anticoagulation had lower rates of stroke/thromboembolism and mortality than those not receiving anticoagulation at all levels of renal function measured by eGFR, suggesting that anticoagulation has benefit in even patients with low eGFR.
  • Third, renal function was not an independent predictor of stroke/thromboembolism at 1 year after adjustment for baseline characteristics. (more…)
Annals Internal Medicine, Author Interviews, CT Scanning, Lung Cancer / 31.12.2013

dr_harry_j_dekonigMedicalResearch.com Interview with: Harry J de Koning, MD PhD Professor of Public Health & Screening Evaluation Rotterdam, The Netherlands. MedicalResearch.com: What are the main findings of the study? Dr. de Koning: Annual CT screening for lung cancer has a favorable benefit-to-harm ratio for individuals ages 55 through 80 years with 30 or more pack-years’ exposure to smoking. It would lead to 50% (model ranges, 45% to 54) of cases of cancer being detected at an early stage (stage I/II), 575 screenings examinations per lung cancer death averted, a 14% (range, 8.2% to 23.5%) reduction in lung cancer mortality, 497 lung cancer deaths averted, and 5250 life-years gained per the 100 000-member (1950-) cohort. Harms would include 67 550 false-positive test results, 910 biopsies or surgeries for benign lesions, and 190 overdiagnosed cases of cancer (3.7% of all cases of lung cancer [model ranges, 1.4% to 8.3%]), again for a 100 000-member (1950-) cohort. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease / 31.12.2013

MedicalResearch.com Interview with: Chia-Hung Kao, MD Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taiwan. MedicalResearch.com: What are the main findings of the study? Answer: Colonic diverticular disease and colorectal cancer shared certain characteristics. Some previous studies aimed to identify their epidemiological correlation. However, their results were discrepant and insufficiently strong to draw firm conclusion. In our nationwide population-based retrospective cohort study, we found that the previously diagnosed colonic diverticular disease is not associated with an elevated risk of colorectal cancer after the first year of a diagnosis of colonic diverticular disease (adjusted HR, 0.96). The increased risk in the first year may be due to misclassification and screening effect. (more…)
Author Interviews, Cognitive Issues, JAMA, Mayo Clinic, Thyroid Disease / 31.12.2013

Ajay K Parsaik, MD, MS Department of Psychiatry and Behavior Sciences The University of Texas Medical School, Houston Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, MinnesotaMedicalResearch.com Interview with: Ajay K Parsaik, MD, MS Department of Psychiatry and Behavior Sciences The University of Texas Medical School, Houston Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Parsaik: Main findings of our study are that clinical and subclinical hypothyroidism is not associated with mild cognitive impairment in an elderly population after accounting for possible confounding factors and interactions. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Hospital Readmissions, Medical Research Centers / 31.12.2013

Dr. Jacques Donzé MD PhD Research Associate Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital Harvard Medical School, Boston, MA 02115, USADivision of General Internal Medicine, Bern University Hospital, 3010 Bern, SwitzerlandMedicalResearch.com Interview with: Dr. Jacques Donzé MD PhD Research Associate Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital Harvard Medical School, Boston, MA 02115, MedicalResearch.com: What are the main findings of the study? Dr. Donzé: In a large retrospective cohort study, we identified the primary diagnoses of 30-day potentially avoidable readmissions in medical patients according to the most common comorbidities. Interestingly, almost all of the top five diagnoses of potentially avoidable readmissions for each comorbidity were possible direct or indirect complications of that comorbidity. Patients with cancer, heart failure, and chronic kidney disease had a significantly higher risk of potentially avoidable readmission than those without those comorbidities. Also, when readmitted, patients with chronic kidney disease had a 20% higher risk of having the readmission be potentially avoidable. (more…)